Polyendocrine metabolic ovarian syndrome

Polyendocrine metabolic ovarian syndrome (PMOS), previously called polycystic ovary syndrome (PCOS), is the most common hormonal disorder in women of reproductive age. PMOS is diagnosed when a woman has at least two of the following three features: irregular menstrual periods, high testosterone or related symptoms (like excess facial hair), or an excess of antral ovarian follicles on ultrasound; women with PMOS are not more likely than those without to have true ovarian cysts. A blood test for high levels of anti-Müllerian hormone can replace the ultrasound in the diagnosis. Other symptoms associated with PMOS are heavy periods, acne, difficulty getting pregnant, and patches of darker skin. The exact cause of PMOS remains uncertain. There is a clear genetic component, but environmental factors are also thought to contribute. PMOS occurs in between 5% and 18% of women. The disorder is linked to insulin resistance, which is made worse by obesity. Insulin resistance and related excess insulin levels increase the risk of complications such as type 2 diabetes and liver disease. Women with PMOS also have higher risk of endometrial cancer.

Management focuses on relieving symptoms and reducing long-term risks. A healthy lifestyle and weight control are recommended for general management. In addition, hormonal contraception can help regulate menstrual cycles and reduce acne and excess hair growth. Metformin, a common anti-diabetes drug, increases insulin sensitivity. For fertility, ovulation can be induced with letrozole, among other methods. In addition, women can be monitored for cardiometabolic risks, and during pregnancy.