PMOS (formerly PCOS)

Hormone Care
Written By Jennifer Tang

Overview

Polyendocrine Metabolic Ovarian Syndrome (PMOS), formerly known as Polycystic Ovary Syndrome (PCOS), is a common hormonal and metabolic condition that can affect menstrual cycles, ovulation, skin and hair, metabolic health, weight, fertility, and overall well-being.¹˒²˒³ Symptoms can look very different from person to person and may change throughout different stages of life.

At Tangible Health, we take a comprehensive and individualized approach to PMOS care. We look at your symptoms, menstrual cycle, metabolic health, fertility goals, nutrition, sleep, stress, lifestyle, and overall health to develop sustainable strategies that support both how you feel now and your long-term health.

What Is PMOS?

PMOS is a complex hormonal and metabolic condition. In 2026, the American Society for Reproductive Medicine endorsed Polyendocrine Metabolic Ovarian Syndrome (PMOS) as the new name for the condition historically known as PCOS, reflecting that it involves more than the ovaries alone.¹

In adults, diagnosis generally looks for at least two of three features:

  • Irregular or absent ovulation

  • Signs of higher androgen activity, such as excess facial or body hair or elevated androgen levels on bloodwork

  • A characteristic ovarian appearance on ultrasound or, in some adults, an AMH blood test²

Other conditions that can cause similar symptoms need to be considered before a diagnosis is made. If irregular menstrual cycles and signs of elevated androgens are both present, ultrasound or AMH testing may not be necessary.²

Common Symptoms of PMOS

PMOS can present differently from person to person. Common signs and symptoms may include:²˒³˒⁵

  • Irregular, infrequent, or missed periods

  • Difficulty ovulating

  • Difficulty becoming pregnant

  • Acne or oily skin

  • Excess facial or body hair

  • Thinning scalp hair

  • Weight gain or difficulty managing weight in some people

  • Darkened or thickened areas of skin associated with insulin resistance

  • Metabolic concerns such as insulin resistance or impaired blood-sugar regulation

PMOS can occur in people of all body sizes, and not everyone experiences the same combination of symptoms.²˒³

Causes & Contributing Factors

PMOS does not have one single known cause. Current evidence suggests that genetics, hormonal signalling, metabolic factors, and environmental influences can all contribute.²˒⁴

Hormonal Factors
Higher androgen activity is a central feature of PMOS for many people. Elevated androgen levels can interfere with regular ovulation and contribute to symptoms such as acne, excess facial or body hair, and scalp hair thinning.²˒⁴

Insulin Resistance & Metabolic Health
Many people with PMOS experience insulin resistance, meaning the body becomes less responsive to insulin. Higher insulin levels can contribute to increased androgen production and other metabolic changes.²˒⁴ PMOS is also associated with a higher risk of impaired glucose tolerance and type 2 diabetes, making metabolic health an important part of ongoing care.²˒³

Genetics & Family History
PMOS tends to run in families, although there is no single identified “PMOS gene.” Multiple genetic and environmental factors appear to influence a person’s likelihood of developing the condition.³˒⁴

Lifestyle, Sleep & Stress
Nutrition, physical activity, sleep, and stress can influence metabolic health and how PMOS symptoms are experienced, but they are not considered the sole cause of the condition.²

Care therefore focuses on realistic, sustainable strategies rather than restrictive diets or blaming individual lifestyle choices.

Our Approach to PMOS

At Tangible Health, we focus on understanding your individual presentation of PMOS rather than using the same plan for everyone.

Your Menstrual & Hormonal Health
We review your menstrual cycle, ovulation patterns, androgen-related symptoms, reproductive history, and other relevant signs to better understand how PMOS is affecting your hormonal and reproductive health.

Your Metabolic & Lifestyle Health
Because insulin resistance and changes in blood-sugar regulation can be important features of PMOS, we may look at nutrition, movement, sleep, stress, cardiovascular risk factors, and other aspects of metabolic health when appropriate.²

The goal is to develop sustainable habits that fit your life, rather than relying on extreme diets or unrealistic routines.

Your Goals
Your priorities may include more regular periods, improving acne or hair concerns, supporting metabolic health, preparing for pregnancy, improving energy and overall well-being, or reducing longer-term health risks. Your care plan is built around the outcomes that matter most to you.

