Polyendocrine Metabolic Ovarian Syndrome (PMOS)

PMOS can cause many frustrating symptoms or fertility issues. At University of Iowa Health Care, you’ll find the help you need.

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Although polyendocrine metabolic ovarian syndrome (PMOS) — formerly known as polycystic ovary syndrome (PCOS) — is a common condition, its severity varies from person to person. While some women may have mild symptoms, most need expert medical care.

If you have PMOS and need help managing your symptoms — or getting pregnant — turn to University of Iowa Health Care. We’re home to numerous PMOS experts, including:

OBGYN providers with expertise in ovarian health and function
Endocrinologists who specialize in hormone disorders like PMOS
Reproductive endocrinologists who can help with diagnosis, PMOS management, and PMOS-related infertility

No matter which provider you choose, you can expect outstanding care, advice, and support. We’re here to help you achieve your goals, whether that’s improving your confidence or your chance of having a baby.

What is PMOS?

Polyendocrine metabolic ovarian syndrome is a medical condition that affects some of your hormones.

For example, with PMOS your ovaries create unusually high levels of male hormones (androgens). As a result, your ovaries have a hard time producing and releasing eggs (ovulation). This can cause irregular menstrual cycles and difficulty getting pregnant.

In addition, you may have insulin resistance, which can lead to Type 2 diabetes. Insulin resistance can also cause your ovaries to produce excess androgens.

Is PMOS the same as PCOS?

Yes. Polyendocrine metabolic ovarian syndrome (PMOS) is the updated name for what was previously known as polycystic ovary syndrome (PCOS). The name was changed to avoid confusion, since many patients diagnosed with PCOS don’t actually have ovarian cysts.

The new name, PMOS, more accurately reflects the condition’s hormonal and metabolic symptoms, such as insulin resistance and weight changes, and better conveys that it affects multiple body systems, not just the ovaries.

PMOS symptoms

Polyendocrine metabolic ovarian syndrome develops after puberty and may not cause noticeable symptoms early on. Many women don’t find out they have it until they try to get pregnant and are unable to conceive.

Signs of PMOS, which are linked to increased androgen and insulin levels, may include:

Abnormal menstruation, including irregular periods, absent periods, or heavy bleeding during your period
Acne that continues into adulthood and is hard to treat
Excess midline hair growth, especially on your face, chest, or abdomen
Hair loss from your scalp
Infertility
Unexplained weight gain or obesity

Having PMOS may also increase your risk of developing other medical conditions. These may include depression, diabetes, high blood pressure, and sleep apnea.

PMOS diagnosis

If you have PMOS symptoms, you should seek care from a specialist who has experience diagnosing and treating this condition.

There isn’t a single test that can identify PMOS. However, we can usually confirm you have it if you meet two of the following criteria:

You have a history of irregular periods.
You’ve had a blood test showing your androgen levels are too high. Or, you have physical signs of too much androgen (like acne and excess body hair).
You have a high number of small cysts on one or both ovaries (identified with a pelvic ultrasound).

PMOS treatment from UI Health Care

Even though there isn’t a cure for PMOS, we can help you manage it. Your treatments may vary over time, depending on what symptoms you have and whether you want to have a child.

Symptom management

If you’re not ready (or planning) to become pregnant, these treatments may help improve your symptoms:

Hormonal contraceptives. Different types of hormonal birth control keep your menstrual cycle regular and may improve acne and hair growth. Your options include birth control pills, injections, and patches, as well as vaginal rings and intrauterine devices (IUDs).
Anti-androgen drugs Certain prescription medicines limit or stop the effects of testosterone and other androgens. Reducing your androgen levels can improve acne and help minimize facial and body hair.
Lifestyle changes. Improving your diet and exercise can lower your insulin level, regulate your blood sugar, and help you lose weight.
Insulin-reducing medicine. Your provider may recommend a diabetes drug called Metformin if you have PMOS with insulin resistance. Metformin lowers your blood sugar levels and can help improve your menstrual and ovulation cycles.

Treatment for PMOS-related infertility

If you want to get pregnant, you should schedule a consultation with a reproductive endocrinologist. Polyendocrine metabolic ovarian syndrome is one of the most common causes of female infertility. And even if you’ve never been diagnosed with PMOS, you can have it without knowing it.

UI Health Care’s reproductive endocrinologists are skilled at pinpointing the cause of infertility in individuals and couples. If we determine you have PMOS, we offer infertility treatments that may help you conceive. These include:

These include:

Fertility medications. Various oral drugs can help your ovaries produce and release eggs. Our goal is to get you on a regular and predictable ovulation cycle. Having sex during ovulation (timed intercourse) increases your chance of getting pregnant.
Intrauterine insemination (IUI). In addition to using the drugs mentioned above, right before or after you ovulate we’ll use a catheter (thin tube) to place sperm directly into your uterus. You may benefit from IUI if you haven’t been able to get pregnant with fertility medications alone. It’s also an option if you’re trying to conceive with donor sperm, or your male partner also has infertility challenges.
In vitro fertilization (IVF). We combine eggs and sperm outside of your body, in a laboratory. The sperm fertilizes the eggs to create embryos. Then we place an embryo directly into your uterus. We may recommend IVF if you’re still unable to get pregnant despite trying the treatments mentioned above.