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Polycystic metabolic ovarian syndrome (PMOS)—previously called polycystic ovary syndrome (PCOS)—affects as many as one in eight women. And while it’s one of the most common women’s health issues, it’s been notoriously difficult to identify, with some women waiting four or more years for a diagnosis.
As a result, treatment is cobbled together. Some women receive acne treatment, others are advised to lose weight, and, of course, women are often told that their problems are simply due to stress. Regardless, the outcome is the same: They’re not getting the treatment they need.
Knowing these facts about PMOS can help open up the conversation with your own doctor. Because while you’re not responsible for your own diagnosis, education goes a long way toward advocating for yourself. Here’s why such a common condition has been traditionally overlooked.
PMOS symptoms don't look the same for everyone
One of the big reasons that the name changed from PCOS to PMOS was because PCOS was misleading. It sounded as if ovaries were the problem because they were riddled with cysts—but this is a misnomer, according to the Endocrine Society.
Rather, PMOS is a complex hormonal and metabolic disorder commonly associated with insulin resistance and excessive androgen hormone levels.
Adding to the question of why is PMOS so hard to diagnose, there’s a huge diversity in PMOS symptoms and their presentation:
- You may have irregular periods, including having a shorter or longer cycle, skipping your period, not having your period at all, or periods that are heavier than usual.
- You may have extra hair on your face and body.
- You may have severe acne.
- You may have insulin resistance.
- You may experience weight gain or have a weight in the obese range, though you can also be lean.
- You may experience difficulty conceiving or infertility. Although this does not affect everyone with PMOS, the World Health Organization describes PMOS as a leading cause of ovulatory infertility.
Why the signs are easy to overlook
PMOS can be a sneaky, hiding-in-plain-sight disease. Historically, there’s been a struggle even among clinicians themselves to identify the condition, which is for several reasons, research points out:
- There isn’t one test that diagnoses PMOS.
- There are wide variations in symptoms among women, and not everyone experiences the same combinations.
- Rates of misdiagnosis are higher depending on race and ethnicity.
- Women may visit multiple specialists for individual symptoms without coordinating care (through no fault of their own).
- Having a lean body weight or normal BMI can increase the likelihood of missed diagnosis, since PMOS is associated with obesity or being overweight.
- Many symptoms are common on their own.
- Symptoms are often “non-specific,” meaning they occur in multiple different health conditions or problems, making untangling their source or connecting the dots tough.
It’s also easy to normalize your symptoms yourself if your periods are usually irregular, you’ve always been dealing with less-than-perfect-skin, your family struggles with their weight, or—and this is the big one—you’re stressed. In all honesty, even if you are stressed or a higher BMI does run in your family, it doesn’t hurt to bring up any concerns about potential PMOS symptoms with your doctor.
Some common symptoms can be easy to attribute to other causes:
- Irregular periods → Stress or birth control
- Acne → Skin care or “just bad skin”
- Hair loss → Genetics or stress
- Weight gain → Diet or lifestyle habits
- Difficulty losing weight → Aging
- Fatigue → Stress or a busy lifestyle
- Infertility → Stress or not trying to conceive for long enough
Why earlier diagnosis by your doctor matters
For people with PMOS, getting the right support and treatment can make a meaningful difference in symptoms and quality of life. At the same time, there can be consequences to missed or late diagnosis. That’s because PMOS is a condition that affects your hormones, metabolism, mood, and skin, according to research in The Lancet. The authors point out that the features of PMOS can be wide-ranging:
- Metabolic dysfunction: Obesity, abnormal blood sugar, type 2 diabetes, high blood pressure, high cholesterol, “fatty liver,” heart disease, sleep apnea
- Reproductive challenges: Irregular ovulation and menstrual cycles, infertility, pregnancy complications, endometrial cancer
- Psychological issues: Depression, anxiety, eating disorders
- Dermatological struggles: Acne, hair loss, excess hair growth
The earlier you’re diagnosed, the better, so you can seek treatment and make lifestyle changes to better manage how your PMOS symptoms affect you now and in the future.
Treatment can include medications, fertility treatments (if you’re looking to get pregnant), and lifestyle habit change. Research suggests that following a balanced diet, exercising regularly, and seeking psychological and social support can help manage bothersome symptoms, provide a sense of control over the condition, and improve your mood.
Because PMOS is associated with a higher risk of cardiometabolic disease, including higher incidence of heart attack and stroke, and a substantially increased risk of developing type 2 diabetes, diagnosis can provide an opportunity to address these risks proactively.
What to do if PMOS sounds familiar
If you’re reading this and the description of these PMOS symptoms is hitting home, make an appointment with your doctor. Don’t self-diagnose.
After excluding other conditions that can cause similar symptoms, PMOS in adults is generally diagnosed when at least two of the following are present:
- Irregular periods or no periods at all
- High androgen levels (symptoms include acne and oily skin, excess body hair and female-pattern hair loss; blood testing can also measure associated hormone levels, such as free and total testosterone)
- Polycystic ovaries shown on an ultrasound test or elevated anti-Müllerian hormone (AMH). (AMH is a hormone that can provide information about ovarian reserve, but it does not by itself predict fertility.)
Your doctor will conduct a physical/pelvic exam, ask you questions about your menstrual cycle and the presence of other symptoms, order blood testing, and more. To best prepare, here’s what you can do:
- Keep a symptom journal: Helps you organize and keep track of symptoms; also helps make connections between seemingly unrelated symptoms.
- Track your menstrual cycles: This is key to establishing if you’re having irregular periods, how heavy they are, and how long they last.
- Write down your family history: PMOS may have a genetic component, so if you have a close relative who has PMOS, bring this up to your doctor.
A key part of PMOS diagnosis is ruling out other disorders, so stay open to your doctor’s suggestions and investigation, but don’t be afraid to ask “is this PMOS?” because that may be the nudge that’s needed to get a proper evaluation.
Putting the pieces together
PMOS is a common, yet underdiagnosed condition because symptoms have traditionally been misunderstood, even by providers themselves. Diagnosis often takes years, but recognizing the symptoms of PMOS can help you find medical help sooner. Understanding the detailed picture of your health begins with recognizing patterns, asking questions, and advocating for yourself when something doesn't feel right.
Prenuvo’s Whole Body Scan and Blood Panels don’t diagnose PMOS, but they can provide additional information about your overall health—including biomarkers, body composition, and liver fat—that can support ongoing conversations with your healthcare provider.
To learn more about the benefits of whole body MRI, blood panels, and other Prenuvo services, book a call with our Patient Services Team.
