Editor’s Note: In May 2026, the Endocrine Society and other international experts officially renamed polycystic ovary syndrome (PCOS) polyendocrine metabolic ovarian syndrome (PMOS). This change better reflects the condition’s nature as a systemic metabolic disorder. This article has been updated to reflect the new terminology. Polyendocrine metabolic ovarian syndrome (PMOS) , formerly known as polycystic ovary syndrome (PCOS), is a hormonal disorder that affects up to 13 percent of women of reproductive age. This disorder commonly causes symptoms such as irregular periods , increased facial and body hair, acne, scalp hair thinning, weight gain, and infertility .e60dc2a1-f33c-4a05-9b50-8e3e8e5976295a95b0e6-d7b8-4666-b6fb-dfefccd93db5 Researchers don’t know exactly what causes PMOS, but some key factors, like genes, stress, and hormones, may play a role.e60dc2a1-f33c-4a05-9b50-8e3e8e597629c68aa907-7833-4079-99e0-a431119cbe5e Here’s what research says about the potential causes of PMOS.
Insulin Resistance Insulin Resistance Another hormone that may be involved in PMOS is insulin .e60dc2a1-f33c-4a05-9b50-8e3e8e597629befa737e-fe69-4fae-aa12-04b901c21c85 Insulin helps the body’s cells uptake glucose from the blood and use it as energy.e60dc2a1-f33c-4a05-9b50-8e3e8e59762953043237-bcd3-4c97-bb60-ef7fcea3f0fb Some people have an increased tolerance to insulin, exacerbated by obesity, so they don’t respond to the hormone as well as they should. This condition is called insulin resistance .e60dc2a1-f33c-4a05-9b50-8e3e8e5976292dac364e-ba99-460b-a61c-ac33dac52219 About 50 to 90 percent of people with PMOS have it.e60dc2a1-f33c-4a05-9b50-8e3e8e59762932e29dd1-74ab-4bb3-979e-217210795e5f With insulin resistance, blood glucose levels go up, which makes the body produce more and more insulin as it tries to compensate for the high blood glucose.e60dc2a1-f33c-4a05-9b50-8e3e8e597629c14f6e02-1cc5-4e35-a5a3-8a10dd10c31f When insulin levels are high, and a person has insulin resistance, androgens also rise. This is because insulin suppresses the production of a protein that binds to androgens and other sex hormones, leaving more free androgens available.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a942fe15-e91e-45b2-9241-130fc254d0b8 Higher androgen levels, in turn, may cause more symptoms of PMOS.e60dc2a1-f33c-4a05-9b50-8e3e8e597629157d0247-7264-42f8-8c17-384d229966bd
Resources We Trust Cleveland Clinic: Polyendocrine Metabolic Ovarian Syndrome (PMOS)Eunice Kennedy Shriver National Institute of Child Health and Human Development: PCOS ResourcesJohn Hopkins Medicine: PMOS DietOffice on Women’s Health: Stress and Your Health
Hormones Hormonal Imbalances An imbalance of sex hormones also seems to contribute to the development of PMOS. Women with PMOS commonly have higher levels of male sex hormones, called androgens.e60dc2a1-f33c-4a05-9b50-8e3e8e59762906562acb-e4e5-4d9f-9793-6da0d919974d Hyperactive gonadotropin-releasing neurons from the hypothalamus lead to the release of more luteinizing hormone (which stimulates the ovaries to produce excess testosterone) and less follicle-stimulating hormone, which results in an excess production of androgens and blocks normal ovulation.e60dc2a1-f33c-4a05-9b50-8e3e8e59762954b3ba9e-48fd-42d8-8407-190ecaea8cc4 Excess androgens may:e60dc2a1-f33c-4a05-9b50-8e3e8e597629efa8d35f-1b57-4484-ac5e-0a51acdeec5ae60dc2a1-f33c-4a05-9b50-8e3e8e59762979e9cc11-184d-45a8-81f7-26caec2e0994 Disrupt ovulation, which can cause irregular periods or no periods at all Stop the ovarian follicles (which typically hold immature eggs) from developing normally Cause extra hair growth on the face or body and hair loss on the scalp Lead to severe acne
Stress Stress Stress and anxiety can contribute to PMOS by raising levels of cortisol, the body’s stress hormone. People with PMOS tend to have higher stress levels, research suggests.e60dc2a1-f33c-4a05-9b50-8e3e8e5976293a999705-726a-4be7-9c7c-9e4fbcc591c9 High cortisol levels from heightened stress may make it harder for your body to use insulin.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296b58e734-6725-4330-aa8d-35fd589c88ad This may worsen PMOS.e60dc2a1-f33c-4a05-9b50-8e3e8e597629ecba5980-e31f-4995-8586-88fe344d478c To help manage PMOS after receiving a diagnosis, try to prioritize rest, relaxation, and other strategies for stress relief .
