Up to 15% of women of reproductive age may have the condition formerly known as polycystic ovary syndrome (PCOS). It can affect many aspects of female health and fertility.
Recently, the condition underwent an official name change to PMOS—polyendocrine metabolic ovarian syndrome. The new name better reflects hormonal, metabolic and reproductive features of the disorder. As a result, more women may finally get the diagnosis and treatment they need.
Why Is PCOS Now Called PMOS?
“Polycystic ovary syndrome—PCOS—was always kind of a misnomer,” explains Alex Tawa, D.O., an obstetrician/gynecologist at Henry Ford Health. “The new name more accurately describes the condition.”
Calling it PCOS puts the emphasis on having polycystic ovaries. “It implied there were clinically relevant ovarian cysts,” says Dr. Tawa. “When really they were just undeveloped follicles in the ovaries.”
The new name, polyendocrine metabolic ovarian syndrome (PMOS), is more accurate:
- Polyendocrine refers to the production of androgens (steroid hormones, including testosterone)
- Metabolic reflects the association with insulin resistance, diabetes and cardiometabolic health
- Ovarian refers to the reproductive symptoms
The old name put the emphasis on the ovaries and potential cysts. The new name reflects the condition’s impact on hormones (the endocrine system) and metabolism.
What Are the Main Symptoms of PMOS?
Because PMOS affects multiple systems in the body, its symptoms are wide-ranging. Common symptoms of PMOS may include:
Abnormal hair growth, caused by an excess of male hormones. This can lead to growth of excess hair on the face or body. It can also result in thinning hair or baldness.
- Acne
- Cysts on the ovaries from undeveloped egg follicles
- Dark patches on the skin
- Infertility
- Irregular periods
- Obesity
Why Is PMOS So Tricky to Diagnose?
PMOS is notoriously underdiagnosed or misdiagnosed. According to the World Health Organization, up to 70% of women worldwide with the condition are undiagnosed.
“There is often a dismissal of symptoms or a focus just on the irregular periods,” says Dr. Tawa. “Often women are told that’s just how their cycles are, and they’re given oral contraceptives to treat the symptoms.”
He also notes that the diversity of symptoms often leads women to seek care from multiple doctors. You might see a gynecologist for irregular periods, a dermatologist for acne and hair issues, and your primary care doctor about weight gain.
“If those doctors aren’t communicating with each other, who is going to put all the pieces together?” asks Dr. Tawa. “That can often lead to a delay in diagnosis.”
Is PMOS Being Diagnosed More Now?
If the number of women with PMOS is rising, the question becomes whether the condition is now more common or whether doctors are getting better at accurately diagnosing it. “I think the answer is a little of both,” says Dr. Tawa.
He acknowledges that the rise in obesity rates—and related insulin resistance and diabetes—is making symptoms more obvious and easier to recognize. “Our tools for diagnosing PMOS and education around the condition are also getting better,” says Dr. Tawa.
Previously, doctors relied mainly on ultrasound to look for cysts in the ovaries. But now lab tests looking at specific hormone levels are key. “We look at anti-Müllerian hormone (AMH), testosterone and other androgens,” says Dr. Tawa. “And we also check insulin resistance.”
In women with PMOS, the ovaries are uniquely sensitive to insulin. And they respond by increasing the production of androgens.
“My hope is that now that the condition has a new name that better reflects the full picture, it will be taught differently in medical school,” says Dr. Tawa. “Instead of only ob/gyn physicians recognizing it, patients who see an endocrinologist or even a dermatologist will get an accurate diagnosis sooner.”
Reviewed by Alex Tawa, D.O., an obstetrician/gynecologist who sees patients at Henry Ford West Bloomfield Hospital and Henry Ford Medical Center - Bloomfield Township.
