Why You’re Treating PMOS Wrong & How To Make It Right
Editor's note: On May 12, 2026, Polycystic Ovary Syndrome (PCOS) was officially renamed Polyendocrine Metabolic Ovarian Syndrome (PMOS), due to the misleading nature of the original name. PMOS more accurately reflects the nature of the condition’s multisystem pathophysiology. The contents of this blog post have been updated to reflect the change, though the references retain the former terminology.
As you likely know, Polyendocrine Metabolic Ovarian Syndrome (PMOS) — formerly known as PCOS — is a female disorder often characterized by irregular or heavy menses, infertility, physical secondary symptoms like acne, and great difficulty losing weight. It is also the most common reproductive disorder and leading cause of infertility in females [1].
If you’re a physician and someone asks you “how do you treat PMOS/PCOS?”, you might give a variety of answers. Based on what you learned in medical school or your training, you might reply with birth control pills, progestins (progestin-only mini pill),
that PMOS doesn’t need to be “treated” at all unless the patient is trying to conceive. But what if you found out that none of these approaches effectively treat PMOS, or may even make it worse? You would be stumped, perhaps even angered.
Sadly, many practitioners, from family physicians to highly trained OB/GYNs, for reasons rooted in prevailing misconceptions about the disorder, including who gets it, what it looks like, how it should be diagnosed, and most importantly, how to treat it. Our content is focused on PMOS aims to clear the air, giving you valuable tools to treat PMOS, so you can help patients who have been underserved or even unfairly blamed by medical professionals and have lost all hope.
But before we can explore how to effectively treat PMOS, we have to expose misconceptions and myths about the disorder, so buckle up and get ready to be thoroughly surprised.
Table of Contents
PMOS(PCOS) is Not an Ovarian Problem - It’s Endocrine
Polycystic Ovarian Syndrome needed a new name because the term implies the problem lies in the ovaries. If you have ever done an ultrasound on a patient with PMOS, you’d note that many don’t even have cystic ovaries, although their labs are disturbed and/or they have physical symptoms that are clearly reflective of what was known as PCOS.
Hence the name change to Polyendocrine Metabolic Ovarian Syndrome.While the ovaries are affected by PMOS, the root cause of PMOS goes beyond the ovary. As you know, the ovaries and menstrual cycle on a whole are controlled by the brain. Much of the metabolic disruption starts there, with problems like chronically elevated Luteinizing Hormone (LH)–a problem that lies in the pituitary gland–not the ovary. Also, most women with PMOS have some degree of insulin resistance and this is widely accepted to explain much of the etiology of PMOS. Other issues include chronically low progesterone levels.
These are all endocrine problems that include multiple organ systems outside the ovary. So, while ovarian dysfunction is a result of PMOS, it is not the cause of it. At its core, PMOS is a metabolic disorder–affecting the whole body–not just a reproductive one.
PMOS(PCOS) is (partly) autoimmune
We know this due to the presence of inflammation and auto-antibodies commonly seen in PMOS, such as anti-ovarian, anti-spermatic, anti-TPO, anti-nuclear, and anti-islet cell antibodies–some of the same antibodies observed in Hashimoto Thyroiditis and Systemic Lupus Erythematosus [1].
PMOS(PCOS) is Inflammatory
Women with PMOS often have higher levels of chronic low-grade inflammation and elevated CRP levels [2]. This is a problem because chronic inflammation of the uterine lining can interfere with implantation, preventing successful pregnancy or may even lead to endometrial and other cancers down the line. Elevated CRP is also a potent predictor of future heart disease.
PMOS(PCOS) is Genetic
PMOS is likely genetic in origin. We know this because PMOS often runs in families. For example, if your mother has PMOS, you are up to 70 percent more likely to have it yourself as her daughter [3]. Also, if PMOS were caused by weight gain alone, it doesn’t explain why lean, fit women can and often do have PMOS.
