PCOS to PMOS: PCOS (polycystic ovary syndrome) is a hormonal condition that affects women’s ovaries, characterised by high androgen levels, irregular periods, and small ovarian follicles. It impacts weight, metabolic and mental health, skin, and the reproductive system; has no medical cure and can be cured only through lifestyle changes. 1 out of 8 women suffered from PCOS, which is more than 170 million women worldwide. For the longest time it was misunderstood as a ‘cyst‘ and taken lightly, which adds to inadequate medical treatment and missed diagnoses.
PMOS: Polyendocrine metabolic ovarian syndrome
The name changed after 14 years of research with experts and patients and finally published in The Lancent on Tuesday. According to the reports, the reasons for the name change include “delayed diagnosis, fragmented care, and stigma”.
“Implementation approaches prioritised evolution rather than transformation. Preferred terms were polyendocrine, metabolic, and ovarian, reflecting the condition’s multisystem pathophysiology, and polyendocrine metabolic ovarian syndrome was the consensus new name. Accuracy was improved by omitting cysts and by capturing endocrine, metabolic, and ovarian dysfunction. A co-designed global implementation strategy, including a transition period, education, and alignment with health systems and disease classification, is under way.” the report says.
Why is PCOS incorrect?
- PCOS encompasses diverse endocrine, metabolic, reproductive, psychological, and dermatological features. The current name reflects only one organ and fails to capture the disorder’s multisystem nature.
- Confusion arising from the current name can delay diagnosis and hinder effective communication between patients and health professionals, contributing to patient dissatisfaction with care.
- The reproductive focus of the name can reinforce stigma, particularly in sociocultural contexts where fertility carries high value. Many individuals report distress associated with the name itself.
- International guidelines, expert groups, and patient organisations have repeatedly called for renaming, with serial surveys and workshops culminating in a mandate to change the name through a rigorous, global consensus process.
Symptoms of PCOS
The symptoms vary from person to person, and some of the common symptoms include the following:
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Irregular Menstrual Cycles: This is the most common sign. It may include infrequent periods, irregular periods, or, in some cases, a complete lack of menstrual cycles.
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Hyperandrogenism (High Androgen Levels): Elevated levels of “male” hormones can lead to physical signs, such as:
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Hirsutism: Excess hair growth on the face, chin, chest, or back.
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Acne: Severe or persistent acne, particularly on the face, back, and chest.
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Male-pattern thinning: Thinning of hair on the scalp.
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Polycystic Ovaries: During an ultrasound, ovaries may appear enlarged and contain numerous small, fluid-filled sacs (follicles) that surround the eggs. It is important to note that you can have PCOS without visible cysts, and you can have cysts without having PCOS.
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Weight Gain or Difficulty Losing Weight: Many people with PCOS struggle with weight management or notice weight gain, particularly around the abdomen.
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Insulin Resistance: The body may have trouble using insulin effectively, which can lead to higher blood sugar levels and may increase the risk of developing Type 2 diabetes.
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Skin Changes: Darkening of the skin, often in body folds like the neck, armpits, or groin area (a condition known as acanthosis nigricans).
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Fatigue: Feeling tired or having low energy levels is commonly reported by individuals with the condition.
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Fertility Challenges: Difficulty getting pregnant is a frequent reason individuals seek a diagnosis for PCOS, often due to irregular ovulation or failure to ovulate (anovulation).
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Mood Changes: Increased rates of anxiety and depression are associated with PCOS, which can be linked to hormonal fluctuations and the physical challenges of the condition.
How can it be treated?
1. Lifestyle Modifications
These are often the first line of treatment and can significantly improve hormonal balance and metabolic health.
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Balanced, Low-Glycemic Diet: Focus on whole foods, fiber-rich vegetables, fruits, lean proteins, and healthy fats (like those found in the Mediterranean diet). These foods help stabilize blood sugar and insulin levels, which can reduce androgen production.
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Regular Physical Activity: A combination of aerobic exercise (like brisk walking, swimming, or cycling) and strength training helps improve insulin sensitivity and aids in weight management.
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Weight Management: Even a modest weight loss (e.g., 5–10% of body weight) can often help regulate menstrual cycles, improve fertility, and reduce the severity of symptoms.
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Stress and Sleep Management: Chronic stress and poor sleep can exacerbate hormonal imbalances. Prioritizing 7–9 hours of quality sleep and utilizing techniques like yoga or meditation can support overall endocrine health.
2. Medical Treatments
If lifestyle changes alone are not sufficient, healthcare providers may recommend medication to target specific issues.
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Hormonal Birth Control: Combination pills (containing estrogen and progestin) can help regulate menstrual cycles, lower androgen levels, and improve acne and excess hair growth.
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Insulin-Sensitizing Medication: Medications like metformin are often used to improve the body’s response to insulin, which can help regulate cycles, support weight management, and lower blood sugar.
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Anti-Androgen Medications: Drugs such as spironolactone may be prescribed to block the effects of androgens, helping to reduce symptoms like acne and unwanted hair growth.
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Fertility Treatments: If pregnancy is a goal, doctors may prescribe ovulation-inducing medications (such as letrozole or clomiphene). In some cases, assisted reproductive technologies like IVF may be discussed.
Whether the renaming effect can be seen on the ground or stays in the paper will be known after some time.
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