The biggest myths about a common women’s condition — and why it’s so difficult to diagnose
What’s in a name?
When it comes to medical conditions, the right moniker can mean the difference between a delayed diagnosis and an accurate one.
Take polyendocrine metabolic ovarian syndrome (PMOS), for example. Formerly known as polycystic ovary syndrome (PCOS), the condition affects 1 in 8 women of reproductive age worldwide.
Experts recently renamed the disorder after decades of confusion caused by the old name, which never accurately reflected what patients were experiencing.
PMOS is a complex condition involving multiple interconnected body systems with symptoms that extend well beyond the ovaries and fertility.
Because medical terminology shapes how both patients and providers understand disease, the old name may have contributed to delayed diagnoses, oversimplified the condition and left many women feeling misunderstood.
Here’s how PMOS can present differently from person to person, what people most often get wrong about the condition and where people should start if they think they have it.
Why PMOS is so difficult to diagnose
One of the biggest reasons PMOS is frequently missed or misdiagnosed is that it doesn’t look the same in every patient.
Unlike many conditions, there is no single test that can confirm PMOS. Diagnosis relies on evaluating a combination of symptoms and clinical findings, and patients may meet some diagnostic criteria but not others.
For healthcare providers who don’t specialize in the condition, those nuances can make PMOS challenging to identify, leading to delayed diagnoses and years of unanswered questions.
Some of its hallmark symptoms also overlap with puberty. Acne and irregular periods, for instance, are often dismissed as typical adolescent changes when they can actually signal an underlying hormonal disorder.
Long-term hormonal birth control can further complicate diagnosis. While birth control doesn’t mask PMOS, it can effectively manage symptoms. As a result, many people don’t realize they have the condition until they stop taking the pill — often when trying to conceive — and their symptoms become apparent.
Treatment depends on each person’s concerns and goals
PMOS treatment is highly individualized and depends largely on a patient’s stage of life and primary concerns.
Someone trying to conceive requires a different approach than someone seeking relief from acne, excess facial hair or irregular periods.
Treatment options may include:
- Acne, excess facial hair and hair thinning: Medications such as spironolactone and hormonal birth control can reduce androgen levels that contribute to these symptoms.
- Insulin resistance and weight management: Medications such as metformin or GLP-1 drugs can improve insulin regulation and support weight loss.
- Irregular or absent periods: Combined oral contraceptives or cyclic progesterone can help regulate menstrual cycles and protect the uterine lining.
- Cardiometabolic health: Regular monitoring of cholesterol, blood sugar and insulin resistance can help reduce long-term cardiovascular and metabolic risks.
- Fertility: Ovulation-inducing medications such as letrozole or clomiphene can help patients ovulate more regularly. For some, IVF is also an effective option.
Ultimately, treatment is tailored to the symptom or health concern that brings a patient to the doctor.
Common myths still persist
One of the biggest misconceptions is that PMOS is defined by ovarian cysts.
The structures seen on the ovaries are actually immature follicles — not true cysts — making the former name, polycystic ovary syndrome, misleading.
Another myth is that only people who are overweight develop PMOS. While obesity can occur alongside the condition, many patients have lean PMOS and experience symptoms such as irregular periods, acne and excess facial hair, despite having a low body weight.
There’s also a persistent belief that PMOS is caused by poor lifestyle habits or overeating. In reality, it’s a complex polygenic disorder influenced by multiple genes and often runs in families. Healthy eating and exercise can help manage symptoms, but they do not cause — or cure — the condition.
PMOS affects far more than fertility
Many people are surprised to learn just how many body systems PMOS can affect.
Beyond irregular periods and acne, the condition is associated with higher risks of cardiovascular disease, insulin resistance, Type 2 diabetes and sleep apnea. Some patients also experience gastrointestinal symptoms such as bloating and inflammation.
Mental health is another important but often overlooked aspect of PMOS. People with the condition have higher rates of anxiety and depression.
Don’t wait to seek answers
Anyone experiencing symptoms such as irregular periods, persistent acne, excess facial or body hair, unexplained weight-loss resistance or other signs of elevated androgens should speak with a healthcare provider rather than waiting for additional symptoms to appear.
Because PMOS affects so many different body systems, care may involve a primary care physician, OB-GYN, reproductive endocrinologist, medical endocrinologist, dermatologist or a team of specialists.
Rather than asking to be tested specifically for PMOS, patients may have more productive conversations by asking broader questions, such as whether hormone levels, insulin resistance or irregular menstrual cycles could point to an underlying endocrine disorder.
Early diagnosis can improve long-term health
PMOS is a lifelong condition that doesn’t necessarily disappear after menopause. Even as reproductive symptoms change, underlying metabolic and hormonal dysfunction can continue to increase the risk of heart disease, diabetes and other chronic health problems.
That’s why early diagnosis and ongoing monitoring are so important. Regular checkups, along with screening for cholesterol, blood sugar and other cardiovascular risk factors, can help prevent complications before they become more serious.
Jacquelyn Shaw, MD, is a reproductive endocrinologist and fertility specialist at the NYU Langone Fertility Center, where she works with couples and individuals to diagnose and manage fertility issues. Also a clinical assistant professor in the Department of Obstetrics and Gynecology at NYU Grossman School of Medicine, Dr. Shaw’s clinical research focuses on improving IVF and reproductive surgery outcomes, preserving fertility, and improving provider skill and comfort in delivering transgender care.
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