Polyendocrine Metabolic Ovarian Syndrome (PMOS)

Polyendocrine metabolic ovarian syndrome, or PMOS, is a very common ovulation disorder. It can affect our whole bodies and many aspects of health throughout our entire lives.¹ This condition was known as polycystic ovary syndrome (PCOS) until 2026.  “Poly” is a word element meaning “many.” The endocrine system is the network of glands and organs in our bodies that produce and regulate hormones. Metabolism refers to the chemical reactions that happen in the living cells in our bodies. And the ovaries produce eggs (ova) along with hormones related to menstruation and pregnancy. The change of name from PCOS  to PMOS recognizes the condition as a whole-body syndrome rather than focusing on ovarian cysts as its distinct marker.2 

The criteria for a PMOS diagnosis have changed a fair amount over time. Doctors and researchers are still learning more about the condition. For example, they are studying why different patients may have totally different symptoms. To diagnose PMOS, doctors nowadays look for at least two of these criteria:³

• Irregular ovulation. For example: your ovaries are not releasing eggs predictably, or when they’re supposed to, which can lead to having irregular periods.
• Too many cysts on your ovaries.
• Producing more androgen hormones (androgens) than expected. (Testosterone is one of the most well-known androgens. People with testes are not the only ones whose bodies make androgens. Most of us produce at least some androgens. We make much more if we have testes.)

Doctors diagnose PMOS through what they call a “process of exclusion.” This means that before deciding whether a patient has PMOS, they first consider whether the patient might have another androgen-related condition. If you have another androgen-related disorder, doctors won’t diagnose you with PMOS.⁴  No double jeopardy!

Causes: While PMOS has been around for a long time, researchers are still learning more about what may cause it to develop for different types of people. Many different factors probably influence how likely a person is to develop PMOS. For example, PMOS can often run in families because of genetics, but scientists think that lifestyle and environment can play a role too.⁵  Whatever the causes, the most important thing to remember is that having PMOS is never anyone’s fault.

PMOS affects different bodies in different ways.⁶  Two people can both have PMOS and have a totally different set of symptoms, and symptoms can also change over time.⁷  The most common symptoms are:

• Irregular periods (periods that don’t typically arrive around the same time every month)⁸
• Hair growth or extra hair in areas like the chin, back, or upper lip, where people with ovaries do not commonly have much hair^{8, 9}

Some of this might sound overwhelming, especially if you’re just learning about PMOS. But there is help for symptoms that bother you.

Really common. It’s the most common ovulation disorder in people who have ovaries, affecting about 5 to 10% (some say even more).^{6, 10}  It’s not always diagnosed, though — a lot of people have it and don’t realize it. Many discover they have it when they see a doctor about difficulty getting pregnant.¹¹

There is no cure for PMOS, even if you have surgery to remove your ovaries. But there is a lot you can do to manage symptoms that bother you.^{12, 13} You might start is by thinking through your own needs and preferences. Which symptoms bother you most? Do you want to become pregnant, now or in the future? How do you feel about taking medications? What are your health goals? What do you want your body to look like?

If you’re seeing a doctor, they will want to know these things so you can come up with a treatment plan together. They’re the experts on the medicine, but you’re the expert on you, and both pieces are important to coming up with a plan that will work for your lifestyle.

Here are a few common treatments and what they’re used for:

Contraception: This is one of the most common ways to manage PCOS symptoms.  Along with lowering the risk of pregnancy, hormonal intrauterine devices (IUDs), birth control pills, the patch and the ring, can help make periods more predictable and lower the risk of certain types of cancers (for many people, not just people with PMOS).¹⁴  Birth control pills also lessen hair growth in uncommon areas.¹⁵

Antiandrogen drugs: These types of drugs (the most common one is called spironolactone) lowers the amount of androgens in your body. As a result, this helps stop some of the symptoms extra androgens cause, like hair growth in less common places, thinning head hair, and acne.¹⁶

Metformin: This is a really common medication prescribed to people with PMOS. It can help your body better process sugar if you have insulin resistance.¹⁷ It can sometimes be a good option to help you have more regular periods for people who don’t want to take birth control, but it isn’t recommended for everyone.

Infertility treatment: If you’re interested in getting pregnant, there are a few therapies that can help with this. What they usually do is cause the ovaries to release more eggs, boosting your chances of getting pregnant.¹⁸

Depression/anxiety treatments: The mental aspects of PMOS can be exhausting, especially if you’re just finding out you have a health condition. And these aspects deserve attention, too. Aside from improving your quality of life, treating depression and anxiety can have a big impact on your physical health — for one thing, it’s hard to manage a health condition (take medications, eat differently, etc) when you aren’t feeling your best.¹⁹  Some people may treat depression or anxiety through therapy, medications, journaling, stress reduction techniques like meditation and yoga, or a mix. Everybody is different, so it’s all about figuring out what makes your mind feel good.

