Polycystic ovary syndrome (PCOS) is one of the most common, yet historically underfunded and under-researched conditions. PCOS was recently renamed polyendocrine metabolic ovarian syndrome (PMOS) to address the inadequate treatment that has resulted from its perception as a condition limited to fertility.
PMOS is a hormonal health disorder that affects 10–13% of reproductive-aged women globally, with estimates that up 70% of women with PMOS worldwide do not know they have this condition. The syndrome presents very differently from patient to patient. Symptoms for PMOS include unpredictable, absent, or heavy, long, and painful periods, infertility, excessive hair on the face or body, female-pattern baldness or hair thinning, and acne or oily skin.
The exact cause of PMOS is unknown, but the diagnosis includes excess androgens, a hormone usually considered a male hormone. Other characteristics include elevated insulin levels, which can promote obesity and increase PMOS symptoms. Due to insulin resistance, slower metabolic rate, hormonal imbalances and increased inflammation, the type of obesity that people with PMOS have is more difficult to treat.
The name change from PCOS to PMOS emphasizes that PMOS is a complex metabolic and endocrine disorder that affects more than reproductive health. For example, patients with PMOS describe symptoms that impact their relationship with food. The change in the name and shift in conversation surrounding the condition, will encourage further research on the effects of PMOS, including a focus on food related behaviors.
With the growing recognition of PMOS as a metabolic disorder, and insulin resistance as a critical aspect of the condition, research has explored the use of GLP-1s in patients with PMOS. Clinical trials assessing combination treatments that included GLP-1s, were found superior for reducing body weight and cardiovascular and metabolic markers, when compared to using sodium-glucose cotransporter-2 inhibitors, which are a different class of glucose-lowering medications. Because 80% of women with PMOS have overweight or obesity, GLP-1 use can dramatically improve their associated symptoms. However, PMOS does not present in the same manner for every patient; treatment should be individualized based on the needs of the specific patient, their symptoms, and their concerns/priorities.
For the millions of women who have spent years undiagnosed, mis-diagnosed, undertreated, or simply not believed, this name shift to PMOS signals an overdue change. The language we use to describe PMOS drastically shapes how patients are treated, how their symptoms are regarded, and whether they seek help at all. The official name change of PCOS to PMOS, is the first step in a long journey to ensure these patients are met with appropriate care and treatment.