Polyendocrine Metabolic Ovarian Syndrome (PMOS) is a complex, multi-system condition that primarily affects reproductive-aged women. It was previously known as Polycystic Ovarian Syndrome (PCOS), but was changed in early May after countless studies indicated that the condition involved far more than the reproductive system alone. In fact, findings have shown that PMOS can involve metabolic, endocrine, reproductive, dermatologic, and mental health components that were never really accounted for prior to the name change. Through this groundbreaking shift, women affected by the condition have a better chance of pinpointing what they’re experiencing and how to treat it appropriately.
Integrative OB-GYN and hormone specialist, Dr. LaKeischa Webb McMillan, believes this shift gives those with symptoms, specifically Black women, stronger language to advocate for themselves while also helping physicians better recognize that PMOS can present differently across different people. “If a Black woman first presents to a dermatologist because of hyperpigmentation, uneven skin tone, acne, or male pattern hair growth, the conversation can now more naturally expand into discussions about hormones, menstrual cycles, weight changes, insulin resistance, and metabolic health,” Dr. McMillan told EBONY. “Similarly, if the initial concern is weight gain or difficulty losing weight, the conversation can move beyond simply telling women to ‘eat less and move more’ and instead encourage a more comprehensive evaluation.”
Perhaps this could have helped Board-Certified OBGYN, Dr. Andrea Alexander, who spent a large part of her life viewing her heavy periods and cystic acne as normal, only to be diagnosed with PMOS after medical school and residency training in women’s care. “This name change has the power to make more women feel heard and validated in their wide range of symptoms as they relate to their multi-organ system dysfunction,” Dr. Alexander told EBONY. “This is especially important for Black women, as we historically have been dismissed in and out of the doctor’s office.”
Now that the language behind the condition has changed, we look to what’s next in understanding PMOS and the many ways to treat it.
What Has Previously Worked
The most commonly used treatments for PCOS, now PMOS, are birth control pills, metformin, or a combination of the two. These options are used to help regulate menstrual cycles and aid in gut dysbiosis, androgen excess, weight loss, and ovulation induction. “I understand there is a lot of controversy against combined oral contraceptives, but they still remain a well-studied and great option for patients with menstrual irregularity, and for those who are at increased risk for endometrial hyperplasia (an abnormally thick uterus lining) and carcinoma (epithelial tissue cancer),” Dr. Alexander said.
Other treatment pathways include GLP-1 medicines, Letrozole, Clomiphene, Gonadotropins, IUI, and IVF to help those struggling with infertility. Spironolactone, Eflornithine, hair removal devices, and acne medication can help reduce male-pattern hair growth and improve breakouts.
“I want women to understand that there is no single silver bullet treatment that physicians or the medical community are withholding,” Dr. McMillan told EBONY. “Because of that, treatment often requires a multidisciplinary and multi-lifestyle approach rather than a one-size-fits-all solution or a magic wand answer.”
Ways To Holistically Support Metabolic and Hormonal Dysregulation
Although there are many medications to help ease PMOS symptoms, making gradual lifestyle changes such as regularly exercising, maintaining a low-calorie diet, and taking supplements is another way to help support the body.
“When we talk about supporting hormonal health holistically, many people assume that only means avoiding medications,” Dr. McMillan said. “In reality, a holistic approach means looking at the entire picture and understanding that there are multiple ways to support the body, depending on the individual woman and how PMOS is presenting for her.”
According to Mayo Clinic, losing 5% of your body weight can improve PMOS symptoms and reduce the risk of other health issues. Additionally, our experts suggest implementing simple habits like consuming more whole foods, increasing fiber intake, taking short walks after each meal, and minimizing exposure to endocrine-disrupting chemicals found in certain plastics and processed foods, which can play an important role in balancing hormones, supporting metabolic health, and reducing insulin spikes and dips.
“I have always supported lifestyle changes to be the biggest foundational treatment,” Dr. Alexander said. “This means that we could, and should use a combination of conservative and well-researched methods in treating affected patients.”
As always, it’s important to discuss your options with your personal physician because not every woman with PMOS has the same symptoms and patterns or needs a singular solution.
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