PCOS is Now PMOS, And Here's Why!
- Shannon Leach, MSN, ARNP
- 4 days ago
- 4 min read
The most frequently diagnosed metabolic and hormonal disease in women recently got a name change… And, for good reason!!
What was once called PCOS (Polycystic Ovarian Syndrome) is now called PMOS (Polyendocrine Metabolic Ovarian Syndrome), a name that far better acknowledges the fact that this disease is incredibly multi-faceted, incorporating many systems in the body, not just the ovaries, as the name PCOS implied.
The statistics:
One in eight women has PMOS
An estimated 170 million women worldwide have PMOS.
At least 70% of them are undiagnosed.
When I evaluate patients for PMOS, I refer to the Rotterdam Criteria (see below), but I also ask certain relevant questions:
Does the patient have ovulatory dysfunction (i.e, irregular menstrual cycles)? This might include:
Infrequent ovulation—–long cycles lasting >35 days
Anovulation— (not ovulating at all and therefore not having a menstrual bleed)
Sporadic ovulation— (cycles may appear relatively normal for a few months, but then are followed by long, unpredictable stretches without ovulation or menstrual bleeding)
Normal cycles—— (while rare, some patients with PCOS may appear to have “normal” cycles because they are bleeding every month, but may not actually be ovulating
Does the patient have hyperandrogenism or hyperandrogenemia? This might include:
Physical symptoms— including acne, unwanted hair growth on parts of the body such as chin/face, abdomen, male pattern baldness, etc.
Lab results indicating elevated total or free testosterone, as well as DHEAs and androstenedione
Testosterone, DHEAs, and androstenedione are all androgens and are sometimes called “male” hormones, but women have the same hormones with differing ranges for normal depending on gender
Does the patient have insulin resistance?
Insulin resistance is frequently noted in patients with PMOS, but some patients with PMOS do not have insulin resistance
Is the patient overweight or obese?
While insulin resistance is more common in overweight or obese people, PMOS can impact any body type.
What does the family history reveal?
Research indicates that patients are far more likely to have PMOS if their mothers had PMOS (particularly if it was not well managed during the pregnancy). Studies show that a daughter’s risk of developing PCOS can be up to 70% if her mother had it.
Rotterdam Criteria
Ovulatory dysfunction (as described above)
Hyperandrogenism
Physical signs/symptoms of elevated androgens
Hyperandrogenemia
Clinical lab results showing elevated androgens
Polycystic ovaries noted on ultrasound
Defined as having ≥ 12 follicles
(small, fluid-filled sacs inside the ovaries that house and nourish
immature eggs (oocytes)) in one or both ovaries, or an enlarged
ovarian volume (> 10 mL))
With this in mind, let's go over some symptoms that might trigger you to seek further evaluation by a medical professional.
Physical signs/symptoms that have been associated with PMOS include but are not limited to the following:
Current acne or a history of acne in adolescence
Excessive unwanted hair growth (chin/face, abdomen, etc.)
Skin tags on armpit area and/or neck
Central obesity (belly fat or abdominal obesity)
Acanthosis nigricans (a common skin condition characterized by dark, thickened, velvety patches that typically appear in body folds and creases, such as the back of the neck, armpits, and groin)
Oily skin/hair
Mood changes
Abnormal uterine bleeding
Mucus patches throughout ovulatory cycle
Irregular cycles
No period (Amenorrhea)
Anxiety/depression, as approximately 57% of those with PMOS have a psychiatric disorder
If you have any of these symptoms, or a combination of these symptoms, and especially if you have irregular menstrual cycles, I strongly encourage you to seek further evaluation with a trusted medical professional. During our well-woman exams at Cascade Women’s Health, we address any and all concerns regarding your menstrual cycle and symptoms. While we do not specifically treat PMOS at our clinic, we can provide you with recommendations for care from a trusted healthcare clinician.
A word of caution, though… In traditional medicine, the recommended treatment for PMOS is often birth control. And, yes, birth control may improve your symptoms, but it absolutely will not treat the root cause of your PMOS. Therefore, years down the road when/if you decide you want children, the cause of your PMOS will have been untreated for years and likely, have worsened over the years.
I recommend finding a clinician who will evaluate your labs and complete an ultrasound to determine the root cause of your PMOS and treat it appropriately. This might include:
Diet/lifestyle changes
Exercise
Weight management
Stress /sleep management
Supplements and/or prescription medications targeting the root cause (ex: treating the insulin resistance, high androgens, etc)
When the root cause is treated, patients often find their cycles start improving and their symptoms do, too.
Please be aware of the misconception that you cannot get pregnant if you have PMOS. I’ve had patients who were shocked at their positive pregnancy test, as they had assumed they could not get pregnant with PMOS. Yes, you often have irregular cycles when you have PMOS. However, that does not mean that women cannot still ovulate. It just may be less predictable and infrequent.
If you want a recommendation for a clinician who would provide you with holistic, adequate care, we would love to see you at Cascade Women’s Health. While we personally cannot treat you for PMOS at our clinic, we can offer you education and referrals to where you can get the best possible care!!!
The name change from PCOS to PMOS is a good first step. It acknowledges that this diagnosis is not just about the ovaries. However, the fact that 70+% of people are undiagnosed still creates a major public health problem. I love the opportunity to educate my patients during their well-woman exams as to how they can seek care for their irregular cycles and unwanted symptoms and get the evaluation and treatment they deserve. Please don’t hesitate to call for an appointment.
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Important Note: The information provided in this article is for educational purposes only. While it was written by a licensed healthcare professional, it is not a substitute for personalized medical advice, diagnosis, or treatment. If you have questions about your health, please schedule an appointment with a healthcare provider who can evaluate your individual needs.
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