What is PMOS?

PMOS, or polyendocrine metabolic ovarian syndrome, is a common hormone and metabolic condition that can affect periods, skin, hair growth, weight, fertility and long-term health. You may still hear the older name PCOS – polycystic ovary syndrome. PMOS is a broader name that better reflects that this is not just about the ovaries. The exact cause of PMOS is unknown but it is thought to be triggered by a combination of genetics and high insulin levels which cause the ovaries to produce slightly higher amounts of male hormones (androgens). 

How is PMOS diagnosed?

There is no single test for PMOS. Your doctor will usually ask about your symptoms, your menstrual cycle, skin and hair changes, weight history and family history. Blood tests may be arranged to look at hormone levels and to exclude other causes of similar symptoms. Some women will also have an ultrasound scan of the ovaries. A diagnosis is usually made when two or more key features are present: irregular or absent periods, signs or blood-test evidence of higher testosterone, and polycystic-looking ovaries on ultrasound.

How can PMOS affect you?

PMOS is different for every person. Some women have mild symptoms, while others find it affects their confidence, wellbeing or day-to-day life. Common symptoms include irregular periods, acne or oily skin, extra hair on the face, chest, tummy or back, thinning hair on the scalp, weight gain or difficulty losing weight, and difficulty getting pregnant because ovulation may not happen regularly.

Why does PMOS matter beyond periods and skin?

PMOS does not usually shorten life, but it can increase some future health risks. These include type 2 diabetes, higher blood pressure, abnormal cholesterol and, in women who have very few periods, thickening of the womb lining. Anxiety, low mood and reduced confidence are also more common. This is why PMOS care should not stop at treating cosmetic symptoms or fertility. It should include regular metabolic health checks and support for emotional wellbeing.

What can you do to help manage PMOS?

Lifestyle treatment is the foundation of PMOS care, but this should not be framed as blame. PMOS is driven by biology, hormones, genetics and environment. Small, realistic changes can make a meaningful difference. Regular meals with protein, vegetables, fruit and high-fibre foods can help. Slower-release carbohydrates such as oats, wholegrain bread, brown rice, lentils and beans are often better tolerated than sugary foods and drinks. Regular movement, such as brisk walking, swimming or cycling, helps insulin work better. Strength exercise is also useful because muscle improves the way the body handles glucose and insulin. For people above their healthiest weight, losing 5-10% of body weight can improve periods, skin symptoms, fertility and long-term metabolic risk.

What treatments are available?

Treatment depends on your symptoms and whether you are trying to become pregnant. The combined contraceptive pill can make periods more regular and may improve acne and extra hair growth. Metformin may be used to help the body respond better to insulin and may help periods or weight in some people. Anti-androgen medicines can reduce the effect of testosterone on skin and hair, but they are not suitable in pregnancy and must be prescribed with appropriate contraception. If periods are very infrequent, for example fewer than three or four a year, treatment may be needed to protect the womb lining. Fertility treatments are available if pregnancy is a priority.

When should you ask for help?

Ask your GP or specialist team for advice if your periods are very infrequent, symptoms are affecting your confidence or mental health, you are trying to conceive, you have rapid hair growth or severe acne, or you are worried about weight, diabetes risk, blood pressure or cholesterol. PMOS can be managed, but good care should be personalised.

PMOS is common and manageable. With the right support, PMOS can be treated in a way that improves symptoms now and protects long-term health.