PMOS: Name change may improve diagnosis
Polycystic ovarian syndrome (PCOS) has been given a new name by the American Society for Reproductive Medicine: polyendocrine metabolic ovarian syndrome (PMOS).
Physicians like Dr. Dipti Banerjee, an obstetrician-gynecologist at UCI Health Women’s Health Services, hope that the change will improve diagnosis and, in turn, treatment and outcomes for the condition that affects one in eight women worldwide
“PMOS better reflects the syndrome as a metabolic dysregulation that affects the whole body, not just the ovaries,” she says. “The new name is a more inclusive and accurate definition.”
The name PCOS was a misnomer, as there are no actual cysts involved in the condition. The name comes from a congestion of early eggs in the ovary that look like a string of pearls on an ultrasound.
“These are not pathologic cysts,” Banerjee points out. “They’re a common finding associated with PCOS.”
She is hopeful that the name change could inspire more women to seek diagnosis for metabolic disorders and allow for broader screening across medical specialties, including primary care, rather than solely through an OB-GYN.
PMOS symptoms
Owing to its varying, common symptoms, PMOS is challenging to diagnose.
“For example, because of maturing hormonal pathways, irregular periods are common in young women,” Banerjee says of the difficulty.
The symptoms include:
- Acne or oily skin
- Dark or thick patches of skin on the back of the neck, in the armpits or under the breasts
- Enlarged ovaries or those that have “cysts”
- Excessive body hair (hirsutism)
- Infertility
- Missed, irregular or very light periods
- Skin tags
- Thinning hair
- Weight gain, particularly around the stomach
A thorough history, pelvic ultrasound and blood tests can help confirm or rule out PMOS.
Searching for a cause
No one knows the exact cause of PMOS, which is usually diagnosed in one’s 20s or 30s. It can be genetic, Banerjee says. Having a family member with it raises one’s risk.
Insulin resistance, obesity and a high level of androgen hormone activity may also play a part.
Recent research from Harvard has found a possible relationship between PFAS (per- and polyfluoroalkyl substances) exposure during pregnancy and the later development of PMOS in female children.
Banerjee says the diagnostic criteria are not suitable for adolescents.
Treating PMOS
How PMOS is treated depends on one’s goals, says Banerjee.
In general, she recommends adhering to a healthy lifestyle involving whole foods, regular activity and weight control.
If the goal is pregnancy, there are medications in addition to lifestyle modifications to help with ovulation.
There are also medications to help with weight loss, hair loss, excessive hair growth, acne and hormone control.
Banerjee says that no one should have to suffer in silence.
“Anyone with the signs of PMOS should speak to their doctor about their concerns and advocate for themselves to have the appropriate workup. There is help available to improve your health and quality of life.”