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PMOS Polyendocrine Metabolic Ovarian Syndrome formerly PCOS

Polyendocrine Metabolic Ovarian Syndrome (PMOS)

PMOS is the updated, systems-based framework that replaces the older term Polycystic Ovary Syndrome (PCOS).

Polyendocrine Metabolic Ovarian Syndrome (PMOS) is the updated, systems-based framework that replaces the older term Polycystic Ovary Syndrome (PCOS).

The new name reflects what research has shown for years: this is not a condition of “cysts”, and it is not limited to the ovaries. Instead, PMOS describes a whole-body metabolic–endocrine pattern that can influence ovarian function, hormone signalling, and overall wellbeing.

PMOS is identified when at least two of the following features are present:

  • Irregular or absent ovulation, often seen as longer or unpredictable menstrual cycles
  • Higher-than-expected androgen activity, which may contribute to acne, excess facial or body hair, or scalp hair thinning
  • Polycystic ovarian morphology, where the ovaries contain a higher number of small follicles

 

Not everyone with PMOS will have all three features, and the presentation can vary across adolescence, reproductive years and perimenopause.

How PMOS can present

Common features include:

  • Longer gaps between menstrual cycles or no cycle at all
  • Difficulties with ovulation, which may affect chances of conceiving
  • Acne or oily skin
  • Excess facial or body hair
  • Scalp hair thinning
  • Weight gain or difficulty losing weight
  • Low mood, anxiety or reduced emotional resilience

 

These features can arise from different underlying drivers, which is why the PMOS model emphasises metabolic and endocrine networks, not a single cause.

What we understand about PMOS

PMOS is considered a polyendocrine and metabolic condition, meaning several hormone systems may be involved. Research suggests a combination of:

  • Insulin resistance, where the body becomes less responsive to insulin
  • Higher androgen activity, which can influence ovulation and skin or hair symptoms
  • Low-grade inflammation, which may affect metabolic and hormonal signalling
  • Genetic and environmental factors, which influence how the condition presents

 

Insulin resistance is common in PMOS. When cells respond less effectively to insulin, the body produces more of it to keep blood sugar stable. Higher insulin levels can stimulate the ovaries to produce more androgens, which may contribute to some PMOS-related symptoms.

PMOS is also associated with a higher long-term risk of certain metabolic conditions, including type 2 diabetes. This does not mean these conditions will develop, but it highlights the value of early support and ongoing monitoring.

Medical approaches

Medical treatment depends on a person’s goals and symptoms.

  • For those not planning pregnancy, hormonal contraception may be used to regulate bleeding patterns and support skin or hair symptoms
  • For those with insulin resistance, medication such as metformin may be recommended to support metabolic health
  • For those trying to conceive, ovulation-inducing medications may be considered

 

Your GP or specialist will advise on the most appropriate options.

Functional and lifestyle support

From a functional medicine perspective, there are evidence-informed ways to support metabolic and hormonal balance alongside medical care.

These approaches do not treat or cure PMOS, but they may help support overall wellbeing and symptom management:

From a functional medicine perspective there’s a lot that can be done to support balanced hormone and insulin levels:

  • Nutrition and movement strategies that support stable blood sugar levels 1 2 4 5 6
  • Personalised dietary approaches for those who would benefit from weight reduction 1, 4, 6
  • Specific nutrients and botanicals shown in research to support insulin sensitivity or menstrual regularity 3, 7, 8
  • Lifestyle habits that support stress regulation, sleep, and inflammation balance

 

Your practitioner can help identify which strategies are most relevant for you and how they can complement any medical treatment.

Book a FREE Discovery Call to see how functional Medicine can support your with PMOS

 

References

  1. Deshmukh H, Papageorgiou M, Wells L, Akbar S, Strudwick T, Deshmukh K, Vitale SG, Rigby A, Vince RV, Reid M, Sathyapalan T. The Effect of a Very-Low-Calorie Diet (VLCD) vs. a Moderate Energy Deficit Diet in Obese Women with Polycystic Ovary Syndrome (PCOS)-A Randomised Controlled Trial. Nutrients. 2023 Sep 6;15(18):3872. doi: 10.3390/nu15183872. PMID: 37764656; PMCID: PMC10536436.
  2. Jurczewska J, Ostrowska J, Chełchowska M, Panczyk M, Rudnicka E, Kucharski M, Smolarczyk R, Szostak-Węgierek D. Physical Activity, Rather Than Diet, Is Linked to Lower Insulin Resistance in PCOS Women-A Case-Control Study. Nutrients. 2023 Apr 27;15(9):2111. doi: 10.3390/nu15092111. PMID: 37432289; PMCID: PMC10180891.
  3. Pkhaladze L, Russo M, Unfer V, Nordio M, Basciani S, Khomasuridze A. Treatment of lean PCOS teenagers: a follow-up comparison between Myo-Inositol and oral contraceptives. Eur Rev Med Pharmacol Sci. 2021 Dec;25(23):7476-7485. doi: 10.26355/eurrev_202112_27447. PMID: 34919250.
  4. Dokras A, Sarwer DB, Allison KC, Milman L, Kris-Etherton PM, Kunselman AR, Stetter CM, Williams NI, Gnatuk CL, Estes SJ, Fleming J, Coutifaris C, Legro RS. Weight Loss and Lowering Androgens Predict Improvements in Health-Related Quality of Life in Women With PCOS. J Clin Endocrinol Metab. 2016 Aug;101(8):2966-74. doi: 10.1210/jc.2016-1896. Epub 2016 Jun 2. PMID: 27253669; PMCID: PMC4971336.
  5. Szczuko M, Kikut J, Szczuko U, Szydłowska I, Nawrocka-Rutkowska J, Ziętek M, Verbanac D, Saso L. Nutrition Strategy and Life Style in Polycystic Ovary Syndrome-Narrative Review. Nutrients. 2021 Jul 18;13(7):2452. doi: 10.3390/nu13072452. PMID: 34371961; PMCID: PMC8308732

  6. Che X, Chen Z, Liu M, Mo Z. Dietary Interventions: A Promising Treatment for Polycystic Ovary Syndrome. Ann Nutr Metab. 2021;77(6):313-323. doi: 10.1159/000519302. Epub 2021 Oct 5. PMID: 34610596.

  7. Lervolino M, Lepore E, Forte G, Laganà AS, Buzzaccarini G, Unfer V. Natural Molecules in the Management of Polycystic Ovary Syndrome (PCOS): An Analytical Review. Nutrients. 2021 May 15;13(5):1677. doi: 10.3390/nu13051677. PMID: 34063339; PMCID: PMC8156462.

  8. Moini Jazani A, Nasimi Doost Azgomi H, Nasimi Doost Azgomi A, Nasimi Doost Azgomi R. A comprehensive review of clinical studies with herbal medicine on polycystic ovary syndrome (PCOS). Daru. 2019 Dec;27(2):863-877. doi: 10.1007/s40199-019-00312-0. Epub 2019 Nov 18. PMID: 31741280; PMCID: PMC6895349.

Tests commonly used for PCOS

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