Treatments That May Be Included

Your individualized PMOS care plan may include:

  • Clinical Nutrition to support blood-sugar regulation, nutritional adequacy, and sustainable eating patterns

  • Lifestyle Medicine to support movement, sleep, stress management, metabolic health, and realistic daily habits

  • Nutraceuticals & Supplements when there is an individualized indication; selected supplements such as inositol may be considered based on your goals and the available evidence²˒⁷

  • Botanical Medicine when clinically appropriate, with consideration of your symptoms, medications, fertility goals, and available evidence

  • Acupuncture as a complementary component of care when appropriate

  • Naturopathic Counselling to support stress management, behavioural changes, and sustainable lifestyle goals

Treatment is individualized according to your symptoms, health history, priorities, and any conventional medical or fertility care you are receiving.

What to Expect

Initial Assessment
We start with a comprehensive review of your symptoms, menstrual cycle and ovulation history, reproductive and fertility goals, medical history, nutrition, sleep, stress, medications, supplements, lifestyle, and overall health.

Hormonal & Metabolic Assessment
Depending on your symptoms and health history, we may review existing bloodwork or discuss whether further testing is appropriate. This may include androgen levels, blood-sugar markers, cholesterol and cardiovascular risk markers, or testing to rule out other conditions that can cause similar symptoms.² Ultrasound or AMH testing is not required for every person with PMOS.²

Personalized Plan
You’ll receive a personalized care plan designed around your specific PMOS presentation, symptoms, health history, and goals. Any relevant test results, fertility plans, and lifestyle factors are also considered when developing your recommendations.

Ongoing Support
PMOS management is an ongoing process, and your needs may change over time. Follow-up allows us to monitor your symptoms and relevant health markers, adjust your plan as needed, and adapt care as your menstrual health, metabolic health, or fertility goals change.²

When to Seek Support for PMOS

Consider speaking with a healthcare provider if you are:

  • Experiencing irregular, infrequent, or absent periods

  • Having difficulty identifying or maintaining regular ovulation

  • Struggling with persistent acne, excess hair growth, or scalp hair thinning

  • Experiencing weight or metabolic concerns that are difficult to manage

  • Trying to conceive without success

  • Concerned about blood sugar, insulin resistance, or your long-term metabolic health

Appropriate assessment and ongoing care can help address current symptoms while also considering the longer-term reproductive and metabolic health concerns associated with PMOS.²˒³

Book An Appointment

Frequently Asked Questions

  • Yes. PMOS is the new name for the condition previously known as PCOS. The name Polyendocrine Metabolic Ovarian Syndrome better reflects that the condition involves hormonal and metabolic health, not simply ovarian cysts.¹

  • Common signs include irregular or missed periods, acne, excess facial or body hair, scalp hair thinning, and difficulty with ovulation. Some people also experience metabolic concerns such as insulin resistance.²˒³˒⁵

  • Diagnosis is based on a combination of menstrual or ovulatory changes, signs of elevated androgens, and sometimes ultrasound or AMH testing. There is no single test that diagnoses PMOS on its own.²

  • Yes. PMOS can make it more difficult to conceive when ovulation occurs irregularly or not at all. However, many people with PMOS are able to become pregnant with appropriate support and treatment.²˒⁶

  • It can for some people. Insulin resistance and other metabolic changes may make weight management more challenging, but PMOS can occur at any body size.²˒³

  • No. Current guidelines emphasize sustainable, individualized healthy eating rather than one specific “PCOS diet.” The goal is to find nutrition strategies that support your metabolic and overall health without unnecessary restriction.²

  • There is currently no cure for PMOS, but symptoms and longer-term health risks can often be managed effectively. Treatment depends on whether your priorities involve menstrual health, skin or hair symptoms, metabolic health, fertility, or other concerns.²˒⁶

  • Naturopathic care can support nutrition, lifestyle, sleep, stress management, appropriate supplementation, and overall hormonal and metabolic health. It can also be used alongside conventional medical or fertility treatment when appropriate.

 

Related Care

PMOS is closely connected to broader areas of health. You may also benefit from:

Jennifer Tang
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