All About Polyendocrine Metabolic Ovarian Syndrome (PMOS)

Polyendocrine metabolic ovarian syndrome (PMOS) is a condition that affects the production and balance of hormones in the body, which can lead to infertility, irregular periods, weight gain, and many other symptoms. It was previously known as polycystic ovary syndrome (PCOS).

This condition can affect anyone born with ovaries, yet studies suggest many people with PMOS are undiagnosed. Many don’t realize they have the condition until they struggle to become pregnant or experience unexplained weight gain.

Symptoms of PMOS typically occur during puberty or the first menstrual period, but they may not become apparent until later in life. Many people miss the signs of PMOS, as they can range widely and vary from person to person.

Additionally, polyendocrine metabolic ovarian syndrome presents symptoms that can be caused by a range of other pelvic conditions. As a condition often diagnosed by exclusion, receiving a timely diagnosis can be more difficult.

Due to this, many people will deal with PMOS symptoms for many years before getting a diagnosis—but why does this matter?

The sooner you get a diagnosis, the sooner you can make lifestyle choices to protect your health and lessen your symptoms. Polyendocrine metabolic ovarian syndrome puts individuals at higher risk of other health conditions such as insulin resistance, type 2 diabetes, cardiovascular disease, sleep apnea, and other metabolic concerns; so diagnosis can be very beneficial for preventative health reasons.

While PMOS does not currently have a known cure, there are ways to manage your symptoms. Therefore, diagnosis can be necessary for those who are looking to lessen their symptoms or become pregnant one day!

Because PMOS can affect blood sugar regulation, hormone signaling, and cardiovascular risk, diagnosis can also support long-term metabolic health.

PMOS symptoms can be very different from person to person. Some more commonly known symptoms include oily skin, acne, weight gain, thinned hair (scalp), increased facial or body hair growth, infertility, and periods that are irregular, heavy, painful, or long.

Other possible symptoms include:

• Dark skin patches
• Fertility struggles
• Challenges pre-pregnancy and during pregnancy
• Enlarged ovaries
• Mood swings
• Anxiety or depression
• Sleep disorders
• Difficulty with weight regulation

One person’s experience with polyendocrine metabolic ovarian syndrome can be very different from another with the same condition. PMOS symptoms can be mild for some, yet more significant for others. Some people may not even experience any symptoms.

This may be because the condition affects many different hormones in different ways, which we’ll discuss below.

First, it may help to understand the systems that this condition affects. Polyendocrine metabolic ovarian syndrome symptoms occur due to a variety of hormonal, metabolic and inflammatory changes within the body.

Your endocrine system is what creates and releases hormones. The “polyendocrine” part of PMOS refers to how this condition affects multiple types of hormones. It is a condition that causes dysregulation of the body’s hormone production and the body’s usage of its hormones.

Unlike with the previous naming of this condition (PCOS), which suggested the idea that the condition only affected the ovaries, polyendocrine metabolic ovarian syndrome can actually affect other areas such as the pancreas, thyroid, adrenal glands, and more.

The updated name better reflects that this condition affects multiple hormonal systems and metabolic processes throughout the body, rather than being solely an ovarian condition. 

This means that PMOS can have very significant effects on metabolic health. Remember how we mentioned that early diagnosis can help you prevent things like diabetes or cardiovascular conditions? These aspects are directly tied to your metabolic health!

Metabolic health refers to your body’s ability to digest and absorb nutrients, as well as how your body manages things like blood sugar, blood pressure, and cholesterol. PMOS can affect how the body processes insulin and energy.

As you can see, the effects of PMOS can result in many different altered processes within the body. However, these effects don’t necessarily look the same for everyone. Individuals with polyendocrine metabolic ovarian syndrome may have any combination of the following characteristics:

Hyperandrogenism

A higher level of androgens (a type of sex hormone, testosterone being the most well-known example) can interfere with regular ovulation, which can lead to more irregular periods, a higher number of immature follicles on the ovaries, excess hair growth, and acne.

