Maybe you've always had unpredictable periods and assumed that was just how your body works. Maybe you've noticed weight settling around your middle no matter how carefully you eat, or dark, velvety patches of skin on your neck that won't wash away. Maybe you feel tired after meals or crave sugar in a way that seems out of proportion. On their own, these things are easy to brush aside. Together, they may be pointing to something worth talking about.
For many women, these symptoms are connected to PMOS and the insulin resistance that often comes with it. During American Diabetes Month, the team at Cary OB/GYN wants to help you understand this connection and what you can do about it.
First, a New Name: PCOS Is Now PMOS
You may know this condition as polycystic ovary syndrome, or PCOS. It now has a new name: PMOS, which stands for polyendocrine metabolic ovarian syndrome.
The change better reflects what the condition really is. The old name focused on ovarian "cysts," which are actually small, immature follicles, and many people with the condition don't have them at all. PMOS recognizes that this is a whole-body condition affecting several hormone systems and the way your body handles energy and blood sugar. If you were diagnosed with PCOS, you have PMOS. The diagnosis itself hasn't changed.
What Is Insulin Resistance?
Insulin is a hormone that helps move sugar from your blood into your cells, where it's used for energy. With insulin resistance, your cells don't respond to insulin as well as they should, so your body has to produce more of it to keep blood sugar in range.
In PMOS, those higher insulin levels can signal the ovaries to make more androgens, hormones such as testosterone. Extra androgens can interfere with ovulation and cause many of the symptoms women with PMOS know too well. Insulin resistance is common in PMOS and can occur in women of any body size, including those who are lean.
Symptoms to Watch For
PMOS and insulin resistance can show up in different ways, including:
- Irregular, infrequent, or absent periods
- Acne that's persistent or appears along the jawline
- Excess hair growth on the face, chest, or abdomen
- Thinning hair on the scalp
- Weight gain, especially around the waist, or difficulty losing weight
- Dark, velvety patches of skin in body folds like the neck or underarms, called acanthosis nigricans
- Skin tags
- Fatigue or strong cravings for sweets and carbohydrates
- Difficulty getting pregnant
You don't need to have all of these for PMOS to be possible, and having one or two doesn't mean you definitely have it. That's where an evaluation comes in.
| “Every member of the staff was very professional, friendly and efficient. Dr. Rodrigo was welcoming, professional, kind and skilled. His examination was thorough and I was pleased that no further procedures were needed at this time. I was also told what symptoms to look for in the future if any of my symptoms recurred.” Cary OB/GYN Patient Testimonial |
How PMOS Is Diagnosed
There isn't a single test for PMOS. Following the International Evidence-Based Guideline for PCOS, your provider looks for at least two of these three features:
- Irregular or absent ovulation, often seen as irregular periods
- Signs of higher androgens, either through symptoms like acne and excess hair or through blood work
- Ovaries with many small follicles on ultrasound, or a high level of a hormone called AMH in adults
Your provider will also rule out other conditions with similar symptoms, such as thyroid problems. At Cary OB/GYN, much of this evaluation, including blood work and pelvic ultrasound, can be done right in our office.
Checking for Insulin Resistance
Because PMOS raises the risk of prediabetes and type 2 diabetes, the international guideline recommends that everyone with PMOS have their blood sugar checked when diagnosed and regularly after that. A two-hour glucose tolerance test is considered the most accurate option, though your provider may also use a fasting glucose or hemoglobin A1c test. Checking blood pressure and cholesterol is also important, since PMOS can affect heart health over time.
How Your OB/GYN Can Help
PMOS is a lifelong condition, but it's very manageable. Your treatment plan will depend on your symptoms and goals, and it can change as your life does.
Lifestyle Support
Balanced meals, regular physical activity, and good sleep can improve insulin sensitivity and help regulate cycles. Our Advanced Care Team can connect you with nutrition specialists who focus on women's health and offer both in-person and telehealth visits.
Medication
Depending on your needs, your provider may discuss metformin to help your body use insulin more effectively, hormonal birth control to regulate periods and improve acne and unwanted hair, or other medications that target specific symptoms.
Fertility Support
PMOS is one of the most common causes of ovulation problems, but many women with PMOS go on to have healthy pregnancies. Our physicians provide infertility evaluations and, for patients who qualify, oral ovulation induction. When more specialized care is needed, we offer expedited referrals to local reproductive endocrinologists. And because PMOS raises the risk of gestational diabetes, your provider may recommend earlier glucose screening once you're pregnant.
Emotional Well-Being
PMOS is linked to higher rates of anxiety and depression, and living with frustrating symptoms can take a toll. Please let us know how you're feeling. We can connect you with trusted mental health resources in our community.
Small Steps You Can Start Today
While you wait for your appointment, a few simple habits can support healthier insulin levels:
- Pair carbohydrates with protein or healthy fat at every meal and snack
- Take a short walk after meals, even 10 to 15 minutes
- Add strength training a couple of times a week, since muscle helps your body use sugar
- Aim for seven to nine hours of sleep when you can
- Track your periods so you can share patterns with your provider
These steps aren't about perfection or a number on the scale. They're about giving your body the support it needs while you and your provider build a longer-term plan.
You Deserve Answers
At Cary OB/GYN, our diverse team of board-certified providers offers comprehensive gynecologic care for every stage of life at our Cary and Morrisville offices. We'll listen to your concerns, explain your options clearly, and build a plan that fits your life. You can meet our team before your first visit.
| “I was able to get a same-day appointment as I was having issues. I was also able to get a same day appointment for an ultrasound. Also, I’m very pleased with Courtney Braswell’s bedside manner, patience and knowledge.” Cary OB/GYN Patient Testimonial |
If you think you may have PMOS or want help managing it, call Cary OB/GYN at (919) 467-5941 or book an appointment online. Understanding your body is the first step toward feeling like yourself again.