Genes that play a role in fat cell function, energy metabolism, and glucose regulation are suspected to have polymorphisms that could be responsible for some of the traits seen in PMOS, such as those found on the PPAR-y gene and genes that play a role in chronic inflammation such as the TNF-alpha gene which is thought to modify some phenotypic traits of PMOS [4].
In fact, there is evidence that PMOS is likely present in infancy–but doesn’t “activate” until menarche [5].
The Bottom Line
There are many misconceptions about PMOS, especially due to its former name of PCOS. A clearer understanding of what PMOS is and what it is not paves the way for more efficacious treatments for managing it.
References
Mobeen H, Afzal N, Kashif M. Polycystic Ovary Syndrome May Be an Autoimmune Disorder. Scientifica (Cairo). 2016;2016:4071735. doi: 10.1155/2016/4071735. Epub 2016 May 5. PMID: 27274883; PMCID: PMC4871972.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4871972/
Watson K. Basina M. PCOS and Chronic Low Grade Inflammation: Should You Worry? Healthline. April 21, 2022. Accessed August 2, 2023. https://www.healthline.com/health/womens-health/inflammatory-pcos
Crisosto N, Ladrón de Guevara A, Echiburú B, Maliqueo M, Cavada G, Codner E, Paez F, Sir-Petermann T. Higher luteinizing hormone levels associated with antimüllerian hormone in postmenarchal daughters of women with polycystic ovary syndrome. Fertil Steril. 2019 Feb;111(2):381-388. doi: 10.1016/j.fertnstert.2018.10.011. Epub 2018 Dec 7. PMID: 30527840. https://pubmed.ncbi.nlm.nih.gov/30527840/
Unluturk U, Harmanci A, Kocaefe C, Yildiz BO. The Genetic Basis of the Polycystic Ovary Syndrome: A Literature Review Including Discussion of PPAR-gamma. PPAR Res. 2007;2007:49109. doi: 10.1155/2007/49109. PMID: 17389770; PMCID: PMC1820621. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1820621/
Welt CK, Carmina E. Clinical review: Lifecycle of polycystic ovary syndrome (PCOS): from in utero to menopause. J Clin Endocrinol Metab. 2013 Dec;98(12):4629-38. doi: 10.1210/jc.2013-2375. Epub 2013 Sep 24. PMID: 24064685; PMCID: PMC3849665. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3849665/#:~:text=However%2C%20there%20is%20evidence%20that,based%20on%20predisposing%20environmental%20influences
Weiss P. Gurevich R. What Is Lean PCOS? Delayed diagnosis and other unique challenges. VeryWell Health. Updated on November 11, 2022. Accessed August 2, 2023. https://www.verywellhealth.com/unique-challenges-of-lean-women-with-pcos-4155138#:~:text=Lean%20PCOS%20is%20polycystic%20ovary,condition%20fall%20into%20this%20group
Welt CK, Carmina E. Clinical review: Lifecycle of polycystic ovary syndrome (PCOS): from in utero to menopause. J Clin Endocrinol Metab. 2013 Dec;98(12):4629-38. doi: 10.1210/jc.2013-2375. Epub 2013 Sep 24. PMID: 24064685; PMCID: PMC3849665. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3849665/#:~:text=However%2C%20there%20is%20evidence%20that,based%20on%20predisposing%20environmental%20influences
Krista Russ
Krista Russ, B.S, is a medical content writer at Worldlink Medical. She frequently contributes to WorldLink Medical’s blog, where exciting new medical content is released regularly, along with other marketing publications. Previously, Krista worked as a health app writer for a digital healthcare startup. She graduated with honors from Baker College with a dual degree in Business Administration and English. Because of her combined passion for human health and writing, she also has an Associates Degree in Health Sciences. Krista is a creative soul. Outside of work, she can be found writing fiction, jamming to electronic music (albeit embarrassingly so), or binge-watching the latest Netflix series.
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