What you may not know about PMOS
By Dr. Shreya Batra, ND
What is PMOS?
Polyendocrine Metabolic Ovarian Syndrome (PMOS), formerly known as Polycystic Ovary Syndrome (PCOS), is a common hormonal and metabolic condition that can affect many aspects of a woman's health, including menstrual cycles, ovulation, metabolism, skin, hair, weight, and fertility.
The condition was renamed this year, 2026, because the previous name placed too much emphasis on the ovaries and “cysts,” when PMOS is a complex, whole-body endocrine and metabolic condition. Importantly, ovarian cysts are not required to have PMOS.
Common signs and symptoms of PMOS include:
Irregular or absent menstrual periods
Difficulty with ovulation
Weight gain or difficulty managing weight
Excess hair growth on the chin, chest, abdomen, thighs, or other areas (hirsutism)
Severe or persistent acne, including acne that continues into adulthood
Oily skin
Darkened patches of skin
Signs of increased androgen levels, such as excess facial or body hair
Polycystic ovarian morphology (an increased number of follicles on the ovaries) seen on ultrasound
It is important to remember that you do not need to have all of these signs and symptoms to have PMOS. In fact, some women with PMOS may have no obvious ovarian changes on ultrasound, or relatively few outward symptoms.
Diagnosis is based on a combination of clinical features, laboratory testing, medical history, and, when appropriate, ultrasound findings. In adults who have both irregular menstrual cycles and signs of increased androgens, an ovarian ultrasound may not be necessary to establish a diagnosis.
What you may not have been told about PMOS
PMOS can affect fertility—but it does not mean you cannot get pregnant
PMOS is one of the most common causes of ovulatory infertility. Irregular periods often indicate that ovulation is occurring inconsistently or not at all, but this does not mean that you are infertile.
Understanding why ovulation is irregular and addressing the underlying hormonal and metabolic factors can help support more regular ovulation and improve fertility. A diagnosis of PMOS is not a dead-end to your fertility journey.
It is not just about reproductive hormones
One of the most important changes reflected in the new name is the recognition of the metabolic and endocrine components of PMOS.
Insulin resistance and impaired glucose regulation can play an important role for many people with PMOS. These metabolic factors can interact with reproductive hormones and influence ovulation, menstrual regularity, weight, and other symptoms.
You do not have to have ovarian cysts
Despite the old name, actual ovarian cysts are not a defining requirement of PMOS.
The ovaries may show an increased number of small follicles, sometimes referred to as polycystic ovarian morphology. These follicles are not the same thing as pathological ovarian cysts.
You can therefore have PMOS without having “cysts” on your ovaries. Conversely, having polycystic-appearing ovaries on an ultrasound does not automatically mean that you have PMOS.
You can have PMOS at any body size
PMOS is not synonymous with obesity.
Although excess weight and metabolic dysfunction can be associated with PMOS, people of all body sizes can have the condition. Someone who is at a “normal” weight and does not have polycystic-appearing ovaries can still meet diagnostic criteria based on other features, such as irregular ovulation and clinical or biochemical evidence of increased androgen levels.
This is one reason it is important to look at the whole picture, rather than relying on weight or ultrasound findings alone.
What happens after stopping the birth control pill?
Some people notice that their menstrual cycles remain irregular for a period of time after stopping hormonal birth control. Acne or increased hair growth may also become more noticeable after stopping the pill.
However, irregular cycles after stopping birth control should not automatically be assumed to represent “temporary PMOS.” Hormonal contraception can suppress ovulation and alter menstrual bleeding patterns, and persistent irregular periods should be evaluated to determine the underlying cause.
If your cycles were previously regular and remain irregular after stopping the pill, it is worth working with your healthcare provider to investigate the possible causes rather than assuming that PMOS is the explanation.
Supporting your health with PMOS
There is no single approach that works for everyone with PMOS. A personalized approach can address menstrual health, ovulation, metabolic health, nutrition, movement, sleep, stress, and fertility goals.
Reduce chronic stress - Chronic stress can affect sleep, appetite, metabolic health, and reproductive hormones, and may contribute to worsening symptoms for some people.
Finding sustainable ways to manage stress—whether through mindfulness, time outdoors, restorative movement, adequate sleep, social connection, or other approaches that work for you—can be an important part of overall hormone and metabolic health.
Move your body regularly - Regular physical activity is beneficial for metabolic health, insulin sensitivity, cardiovascular health, mood, and overall well-being.
The best form of exercise is one that is sustainable and appropriate for your body. This may include strength training, walking, cycling, swimming, yoga, or other forms of movement.
More exercise is not always better. Excessive training combined with inadequate nutrition can interfere with reproductive function in some individuals. The goal is to find a balance that supports your health rather than placing additional stress on your body.
Focus on balanced nutrition - Nutrition can play an important role in supporting metabolic and hormonal health.
Rather than focusing on restrictive diets, consider building balanced meals that include:
Protein
Fibre-rich carbohydrates
Healthy fats
Plenty of vegetables and other nutrient-dense foods
Consistently under-eating or overeating can affect energy availability, metabolic health, and reproductive function. If insulin resistance or glucose regulation is a concern, your individual dietary pattern should be assessed as part of a broader treatment plan.
What’s Next?
If you are experiencing irregular periods, acne, unwanted hair growth, difficulty with ovulation, metabolic concerns, or other signs of hormonal imbalance, you do not have to navigate it alone.
Book an appointment—or a complimentary 15-minute meet and greet—to learn more about your symptoms and how we can work together to support your hormonal, metabolic, and reproductive health.
Disclaimer
Please note that content on this website is intended for informational purposes only and is not intended as a substitute for the advice provided by your physician or other healthcare professional, nor is it meant to diagnose or treat a health problem, symptom, or disease. Always speak with your physician or other healthcare professional before taking any medication or nutritional supplement or using any treatment for a health problem. If you have or suspect that you have a medical problem, contact your healthcare provider promptly. Do not disregard professional medical advice or delay in seeking professional advice because of something you have read on this website. Information provided on this website does not create a doctor-patient relationship between you and any doctor affiliated with our website.
Comments