Finding community: For many people, it helps to hear from others who are going through the same thing. Having a health condition like PMOS can feel isolating. People just don’t talk enough about PMOS outside of a few online communities.  Unfortunately, many communities center mostly around cis women, although there are a few sites with information specific to trans men or gender nonconforming people. Many people find comfort in connecting with others online about their condition, though it is important to remember that even well-meaning people may sometimes share things that aren’t always accurate in these spaces. Our Bodies Ourselves and your doctor are good sources for medical information itself.

Sleep treatment: Not feeling rested is another one of those things that just makes everything else harder. People with PMOS are more likely to have a condition called sleep apnea, for which there is testing and treatment available.²⁰ You can also try to improve your sleep through habits, like going to bed at a more regular time, drinking enough water before bed, or drinking less caffeine late in the day.²¹

Lifestyle changes: And now, dear readers, for the diciest yet possibly powerful treatment option: lifestyle change. Odds are good that if you talk to a doctor about PMOS, they’ll recommend some form of lifestyle change, either on its own or along with another treatment. That’s because the way you live day-to-day, like the foods you choose to eat or how much exercise you get, can have a really big impact on PMOS. Some studies show changing your diet can help with a wide range of symptoms like period regularity, fertility, mood, risk of getting a heart condition, risk of getting diabetes, and overall quality of life.²²

Another tricky subject is weight loss. Doctors will often specifically recommend weight loss for PMOS if you are overweight according to their metrics. And this recommendation is just.so.complicated. Yes, there’s evidence that lowering your body weight can help with some symptoms of PMOS. But experts do not agree about the exact relationship between weight and PMOS.^{23, 24} And losing weight long-term is very, very difficult. In fact, when a doctor recommends weight loss, not only is it unlikely to be helpful, but it may actually worsen weight-related stigma and stress. According to a 2010 article in Nutrition Journal, “Concern has arisen that this weight focused paradigm is not only ineffective at producing thinner, healthier bodies, but also damaging, contributing to food and body preoccupation, repeated cycles of weight loss and regain, distraction from other personal health goals and wider health determinants, reduced self-esteem, eating disorders, other health decrement, and weight stigmatization and discrimination.”²⁵

Focusing less on weight, and more on body positivity and health-promoting behaviors (like through a movement called Health at Every Size) may be a much better way to improve your health.²⁵ It can be difficult to choose against attempting weight loss when many cultures and many doctors discriminate against fat people.²⁶ (Plus when there’s a multi-billion dollar diet industry in the US alone tries to tell you that changing your body shape is the key to health and happiness…) But you have a right to do what you feel is best for you and your body.

The effect of GLP-1 medications like Ozempic for people with PMOS is still unclear. So far, the scientific evidence suggests that GLP-1s can often help with hormone levels, lowering excess fats called “triglycerides,” and slimming bellies overall. It is becoming more common for people with PMOS to discuss these medications with their healthcare providers. But it’s always important to remember that there is a lot more to health than your body size alone.²⁷

Getting started with a health behavior change

If you decide to try some form of lifestyle changes (whether you’re attempting weight loss or not), here are a few behaviors that are shown to help people with PMOS:

• Eating low-glycemic foods (foods that are less likely to spike your blood sugar).²⁸
• Getting more physical activity that you enjoy.²⁹
• Lowering the amount of alcohol you drink.³⁰
• Smoking less (or quitting) if you smoke currently.³⁰

If you do attempt some kind of lifestyle change, it’s best to start slowly instead of trying to change everything at once. Pick one small thing to try first, and when that’s become a habit, add another. And keep in mind that changing behaviors is difficult—so give yourself some grace when you mess up. You’re more likely to succeed long term if you avoid blaming yourself (“I have no willpower!” “I’m never going to get this!”) and instead simply tell yourself that your strategy needs some editing (“Maybe if I make myself a playlist, I’ll be more motivated to go for a walk”).^{31, 32}

PMOS might be more common among trans men who haven’t started testosterone therapy.³³  It’s unfortunate that, like with many areas of scientific study, research and treatment focus primarily on cis people. But there is some research that shows people can successfully take testosterone therapy without making metabolic symptoms of PMOS (like diabetes risk) worse. One study showed that taking additional testosterone did not lead to worse PMOS symptoms like high blood sugar, high cholesterol, or higher diabetes risk among transgender men.^{34, 35} (Taking testosterone may, however, lead to more acne, thinning head hair, and hair growth on the face and body.)

Especially if you’re new to PMOS, getting used to having a lifelong condition and sorting through all the treatment options can be overwhelming. And if, like many people, it took a while for your symptoms to get diagnosed, you may be just plain exhausted with the healthcare system. This is normal and very understandable.

