PMOS (Formerly PCOS)
PMOS, or Polyendocrine Metabolic Ovarian Syndrome, is a term used to describe a multi-systemic condition that involves more than just the ovaries. It can present with a range of symptoms such as insulin resistance, metabolic dysfunction, hormonal imbalances, inflammation & nervous system dysregulation.
In the past, PMOS (formerly known as PCOS) has been difficult to diagnose due to varying symptoms, as well as constant changes in testing and diagnostic guidelines, however having recently been renamed PMOS, this .
There are four types of PMOS, that are characterised by different symptoms and pathology. Identifying the correct type of PMOS is important in order to inform treatment.
The four types of PMOS include:
• Insulin resistance PMOS
• Adrenal PMOS
• Post-pill PMOS
• Inflammatory PMOS
Insulin Resistant PMOS:
This type of PMOS is characterised by elevated insulin levels, which then increase androgen levels. As a result, insulin resistant MCOS can present with symptoms of androgen excess such as weight gain, acne, dark hair growth, fatigue and sugar cravings.
A primary focus of addressing insulin resistant PMOS is stabilising blood sugar levels and reducing insulin.
Post-Pill PMOS:
Post-pill PMOS occurs when transitioning off the oral contraceptive pill as a result of a surge in androgens that were previously suppressed while on the pill. This type of PMOS is temporary, and generally lasts for 3-6 months after cessation of the pill. Post-pill PMOS is typically characterised by irregular or absent menstrual cycle, acne & dark hair growth.
Inflammatory PMOS:
Inflammatory PMOS leads to hyperstimulation of the ovaries, which results in an overproduction of testosterone. Common symptoms of inflammatory PMOS include headaches, joint pain, fatigue, skin complaints and bowel changes alongside an irregular menstrual cycle.
Adrenal PMOS:
Adrenal PMOS is characterised by elevated DHEAS alongside normal testosterone and androstenedione levels on a blood test. Adrenal PMOS is fairly uncommon, and accounts for only 10% of PMOS cases. It is generally a result of an impaired stress response.