5 Myths About PMOS (PCOS) Gynecologists Wish You’d Stop Believing

Reviewed by Dietitian Madeline Peck, RDN, CDN

Key Points

• PMOS impacts metabolic, cardiovascular and mental health.

• PMOS affects women of all body sizes, and symptoms can vary between people and change throughout life.

• Having PMOS doesn’t mean you can’t get pregnant. Some people conceive without assistance, while others may benefit from fertility treatment.

Misconceptions about polyendocrine metabolic ovarian syndrome (PMOS), formerly known as polycystic ovary syndrome (PCOS), are all too common. PMOS affects hormones, metabolism and reproductive health in more than 170 million women worldwide. Yet diagnosis isn’t always straightforward, and misconceptions can make an already complex diagnosis more confusing.

To clear up the confusion, we asked gynecologists which PMOS myths they wish people would stop believing. Here, they explain how the condition extends beyond the ovaries, why symptoms can differ from person to person and change over time, and how everyday habits can help manage PMOS.

Myth: You Can Only Have PMOS If You Are Overweight

“Women of all shapes and sizes can have PMOS, and while excess weight can make some symptoms worse, weight alone doesn’t tell us how healthy someone is or how PMOS is actually affecting them,” shares Rachel Miller, M.D., M.S.C.P. In fact, body weight isn’t part of the diagnostic criteria for PMOS. In adults, clinicians look for at least two of three features: irregular ovulation or periods; signs of higher androgen levels, such as excess facial hair, or elevated levels on blood tests; and polycystic ovaries identified through an ultrasound or hormone blood test.

A lower body weight doesn’t rule out PMOS’s metabolic effects, either. Guidelines recognize an increased risk of blood sugar problems and type 2 diabetes among individuals with PMOS regardless of BMI.

Myth: Having PMOS Means You Can’t Get Pregnant

Ovulation may be irregular with PMOS, but that doesn’t mean pregnancy is impossible. A PMOS diagnosis does not mean a diagnosis of infertility, says Miller. Because PMOS can make ovulation—the release of an egg—less predictable or less frequent, getting pregnant may take extra time. While PMOS can make conceiving more challenging, some women can conceive without medical assistance, while others may need help with ovulation. Certain lifestyle changes related to exercise, nutrition, sleep and mental health can support pregnancy, and medications can improve ovulation and your chances of getting pregnant.

Myth: PMOS Only Impacts the Ovaries

Before the recent name change, many people assumed polycystic ovaries were a requisite of having PMOS. But that’s not true, Miller says. Not everyone has polycystic ovaries with PMOS. “PMOS affects much more than just the ovaries; it can affect how the body handles blood sugar, hormone levels, menstrual cycles and even mental health,” Miller explains.

Research estimates that more than 80% of individuals with PMOS have hyperandrogenism, characterized by elevated testosterone levels, which can present as excess hair on the face, acne or female-pattern hair loss. Additionally, roughly 70% of individuals with PMOS have insulin resistance, which negatively affects metabolic health and weight and can increase the risk of developing type 2 diabetes.

Myth: PMOS Is the Same for Everyone

“PMOS does not look the same in everyone,” shares Sweta Patel, D.O., FACOG, M.S.C.P. Some women experience irregular periods, while others have more noticeable acne, unwanted facial or body hair or thinning hair on their scalp. The combination and severity of symptoms vary, and emotional well-being and metabolic health deserve just as much attention as other symptoms.

Furthermore, PMOS symptoms can change throughout life, Patel adds. In adolescence, PMOS can lead to irregular periods and acne. During the reproductive years, PMOS may present as irregular ovulation, difficulty conceiving, insulin resistance and androgen-related symptoms that can impact mental health. In menopause, some androgen-related features may persist, and the increased risk of diabetes and cardiovascular disease that accompanies both aging and PMOS becomes more relevant.

Myth: PMOS Only Impacts Reproductive Health

“PMOS can affect much more than reproductive health,” comments Patel. PMOS is associated with other metabolic and cardiovascular conditions, such as metabolic dysfunction-associated steatotic liver disease, elevated cholesterol and high blood pressure. Additionally, women with PMOS have higher odds of depressive and anxiety symptoms, further emphasizing the fact that PMOS is not just an ovary or fertility problem.

Tips for Managing PMOS

• Make a plan with your health care provider. There’s no one-size-fits-all approach to managing PMOS. Treatment typically involves a combination of lifestyle, medical and nutrition interventions.

• Discuss supplements with your health care provider. Inositol is one supplement that may help with certain metabolic aspects of PMOS, Miller says. Still, more research is needed, and you should decide whether to start inositol with your health care provider.

• Prioritize sleep. Research suggests that individuals with PMOS have worse sleep efficiency and take longer to fall asleep than those without PMOS. High-quality sleep supports metabolic health, influencing abdominal fat accumulation and blood sugar regulation. Aim for seven to nine hours of sleep nightly.

• Incorporate physical activity. “Regular physical activity, including both aerobic exercise and strength training, can help maintain a healthy weight and improve insulin sensitivity and overall cardiometabolic health,” says Patel. The general recommendation is to aim for 150 to 300 minutes of moderate-intensity aerobic exercise or 75 to 150 minutes per week of vigorous-intensity aerobic activity, plus two strength-training sessions weekly.

• Focus on adding nutrient-dense foods to your diet. Cutting carbohydrates or only focusing on protein shows no benefit in managing PMOS. Prioritize an eating pattern rich in nutrient-dense and high-fiber foods, such as legumes, whole grains, fruits, nuts, seeds, lean proteins and vegetables.

Our Expert Take

It’s important to cut through the noise to understand what a PMOS diagnosis may actually look like. PMOS can affect women of all body sizes, doesn’t mean infertility, and reaches beyond the ovaries to influence metabolic health and mental health. Because symptoms and health needs can change throughout life, how you manage PMOS should evolve as well. Work with your health care team to monitor your metabolic health, support emotional well-being and build sustainable habits around food, movement and sleep.

Read the original article on EatingWell