But there is a good chance that, in time, you can find a way to treat symptoms that bother you. Go at a pace that feels right to you, and if you’re talking with a doctor, stay in touch about what is or isn’t working. You may need to try a few different things before you find a plan that works well for your life and needs. Although it may not always be easy, it is possible to live a full and happy life with PMOS.

A Note on Forums: As you know, community forums can contain wonderful solidarity and important perspectives that don’t make it to academic journals, but can also contain negativity and inaccuracies. Seek out the resources that feel right for you.

1 Peebles E, Wang Z, Dracup E, Sarcione C, Curry CL, Abrams K, Onnela JP, Williams MA, Hauser R, Coull B, Mahalingaiah S. "Utilizing a digital cohort to understand the health burden and lifestyle characteristics across the life course in individuals with polycystic ovary syndrome and possible PCOS." Front Endocrinol (Lausanne). 2025 Sep 19;16:1585628. doi: 10.3389/fendo.2025.1585628. PMID: 41048429; PMCID: PMC12491046.  (2025)

2 American Society for Reproductive Medicine. "PCOS is Now PMOS: Understanding the Name Change," accessed August 4, 2026.

3 Apple Women's Health Study. "Periods, polycystic ovarian syndrome, and heart health," accessed August 4, 2026.

4 Goodarzi M, Azziz R. “Diagnosis, epidemiology, and genetics of the polycystic ovary syndrome.” Best Practice & Research Clinical Endocrinology & Metabolism. 20(2). (2006): 193-205.

5 Peebles E, Mahalingaiah S. "Environmental Exposures and Polycystic Ovary Syndrome: A Review." Semin Reprod Med. 2024 Dec;42(4):253-273. doi: 10.1055/s-0044-1801405. Epub 2025 Feb 5. PMID: 39909399; PMCID: PMC12161124.

6 Mohammad M, Seghinsara A. “Polycystic Ovary Syndrome (PCOS), Diagnostic Criteria, and AMH.” Asian Pacific Journal of Cancer Prevention. 18 (1). (2017): 17-21.

7 Welt C, Carmina E. “Lifecycle of Polycystic Ovary Syndrome (PCOS): From In Utero to Menopause.” Journal of Clinical Endocrinology & Metabolism. 98 (12). (2013): 4629-4638.

8 Norman R, Dewailly D, Legro R, Hickey T. “Polycystic Ovary Syndrome.” The Lancet. 370(9588). (2007): 685-697. https://pmc.ncbi.nlm.nih.gov/articles/PMC12086426/

9 Wolf AT, Wang Z, Onnela JP, Baird DD, Jukic AMZ, Curry CL, Fischer-Colbrie T, Williams MA, Hauser R, Coull BA, Mahalingaiah S. Signs of Potential Androgen Excess Across the Lifespan in a US-based Digital Cohort Study. J Clin Endocrinol Metab. 2025 May 19;110(6):1667-1679. doi: 10.1210/clinem/dgae674. PMID: 39388314; PMCID: PMC12086404. https://pubmed.ncbi.nlm.nih.gov/39388314/

10 Setji T, Brown A. “Polycystic Ovary Syndrome: Update on Diagnosis and Treatment.” The American Journal of Medicine. 127(10). (2014): 912-919.)

11 Dunaif A, Fauser B. “Renaming PCOS — A Two-State Solution.” The Journal of Clinical Endocrinology & Metabolism. 98(11). (2013): 4325-4328.

12 Imborek K, Graf E, McCune K. “Preventive Health for Transgender Men and Women.” Reproductive Medicine. 35 (5). (2017): 426-433

13 ASRM. Recommendations from the 2023 International Evidence-Based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. 2023.

14 Azziz R, Chang W, Stanczyk F, Woods K. “Effect of Bilateral Oophorectomy on Adrenocortical Function in Women with Polycystic Ovary Syndrome (PCOS).” Fertil Steril. 99(2).(2013): 599-604.

15 Chan KJ, Liang JJ, Jolly D, Weinand JD, Safer JD. “Exogenous Testosterone Does Not Induce Or Exacerbate The Metabolic Features Associated With Pcos Among Transgender Men.” Endocrinology Practice. 24(6). (2018): 565-572.

16 American College of Obstetricians and Gynecologists. “Polycystic Ovary Syndrome (PCOS) FAQ.” (2017)

17 Benshushan A, Paltiel O, Rojansky N, Brzezinski A, Laufer N. “IUD use and the risk of endometrial cancer.” European Journal of Obstetrics & Gynecology and Reproductive Biology. 105(2). (2002): 166-169.

