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Medical Review by Dr Zoe Miller
Dr Zoe Miller graduated from the University of Warwick with an MBChB degree and has reviewed this content for medical accuracy.
Polycystic Ovary Syndrome (PCOS)is a hormonal condition that affects women and people assigned female at birth. It is one of the most common hormonal disorders, yet many people do not realise they have it until symptoms begin affecting their daily life.
The name PCOS has recently been changed to polyendocrine metabolic ovarian syndrome (PMOS) to reflect that the condition is a metabolic disorder impacting more than just the ovaries.
PCOS/PMOS can impact periods, fertility, weight, skin and overall wellbeing. Symptoms can vary from person to person, which is why the condition can sometimes feel confusing or difficult to recognise.
What is PCOS/PMOS?
PMOS is a hormonal and metabolic disorder that affects how the ovaries function. Many people with the condition have higher levels of androgens, sometimes referred to as “male hormones.” This can interfere with ovulation, menstruation, and hormone balance.
PCOS/PMOS is also linked to metabolic health and a condition known as metabolic syndrome. This means it can negatively affect how the body regulates blood sugar levels (via the hormone insulin), stores fat, uses energy, and the hormones that control hunger.
Despite the name PCOS, people with the condition don’t have cysts on their ovaries. However, some people do have fluid-filled sacs in their ovaries that can look similar to cysts, hence the name PCOS.
A diagnosis of PMOS/PCOS is usually made based on a combination of symptoms, hormone levels and medical assessments including ultrasound.
Common Symptoms of PCOS/PMOS
Irregular Periods
One of the most common symptoms of PMOS/PCOS is irregular menstrual cycles. This may include:
- Infrequent periods
- Missed periods
- Heavy or prolonged bleeding
- Unpredictable cycles
These changes are often linked to irregular ovulation.
Excess Hair Growth and Acne
Higher androgen levels can lead to symptoms such as:
- Excess hair growth on the face, chest or body
- Persistent acne
- Oily skin
- Thinning hair on the scalp
It may also affect other hormones in the body, leading to a variety of additional hormonal and metabolic symptoms.
Weight Gain and Insulin Resistance
Many people with PMOS experience weight gain or find it difficult to lose weight. This is often connected to insulin resistance, where the body no longer responds effectively to insulin and needs to produce more and more to regulate blood sugar levels.
Insulin resistance can increase the risk of developing type 2 diabetes and may also contribute to fatigue and increased hunger.
Other Symptoms
Some individuals may also experience:
- Fatigue
- Mood changes
- Skin tags
- Darkened skin patches
- Fertility difficulties
- Hair thinning on the head
Not everyone with PCOS/PMOS will experience the same symptoms, and severity can vary greatly
What Causes PCOS/PMOS?
The exact cause of PCOS/PMOS is still unknown, but research suggests several factors may contribute to its development.
Hormonal Imbalances
Hormone imbalances play a major role in PCOS. Increased androgen levels can prevent the ovaries from releasing eggs regularly, affecting the menstrual cycle. The condition is also linked to disruption in several other hormones, including:
- Hormones involved in the menstrual cycle (such as oestrogen, gonadotropin-releasing hormone (GnRH), luteinizing hormone (LH), and follicle-stimulating hormone (FSH))
- Growth hormone
- Hunger hormones
Genetics
PMOS often runs in families, suggesting there may be a genetic link. If a close family member has the condition, there may be a higher chance of developing it.
Insulin Resistance
Many people with PCOS/PMOS produce higher levels of insulin to make up for their bodies responding less well to it. Increased insulin can stimulate the ovaries to produce more androgens, worsening symptoms such as irregular periods, acne and weight gain.
Lifestyle Factors
Lifestyle factors such as stress, sleep, nutrition and physical activity may influence symptom severity. While lifestyle alone does not cause PMOS, healthy habits can play an important role in managing symptoms.
Can PCOS/PMOS Affect Fertility?
PCOS/PMOS is one of the most common causes of ovulation-related fertility challenges. Irregular ovulation can make it more difficult to conceive naturally.
However, many people with the condition are still able to become pregnant with the right support, lifestyle changes or medical treatment. Speaking to a healthcare professional can help individuals understand their options.
If you think you may have PCOS, seeking medical advice can help you better understand your symptoms and explore the support available (including hormonal treatments, metformin for insulin resistance, unwanted hair growth treatments, and fertility support).
Early diagnosis and management can make a positive difference and help individuals feel more informed and supported in their health journey .
