Published on June 30, 2026

illustration of the female reproductive system.

What Is Polyendocrine Metabolic Ovarian Syndrome (PMOS)?

There’s a lot of misconception around polycystic ovary syndrome (PCOS), a condition that affects women of all ages. In fact, it underwent a name change in 2026. PCOS was renamed to polyendocrine metabolic ovarian syndrome (PMOS) to recognize the complexity of this hormone-related disorder.

“The first misconception is that PMOS means there are simply cysts on your ovaries,” said Susan Wik, MD, an OB/GYN at Avera OB/GYN in Aberdeen, SD. “There are a lot of factors at play regarding this condition, and every OB/GYN has felt that the original term hasn’t done it justice.”

It’s not cysts at all, but collections of immature follicles on the ovaries that prevent them from creating mature eggs. These aren’t typically painful, but can enlarge the ovaries. The cyst-ovary misconception causes people to think it’s just a reproductive issue — rather than a whole-body, metabolic issue — which results in PMOS being an underdiagnosed and undertreated condition.

What Causes PMOS (or PCOS)?

“There’s no exact, known cause of PMOS, but it’s a super complex condition that’s influenced by genetics, metabolic and environmental factors,” said Wik. “Insulin resistance is a big proponent in creating a negative feedback loop.”

If you have PMOS, the body’s cells may become less sensitive to insulin, causing the pancreas to release larger amounts into the bloodstream. These elevated insulin levels can cause the ovaries to increase testosterone production. Testosterone can impair the metabolism and increase insulin resistance — reinforcing a self-perpetuating cycle.

In relation to insulin resistance, PMOS can lead to a higher chance of developing metabolic syndrome, which puts women at risk for type 2 diabetes, high blood pressure, high cholesterol, obesity and depression. Added body weight then exacerbates PMOS symptoms.

Symptoms of PMOS (or PCOS)

Wondering if you could have PMOS? Here are some of the symptoms you could be experiencing:

  • Irregular menstrual cycles (not ovulating regularly)
  • Higher risk of depression
  • Hormonal acne
  • Dark, thick hair growth on the upper lips, chin, chest and abdomen
  • Male-pattern balding
  • Weight gain, or carrying a little excess weight
  • Infertility or difficulty getting pregnant
  • Insulin resistance
  • Onset of type 2 diabetes

Things That Make PMOS (or PCOS) Worse

Lifestyle habits don’t necessarily cause PMOS, but they can worsen symptoms and the overall course of the condition. Poor habits that could mess with hormone production and function include:

  • A diet high in processed meat, fried foods, salty or sugary snacks
  • A sedentary life
  • Unmanaged, chronic stress
  • Lack of sleep or poor quality of sleep
  • Excess alcohol

How PMOS (or PCOS) Is Diagnosed

The Rotterdam criteria is what most OB/GYNs use to diagnose PMOS. According to this, you need to exhibit two out of three signs:

  • Irregular periods (cycles >35 days apart or <8 menstrual cycles per year)
  • Evidence of elevated androgen hormone (including testosterone), which includes hormonal acne and body and facial hair
  • Polycystic-appearing ovaries — slightly enlarged with clusters of immature follicles — which can be detected on an ultrasound

Hormonal labs can be drawn to detect hyperandrogenism levels. In addition, OB/GYNs don’t always need ultrasound imaging to get a PMOS diagnosis.

“You don’t necessarily need an ultrasound to diagnose PMOS, but it can be useful in certain cases,” said Wik. “I like to offer that option to my patients to gain more information regarding the disease process.”

If you’re experiencing PMOS symptoms, press in with your physician to get an official diagnosis so you can be directed to the next steps, treatment and experts. Fortunately, the medical world is becoming more aware of the prevalence of PMOS because women are advocating more about their bodies.

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If you have PMOS, or suspect you do, talk to your provider about possible treatment options.

Treatments for PMOS (or PCOS)

Unfortunately, there’s no cure for PMOS, and various symptoms can take prominence based on your age. In general, it’s a long-lasting condition that can be managed effectively by lifestyle alterations as well as medicines prescribed by your OB/GYN or primary care physician.

Lifestyle Changes and Natural Options

Improvements in your lifestyle will positively affect the intensity of your symptoms. One big thing is diet — focusing on foods rich with protein and fiber. Think single-ingredient, whole foods. Getting in adequate movement throughout the week, eliminating unnecessary stressors, and sticking to a bedtime will reap excellent results on weight, blood pressure, blood sugar and mental health.

“Even losing 5% of body weight through good habits can help resume normal ovulation and increase fertility, if that is your goal,” said Wik.

When it comes to over-the-counter supplements, Wik recommends inositol because data shows that it can improve insulin sensitivity and help regulate menstrual cycles. It’s found online, and unfortunately, can run $30 to $60 per month.

Also, drinking spearmint tea is a reasonable supplement to soothe acne. Wik said this is something she’s even run by colleagues in dermatology.

“This is the lifestyle we all should be living, not just women with PMOS,” said Wik.

Clinical Options

In the clinic, your OB/GYN might prescribe different medications to regulate menstrual cycles and hormones. Here are some of those options:

  • Cyclic hormonal prescription – taking this progesterone medication during specific days of the month induces a bleed to ensure your periods are regular (good for if you don’t want to be on birth control)
  • Ovulation prescription – taking this medication early in your cycle stimulates egg production, encourages egg maturation and induces ovulation (good for if you want to become pregnant)
  • Hormonal options for treating PMOS (oral, patch, ring, injection, IUD) – taking these kinds of medications as treatment for PMOS can bind and reduce androgen levels, normalize your periods and relieve other symptoms

“Irregular menstrual cycles put your body at risk of developing uterine cancer because the lining of the uterus is continually building and never sloughing,” explained Wik. “In order to help prevent uterine cancer, you can use medications such as cyclic progesterone and different forms of contraceptives for PMOS treatment.”

Surgical Interventions

Surgical treatments, like ovarian drilling or ovarian wedge resection, are rare as the outcomes aren’t usually satisfactory. There are also general risks associated with surgery, including scar tissue.

“It’s a complicated disorder, so seeing what works might be trial and error,” said Wik. “The best thing to do is to start working with your physician and implementing options to see what works for you.”

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