Insulin Resistance

Insulin resistance often causes an overabundance of insulin (known as hyperinsulinemia), as the body tries to make up for the lowered usage of insulin by creating more and more of the hormone. This overabundance of insulin increases production of androgens and negatively affects ovulation.

Hormonal Imbalances

As you can see from the points listed above, an overabundance of hormone production is the primary cause of PMOS symptoms, though this overabundance can be a result of many different processes and occur in different severities. These hormones cause irregular ovulation, irregular menstruation, difficulties with fertility, and a wide range of other symptoms.

It’s important to note that insulin and androgen are not the only hormones at play for those with PMOS. For example, the luteinizing hormone (LH) also holds an important role in ovulation, and an imbalance of this hormone (often seen in PMOS) can affect fertility and menstruation.

Polyendocrine metabolic ovarian syndrome is actually rather complex, as it can be caused by a combination of many different hormonal disruptions—hence the shift away from the previous naming of “polycystic ovary syndrome.”

About Polycystic Ovaries

Polycystic ovaries refer to ovaries with a higher number of small fluid-filled structures, often called follicles.

These follicles are most commonly identified on pelvic ultrasound, the standard imaging study for evaluating polycystic ovaries. They may also be visible on other imaging studies performed for unrelated reasons. Although these structures are commonly referred to as “cysts,” they are not the same as the larger ovarian cysts that people often associate with pain or other problems. 

Ovarian follicles are a normal part of the ovulation process and do not necessarily cause pain or symptoms. Painful ovarian cysts are usually much larger and can cause discomfort, pulling, or a bursting sensation. 

Everyone has ovarian follicles, but people with polycystic ovaries often have a greater number of them. These ovarian changes are often associated with the hormonal and metabolic dysregulation found with polyendocrine metabolic ovarian syndrome. 

However, it’s important to know that not every person with PMOS has polycystic ovaries, nor does everyone with polycystic ovaries have PMOS. This aligns with the recent renaming of the condition and the recognition that it is more complex than we originally thought.

Unfortunately a direct cause for PMOS isn’t known, and while there is currently no known cure for PMOS, the good news is that your symptoms can be effectively managed!

There are many effective ways to manage your symptoms and improve your quality of life while living with PMOS. In addition to hormonal therapies and lifestyle changes, pelvic floor physical therapy can help support a healthy exercise regimen, better manage your period pain, and provide relaxation strategies and nervous system regulation techniques.

It is also important to note that the symptoms of PMOS (painful or irregular periods, weight gain, anxiety, etc.) often affect a person’s quality of life, work, intimacy, and overall health. Each of these symptoms, in addition to the stress of living with chronic health struggles, can lead to pelvic floor tension or pelvic floor weakness.

About Your Pelvic Floor

You might be wondering, “What’s a pelvic floor?” The pelvic floor is an important group of muscles in the pelvis that each and every person has. They support your pelvic organs, stability, balance, and movement. They help you lift items, play sports, support pregnancy, use the restroom, engage in sexual activity, and much more!

In many cases, these muscles can become dysfunctional, which is known as pelvic floor dysfunction. Pelvic floor tension and weakness are two very common types of pelvic floor dysfunction, and they can contribute to symptom burden and quality-of-life limitations.

Polyendocrine metabolic ovarian syndrome can also contribute to the presence of pelvic floor dysfunction through weight fluctuations, hormonal imbalances, stress, and pain guarding (associated with irregular or painful periods).

In other words, individuals with PMOS may experience a cycle of perpetuated symptoms due to pelvic floor dysfunction. If you experience symptoms like urinary incontinence, pelvic pain, constipation, painful sex, back pain, or other urinary, bowel, and sexual dysfunctions, you are experiencing pelvic floor dysfunction.

A pelvic floor physical therapist will be able to identify weakness or tension in your pelvic floor and address those problems with a variety of treatment methods. Manual therapy, curated exercise, behavioral modifications, relaxation techniques, and many other treatments will support better pelvic health and a better overall quality of life!

Don’t hesitate to reach out for a consultation if you are struggling with pelvic floor dysfunction or other effects of PMOS. We can get you started right away on treatment to better manage your symptoms!

If you have any appointment related questions, try a free discovery call.