Polyendocrine Metabolic Ovarian Syndrome (PMOS)

Overview

What Is Polyendocrine Metabolic Ovarian Syndrome (PMOS)?

Polyendocrine metabolic ovarian syndrome (PMOS) is a common health problem that can affect teen girls and young women. It can cause irregular menstrual periods, make periods heavier, or even make periods stop. It can also cause a girl to have excess hair and acne. PMOS used to be called polycystic ovarian syndrome or PCOS.

Doctors can't say for sure what causes it, but PMOS seems to be related to imbalanced .

Both males and females produce sex hormones, but in different amounts. In girls, the ovaries make the hormones estrogen and progesterone, and also androgens, such as testosterone. The adrenal glands also make androgens. These small glands sit on top of each kidney. These hormones regulate a girl's menstrual cycle and (when the egg is released).

Androgens are sometimes called "male hormones," but the female body also makes them. In girls with PMOS, the body makes a higher than normal amount of androgens. Research also suggests that the body might make too much insulin, signaling the ovaries to release extra male hormones.

PMOS seems to run in families too, so if someone in your family has it, you might be more likely to develop it.

What Happens in Polyendocrine Metabolic Ovarian Syndrome (PMOS)?

The higher amounts of androgens that happen in PMOS can interfere with egg development and release. Instead of the eggs maturing, sometimes cysts (little sacs filled with liquid) develop. Then, instead of an egg being released during ovulation as in a normal period, the cysts build up in the ovaries and ovaries can become enlarged. Girls with PMOS might not be ovulating or releasing an egg each month, so many have irregular or missed periods.

What Problems Can Polyendocrine Metabolic Ovarian Syndrome (PMOS) Cause?

Someone with PMOS is more likely to:

• have trouble getting pregnant, but this is treatable when a woman decides she wants to become pregnant
• have excessive hair growth on places such as the face, chest, or belly
• get acne or have their acne get worse
• be obese
• develop diabetes, heart disease, or high blood pressure
• have obstructive sleep apnea

There's no cure for PMOS, but it can be treated.

Signs & Symptoms

What Are the Signs & Symptoms of Polyendocrine Metabolic Ovarian Syndrome (PMOS)?

A key sign of PMOS is irregular periods or missed periods. The effects of PMOS on the ovaries can make a girl stop ovulating. PMOS cannot be diagnosed until 2–3 years after a girl’s first menstrual cycle because it can take up to 2 years after a first period for any girl's cycle to become regular.

Still, many girls with PMOS can get pregnant if they have sex. So if you're sexually active, use condoms every time you have sex to avoid becoming pregnant or getting a sexually transmitted disease (STD). (Of course, this is important whether you have PMOS or not.)

Imbalanced hormone levels can cause changes in a girl's entire body, not just her ovaries. So doctors also look for these other signs of PMOS:

• weight gain, obesity, or difficulty maintaining a normal weight, especially when the extra weight is concentrated around the waist
• a condition called hirsutism (pronounced: HER-suh-tiz-um), where a girl grows extra hair on her face, chest, abdomen, nipple area, or back (a little of this is normal for most girls, though)
• thinning hair on the head (alopecia)
• acne and clogged pores
• darkened, thickened skin around the neck, armpits, or breasts (this is called acanthosis nigricans), which is a sign of insulin resistance
• high blood pressure, high cholesterol, or diabetes mellitus (high blood sugar levels)

Girls who show signs of puberty early — such as developing underarm or pubic hair before age 8 — may be at greater risk for PMOS later on.

Diagnosis

How Is Polyendocrine Metabolic Ovarian Syndrome (PMOS) Diagnosed?

If your doctor thinks you might have PMOS, they might want you to see a or an for a diagnosis.

The gynecologist or endocrinologist will ask about your concerns and symptoms, your past health, your family's health, any medicines you're taking, any allergies you have, and other issues. They'll also ask about your period and its regularity.

Your doctor also will do an exam, which includes checking your weight, and looking for physical signs such as acne, hair growth, and darkened skin. The doctor might do a gynecologic exam to rule out other possible causes of your symptoms, but this is not always necessary for diagnosis.

Doctors sometimes order blood tests to diagnose PMOS and or to see if the symptoms are caused by other conditions, such as thyroid or other ovarian or gland problems.

Your doctor might order a pelvic ultrasound (a safe, painless test that uses sound waves to make images of the pelvis) to check your ovaries for cysts or other problems. Because cysts aren't always visible, this test isn't always done.

Treatment & Care

How Is Polyendocrine Metabolic Ovarian Syndrome (PMOS) Treated?

There's no cure for PMOS, but there are several ways to treat and manage it.

Diet and Exercise

If you're overweight or obese, a doctor will recommend lifestyle changes. Weight loss can be very effective in easing many of the health conditions associated with PMOS, such as high blood pressure and diabetes.

Your doctor or a registered dietitian can look at your food intake and your exercise and activity to create a weight-loss program for you. Exercise is very important to improve your body’s sensitivity to insulin and prevent progression to diabetes.

Medicines

Sometimes doctors prescribe medicines to treat PMOS. A doctor might first have someone try birth control pills to help control androgen levels in their body and regulate their menstrual cycle. Birth control pills may help control acne and excessive hair growth, but they don't work for everyone. It may take up to 6 months to see whether treatment with birth control is effective.

Antiandrogens also are sometimes used to treat PMOS. These medicines counter the effects of excess androgens, and can help clear up skin and hair growth problems.

A diabetes medicine, metformin, can lower insulin levels. In some girls with PMOS, it can help control ovulation and androgen levels. This can make menstrual cycles more regular.

Medicines should always be combined with the recommended lifestyle changes.

How Can I Cope With Polyendocrine Metabolic Ovarian Syndrome (PMOS)?

Having PMOS can be hard on a girl's self-esteem. Fortunately, there are things you can do to reduce the physical symptoms and take care of the emotional side of living with PMOS.

Medicines used to treat PMOS will slow down or stop excessive hair growth for many girls. Also, different types of products can help get rid of hair where it's not wanted. Depilatory creams can gently remove facial hair on the upper lip or chin. Follow the instructions carefully so you don't develop a rash or allergic reaction.

Tweezing and waxing done at home or at a salon can manage excess hair growth. A dermatologist (a doctor who specializes in skin problems) or qualified hair removal specialist can use electrolysis and laser surgery treatments for long-term removal of unwanted hair, but they're more expensive.

Treatment with birth control pills or antiandrogens might make severe acne better. If it doesn't, your doctor may refer you to a dermatologist for treatment. A dermatologist can also recommend medicines to reduce skin darkening or discoloration, and to prevent hair growth.

Some girls with PMOS may become depressed, in which case it may help to talk to a therapist or other mental health professional. Talking with other teens and women with PMOS is a great way to share information about treatment and get support. Ask your doctor or search online for a local support group.