Obesity Obesity Obesity is common among people with PMOS, affecting 38 to 88 percent of those with the disorder.e60dc2a1-f33c-4a05-9b50-8e3e8e597629ed445a30-04ec-4794-b95c-a0ef07c4a19a The link between obesity and PMOS is complex. While it isn’t entirely clear which one causes the other, the two are very closely linked: Obesity seems to increase PMOS risk, and vice versa.e60dc2a1-f33c-4a05-9b50-8e3e8e5976292e344ca1-620d-4f06-ad57-ef8dd979ed22 Insulin resistance also plays a role. It’s more difficult to lose weight or maintain a healthy weight with insulin resistance. And in turn, excess fat causes your body to produce more insulin.e60dc2a1-f33c-4a05-9b50-8e3e8e5976298a9a678f-31d0-420e-9da1-64f2ee2ace84 A strong genetic component to obesity may be at play here too. Studies suggest that genes associated with fat mass and obesity are involved in PMOS. It may be the case that people with a genetic predisposition toward obesity are also more prone to developing PMOS.e60dc2a1-f33c-4a05-9b50-8e3e8e59762942f46c52-6f85-4fdd-b998-555b04193108 Either way, reducing obesity and overweight may go a long way in preventing and managing PMOS, with even modest weight loss leading to symptom improvement in some research.e60dc2a1-f33c-4a05-9b50-8e3e8e59762926ae3fdf-a3df-4797-a161-a6e03b3e516a If you’re looking to lose weight, you can talk to your doctor for their guidance on diet , exercise, and medication.
Genetics Genetics PMOS is a highly heritable condition, which means that it runs in families. In fact, most cases are genetic.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a5a8ae6d-14bb-43f5-bc44-fff9fce0a1db So far, researchers have found 19 genes that are strongly associated with PMOS.e60dc2a1-f33c-4a05-9b50-8e3e8e59762966087f83-a2ad-47b5-8ea5-4c5569879f16 A genetic predisposition doesn’t necessarily mean you’ll develop the condition though. Environmental and other risk factors, such as poor diet, stress, and diabetes, may also play a role.e60dc2a1-f33c-4a05-9b50-8e3e8e59762916b75c99-eb1b-4029-84fc-200113f0c7fe Researchers have called for more large-scale studies to better understand how genetic and environmental factors may interact to influence the development of PMOS.e60dc2a1-f33c-4a05-9b50-8e3e8e59762926dc7cfd-4271-472c-9f4f-6d3236393a13
Inflammation Inflammation Some evidence suggests that chronic inflammation may play a role in PMOS.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291995137f-e46f-463f-8946-9a16f839c507 Typically, inflammation happens when your immune system responds to injury or illness. Chronic, or long-lasting, inflammation may be caused by obesity, insulin resistance, or other conditions.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f4a3fc4d-02f3-4ca7-91a1-e64eadaf9895 Some researchers also believe that increased inflammation in the body can cause insulin resistance, which in turn causes excessive levels of male hormones, contributing to PMOS symptoms.e60dc2a1-f33c-4a05-9b50-8e3e8e597629c6133d91-db5d-4965-abc7-c958eb53cab7 Excess body fat acts like an active hormone factory, pumping out signals that increase inflammation, while cutting back on helpful, insulin-boosting hormones (like adiponectin). This blocks cells from effectively absorbing sugar and forces the body to produce even more insulin.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291705060f-87c8-4b44-b6fe-4722029208b0 Inflammation can also affect how well the ovaries function, stopping the follicles from evolving normally and leading to PMOS.e60dc2a1-f33c-4a05-9b50-8e3e8e59762978f4c2e4-38e2-4b39-b4a9-3aa369b497d7
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