What is polyendocrine metabolic ovarian syndrome (PMOS)?
PMOS is a hormonal disorder that affects about one in every 10 females. It is caused by a hormone imbalance in the brain and ovaries. There is a genetic predisposition for PMOS. Adolescents with PMOS often have a family history of PMOS in female family members.
Normally, the ovaries make estrogens and progesterone, which are female hormones. The ovaries also make some androgens, which are male hormones. In PMOS, the ovaries produce too many androgens. This creates a hormonal imbalance, which can have wide-ranging effects on the body. These effects can be mild or severe.
In females with PMOS, the brain does not send a hormone message to the ovary to help mature and release eggs. Because of this, ovulation may only happen sometimes or not at all. Instead of bursting, the follicles grow into many small cysts in the ovaries.
Symptoms of PMOS often start during puberty
PMOS is usually first noticed around the time when an adolescent female is expecting their first menstrual period. Because of the extra androgens, females with PMOS may have few or no periods.
Other possible symptoms of PMOS include the following:
- heavy hair growth on the face and body
- trouble keeping a healthy weight
- acne
- ovaries that have many small cysts (polycystic ovaries)
- increased blood fat (lipid) levels
- increased insulin or glucose levels
- increased androgens in the blood
Not all females with PMOS will have all these symptoms.
PMOS is diagnosed with a patient history, examination and blood tests
There is no one test for PMOS. The health-care provider will ask questions about:
- your child's menstrual period
- any hair and skin problems
- any unexplained weight gain
- what your child's health has been like in the past (your medical history)
The health-care provider will measure your child's weight, height and blood pressure.
They will take a blood sample. The blood will be tested for insulin, hormone and glucose levels.
The health-care provider may also do an ultrasound scan of the ovaries to look for cysts.
PMOS can be managed and its effects on the body can be reduced
There is no cure for PMOS. But it can be treated and managed. Treating PMOS is important for two reasons:
Appearance
Many young females with PMOS are worried about the disorder's effect on how they look. This is understandable. Treating PMOS will reduce the effect on your child's appearance. This will help them feel better about themselves.
Long-term health
If it is not treated, PMOS raises the risk of other health problems. These health problems include the following:
- heart disease
- diabetes
- obesity
- cancer of the lining of the uterus (endometrial cancer)
- infertility (trouble getting pregnant)
Treating PMOS
How PMOS is treated is based on the symptoms.
Because PMOS often causes weight gain, your child should eat a healthy diet. They should also exercise regularly.
Treatment with hormones
PMOS is a hormone imbalance, so part of its treatment is trying to restore that balance. There are two ways to do this:
- Increase the level of female hormone.
- Decrease the effect of the elevated male hormone.
To increase the level of female hormones, your child's health-care provider may prescribe oral contraceptives (birth control pills). Oral contraceptives will:
- help make periods more regular
- improve acne and reduce hair growth on the face and body
- lower the risk of endometrial cancer
To reduce the effect of male hormones, your child's health-care provider may prescribe medications called anti-androgens. Anti-androgens will:
- block the action of male hormones
- reduce unwanted hair growth and acne
One common anti-androgen is called spironolactone. Some adolescents with PMOS also develop diabetes and will need to manage it with lifestyle changes and/or medications.
Removing unwanted hair
A proper hormone balance will help stop the growth of unwanted hair. It will not help get rid of existing hair. Some females with PMOS may choose to undergo hair removal.
PMOS and getting pregnant
Females with PMOS who do not ovulate have trouble getting pregnant and may need fertility treatment to help with ovulation. Weight loss in females with PMOS may increase ovulation and the chances of pregnancy.