PCOS has been renamed PMOS: The role of nutrition in a new approach to polycystic ovarian syndrome
As announced in The Lancet recently, PCOS (Polycystic Ovary Syndrome) has been renamed PMOS: Polyendocrine Metabolic Ovarian Syndrome.
It is a change that better reflects what we have understood about the condition for some time.
The name “polycystic ovary syndrome” has always been misleading. Not everyone with the condition has polycystic ovaries, and the structures seen on an ultrasound are actually follicles rather than ovarian cysts. More importantly, PMOS is far broader than a condition affecting the ovaries.
The new name recognises the interconnected roles of hormones, insulin and metabolic health alongside reproductive health. PMOS can affect blood sugar regulation, skin and hair, mood, energy, menstrual cycles and fertility, with symptoms varying considerably from one person to another. And it’s impact lasts beyond fertile years.
It is also very common, affecting around 1 in 8 women worldwide.
What Are The Signs of PMOS?
PMOS can present differently in different women, which is one reason it can sometimes take a long time to recognise. Common signs and symptoms can include:
irregular, infrequent or absent periods
difficulties with ovulation or fertility
acne, particularly persistent or adult acne
increased facial or body hair
thinning hair or hair loss from the scalp
weight gain or difficulty managing weight
evidence of insulin resistance or impaired blood glucose regulation
darker, thickened patches of skin, particularly around the neck or underarms
mood difficulties, including anxiety and depression
sleep problems, with an increased prevalence of obstructive sleep apnoea
You do not need to experience all of these symptoms to have PMOS.
Diagnosis is not based simply on finding “cysts” on the ovaries. Assessment looks at a combination of ovulation and menstrual cycles, signs or blood markers of raised androgens (testosterone), and ovarian appearance while also excluding other possible causes.
PMOS and ADHD - Is There a Link?
Interestingly, PMOS also appears to be associated with ADHD. Research has found higher levels of ADHD symptoms in women with PCOS compared with women without the condition, although this is still an emerging area of research and we do not yet have a reliable figure for how much more common ADHD is in women with PMOS. Researchers are investigating whether shared hormonal and metabolic factors may help explain the overlap.
Why Nutrition Matters In PMOS
The change of name feels particularly significant from a nutritional perspective because metabolic health and insulin resistance are important components of PMOS for many women.
Insulin is not simply involved in controlling blood glucose. Higher insulin levels can also interact with ovarian hormone production, which is one of the reasons nutrition and lifestyle approaches that support metabolic health can be so valuable.
There is no single “PMOS diet” that is right for everyone. A nutritional approach should be personalised according to symptoms, health history, metabolic health, food preferences and lifestyle.
Areas I commonly consider include:
Supporting blood sugar regulation
Meals containing a good source of protein, plenty of vegetables or other fibre-rich foods, healthy fats and appropriately portioned carbohydrate can help reduce large fluctuations in blood glucose and insulin.
This does not necessarily mean following a very low-carbohydrate diet. The type, quantity and combination of carbohydrates can be just as important. Wholegrains, beans, lentils, vegetables, fruit, nuts and seeds can all form part of a PMOS-supportive way of eating.
Increasing fibre and plant diversity
Fibre-rich foods can support blood glucose regulation, digestive health and the gut microbiome. I generally encourage a wide variety of vegetables, fruit, pulses, wholegrains, nuts, seeds, herbs and spices rather than concentrating on individual “superfoods”.
Including adequate protein
Protein at meals can help with satiety and blood sugar stability, as well as providing amino acids needed throughout the body. Eggs, fish, poultry, yoghurt, tofu, beans, lentils, nuts and seeds are just some of the options.
Choosing good-quality fats
Foods such as extra virgin olive oil, nuts, seeds, avocado and oily fish provide unsaturated fats and can form part of a cardiometabolic-supportive dietary pattern.
Looking for nutritional deficiencies
Rather than assuming that everyone with PMOS needs the same supplements, I prefer to look at the individual. Dietary intake, symptoms, medication, blood results and other health issues may all influence nutritional requirements.
Supplements can be helpful, but they should be chosen carefully and personalised to the individual.
Nutrition Is Only Part Of The Picture…What Else Supports PMOS?
Movement, sleep and stress also matter. Regular physical activity can support insulin sensitivity and metabolic health, while poor sleep and chronic stress can make blood sugar regulation, appetite and energy more difficult.
This is why I tend to take a whole-person approach rather than simply handing someone a list of foods to eat and avoid.
For me, this name change feels particularly personal. I was diagnosed with PCOS, as well as endometriosis, in my 20s after years of GP visits. I also have considerable experience working with clients with PCOS/PMOS and regularly see how individualised dietary and lifestyle changes can support symptoms and overall health.
Supporting blood sugar regulation, improving the quality and balance of the diet, addressing stress, sleep and movement, and using specific, carefully chosen supplements where appropriate can all form part of a personalised nutritional approach.
The change from PCOS to PMOS is therefore much more than a change of terminology. It moves the conversation away from a narrow focus on ovaries and fertility and towards a better understanding of a complex condition with hormonal, reproductive and metabolic features.
And that broader understanding also makes it clearer why nutrition and lifestyle deserve to be part of the conversation.
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