Polyendocrine metabolic ovarian syndrome (PMOS) affects around one out of 8 women globally. PMOS often involves insulin resistance and excess fat around internal organs in the abdomen. This can happen even if a woman is not obese. Insulin is a hormone that helps the body process and store blood sugar. When the body does not respond well to insulin, levels can rise. This imbalance can disrupt the systems that control sex hormones and the ovaries.

Why Did PCOS Become PMOS?

PMOS was formerly known as polycystic ovary syndrome (PCOS). The name was recently changed because the condition involves several hormonal and metabolic systems, while the old name placed too much emphasis on ovarian “cysts.” The new name also reflects that ovarian cysts are not a defining feature of the condition and are not required for diagnosis.

How Does PMOS Affect the Body?

High levels of insulin can contribute to excess androgen production. So, if a woman has too much insulin, her body might make more androgens. It is normal for women to produce androgens, but the problem occurs when androgen levels become too high.

Excess androgens can interfere with ovulation, when an ovary releases an egg. In PMOS, follicles that contain developing eggs may stop developing before an egg is released. This can cause many small follicles to be visible on the ovaries during an ultrasound. Although these were historically described as “cysts,” they are not abnormal ovarian cysts.

What Are the Symptoms and Health Effects of PMOS?

Irregular or absent ovulation can lead to irregular or absent periods and difficulty becoming pregnant. Other symptoms of PMOS may include acne, excess hair growth (hirsutism), thinning scalp hair, darkened patches of skin, and skin tags.

• PMOS is also associated with health risks outside of the reproductive system, including: Cardiovascular health: Women with PCOS have a higher risk of high blood pressure, unhealthy cholesterol levels, and problems controlling their blood sugar. These conditions can increase the risk of heart disease and type 2 diabetes. Regular health checks can help identify these problems early.
• Endometrial health: PMOS can increase the risk of endometrial hyperplasia, or thickening of the uterine lining, and endometrial cancer. When ovulation doesn’t happen regularly, the lining may build up over time. This is especially concerning for women who go a long time without a period.
• Obstructive sleep apnea (OSA): Women with PMOS may have a higher risk of OSA, a condition that causes breathing to repeatedly stop and start during sleep. Symptoms include loud snoring, poor sleep, and daytime tiredness. 
• Pregnancy-related complications: During pregnancy, women with PMOS may have a higher risk of miscarriage, gestational diabetes, high blood pressure during pregnancy, and preterm birth. Some babies may also be smaller than expected at birth. Those planning a pregnancy should discuss these risks with their healthcare provider to help ensure appropriate care.

Beyond its physical symptoms and health risks, PMOS can also affect mental health and sexual well-being. Changes in body image and self-esteem, along with concerns about fertility, may contribute to emotional distress. Women with PMOS may also experience difficulties with sexual desire, arousal, and satisfaction, which can affect intimate relationships. These challenges may contribute to sexual distress, and women with PMOS are also at increased risk of depression and anxiety.

PMOS can run in families, particularly among first-degree relatives such as parents, children, and siblings. Researchers have identified several genes associated with insulin function and sex hormone production, but there is no single gene that causes PMOS.

How Is PMOS Treated?

There is no cure, but certain lifestyle changes and medical treatment can help manage symptoms, improve metabolic health, and support women who want to become pregnant.

Healthy lifestyle habits are an important part of managing PMOS, regardless of weight or plans for pregnancy. Regular physical activity, a balanced diet, and healthy daily habits can help improve blood sugar and cholesterol levels, reduce excess abdominal fat, and support overall health.

Adults should aim for 150–300 minutes of moderate physical activity each week, such as brisk walking or cycling. Another option is 75–150 minutes of more intense activity each week, such as running. Strength-building exercises are also recommended at least twice a week.

For women with excess weight, losing around 5–10% of body weight over six months may improve menstrual cycles, ovulation, and metabolic health. These benefits vary from person to person, and weight loss is not required to receive treatment for PCOS.

For women who are not trying to become pregnant, treatment may include hormonal birth control to regulate menstrual cycles, metformin to improve insulin sensitivity, or antiandrogens to manage symptoms such as excess hair growth. Lifestyle changes, including regular exercise and a balanced diet, may also improve metabolic health.

For women trying to become pregnant, medications such as letrozole can help stimulate ovulation. Other fertility treatments, including IVF, may be considered if medications are unsuccessful.

Mental and sexual health are also important considerations in PMOS treatment. Women experiencing emotional distress or sexual difficulties should feel comfortable discussing these concerns with their healthcare provider, who can offer guidance and refer them to a qualified sexual health or mental health specialist when needed.

Key Takeaways

• PMOS, formerly called PCOS, is a common hormonal and metabolic condition that can affect menstrual cycles, fertility, and other areas of health.
• There is no cure, but treatments can help manage symptoms and support women who want to become pregnant.
• If you have symptoms of PMOS or concerns about your mental or sexual health, it may be beneficial to speak with a healthcare or sexual health provider.

Resources:

• Bahri-Khomami, M., Hoeger, K. M., Huddleston, H., Mahalingaiah, S., Teede, H. J., & Dokras, A. (2026). From polycystic ovary syndrome to polyendocrine metabolic ovarian syndrome: What obstetricians and gynecologists need to know. American Journal of Obstetrics and Gynecology. Elsevier. https://doi.org/10.1016/j.ajog.2026.08.024
• Chan, J. L., Masini, I., & Pisarska, M. D. (2026). Polyendocrine metabolic ovarian syndrome (PMOS)/polycystic ovary syndrome (PCOS): Current and future trends. The Journal of Clinical Investigation, 136(12), e202824. PubMed Central. https://doi.org/10.1172/JCI202824
• Shukla, A., Rasquin, L. I., & Anastasopoulou, C. (2025, July 7). Polyendocrine metabolic ovarian syndrome. StatPearls Publishing. Ncbibooks. https://www.ncbi.nlm.nih.gov/books/NBK459251/
• Singh, S., Pal, N., Shubham, S., Sarma, D. K., Verma, V., Marotta, F., & Kumar, M. (2023). Polycystic ovary syndrome: Etiology, current management, and future therapeutics. Journal of Clinical Medicine, 12(4), 1454. PubMed Central. https://doi.org/10.3390/jcm12041454