18 Archer JS, Chang J. “Hirsutism and acne in polycystic ovary syndrome.” Best Practice & Research Clinical Obstetrics & Gynaecology. 18(5). (2004): 737-754.

19 Nardo LG, Rai R. “Metformin therapy in the management of polycystic ovary syndrome: endocrine, metabolic and reproductive effects.” Gynecological Endocrinology. 15(5). (2009): 373-380.

20  Tannus S, Burke YZ, Kol S. “Treatment strategies for infertile polycystic ovary syndrome patient." Womens Health. 11(6). (2015): 901-12.)

21 Moussavi S, Chatterji S, Verdes E, Tandon A, Patel V, et al. “Depression, chronic diseases, and decrements in health: results from the World Health Surveys.” The Lancet. 370(9590). (2007): 851-858.

22 Thomson RL, Buckley JD, Lim SS, Noakes M, Clifton PM, et al. “Lifestyle management improves quality of life and depression in overweight and obese women with polycystic ovary syndrome.” Fertility and Sterility. 94(5). (2010): 1812-1816.

23 Clark AM, Ledger W, Galletly C, Tomlinson L, Blaney F, et al. “Weight loss results in significant improvement in pregnancy and ovulation rates in anovulatory obese women.” Human Reproduction. 10(10). (1995): 2705-2712.

24 Kataoka J, Tassone EC, Misso M, Jaham AE, Stener-Victorian, et al. “Weight Management Interventions in Women with and without PCOS: A Systematic Review.” Nutrients. 9(9). (2017): E996.

25  Bacon L, Aphramor L. “Weight Science: Evaluating the Evidence for a Paradigm Shift.” Nutrition Journal. 10(9). (2011): 69.

26 Phelan SM, Burgess DJ, Yeazel MW, Hellerstedt WL, Griffin JM, van Ryn M. “Impact of weight bias and stigma on quality of care and outcomes for patients with obesity.” Obesity Treatments/Outcomes. 16(4). (2015): 319-326.

27 De Athayde De Hollanda Morais BA, Prizão VM, Souza MM, Mendes BX, Defante MLR, Martins OC, Rodrigues AM. "The efficacy and safety of GLP-1 agonists in PCOS women living with obesity in promoting weight loss and hormonal regulation: A meta-analysis of randomized controlled trials." Journal of Diabetes and its Complications 38:10 (Oct 2024).

28 Marsh KA, Steinbeck KS, Atkinson FS, Petocz P, Brand-Miller JC. “Effect of a low glycemic index compared with a conventional healthy diet on polycystic ovary syndrome.” The American Journal of Clinical Nutrition. 92(1). (2010): 83-92.

29 Moran LJ, Harrison CL, Hutchison SK, Stepto NK, Strauss BJ, et al. “Exercise Decreases Anti-Müllerian Hormone in Anovulatory Overweight Women with Polycystic Ovary Syndrome – A Pilot Study.” Hormone and Metabolic Research. 43(13). (2011): 977-979. Also see Hutchison SK, Stepto NK, Harrison CL, Moran LJ, Strauss BL, Teede HJ. "Effects of Exercise on Insulin Resistance and Body Composition in Overweight and Obese Women with and without Polycystic Ovary Syndrome." The Journal of Clinical Endocrinology & Metabolism, Volume 96, Issue 1, 1 January 2011, Pages E48–E56, https://doi.org/10.1210/jc.2010-0828

30 Norman RJ, Davies MJ, Lord J, Moran LJ. “The role of lifestyle modification in polycystic ovary syndrome.” Trends in Endocrinology and Medicine. 13(6). (2002): 251-257.

31 Gilbert P, Procter S. “Compassionate mind training for people with high shame and self‐criticism: overview and pilot study of a group therapy approach.” Clinical Psychology and Psychotherapy. 13(6). (2006): 353-379.

32 Strecher VJ, DeVellis BM, Becker MH, Rosenstock IM. “The Role of Self-Efficacy in Achieving Health Behavior Change.” Health Education & Behavior. 12(1). (1986)

33 Kahal H, Kyrou I, Tahrani AA, Randeva Hs. “Obstructive sleep apnoea and polycystic ovary syndrome: A comprehensive review of clinical interactions and underlying pathophysiology.” Clin Endocrinol (Oxf). 87(4). (2017): 313-319.

34 Kahal H, Kyrou I, Tahrani AA, Randeva Hs. “Obstructive sleep apnoea and polycystic ovary syndrome: A comprehensive review of clinical interactions and underlying pathophysiology.” Clin Endocrinol (Oxf). 87(4). (2017): 313-319..

35 Brown FC, Buboltz WC, Soper B. “Relationship of Sleep Hygiene Awareness, Sleep Hygiene Practices, and Sleep Quality in University Students.” Behavioral Medicine. 28(1). (2010): 33-38.