Pcos is now PMOS - is this the missing piece of your health puzzle?
PMOS — What it actually is, what it means for your health, and what you can do about it
In May 2026 a landmark paper officially renamed Polycystic Ovary Syndrome (PCOS) to Polyendocrine Metabolic Ovarian Syndrome (PMOS). Yes, it's a mouthful! But the reasoning behind it actually makes a lot of sense. The old name was genuinely misleading, the term "polycystic ovary" implied the whole condition was about cysts on the ovaries, which it really isn't. The new name better reflects what's actually going on - a complex hormonal and metabolic condition that affects the whole body, not just the ovaries.
Your GP possibly won't be using the new name just yet, these things take time to filter through, so don't be alarmed if they're still calling it PCOS. Throughout this blog you'll see both terms, just know they're referring to the same thing.
It might surprise you that research suggests PMOS affects anywhere between 8–13% of women of reproductive age, but up to 70% of those affected may never actually receive a formal diagnosis. That's a huge number of women living with symptoms and no answers. It's the most common reason behind irregular or absent periods, a leading cause of infertility, and its links to diabetes, cardiovascular, and autoimmune conditions mean that getting on top of it now is genuinely one of the best things you can do for your long term health.
It's not just about fertility either…
This is something that doesn't get talked about nearly enough. As we move into perimenopause, the body relies heavily on progesterone to smooth out the hormonal transition, and progesterone is only produced after ovulation. For women with PMOS who have irregular or absent ovulation, this means arriving at perimenopause already at a disadvantage. So whether you're in your twenties, thirties, or forties, this is worth paying attention to now.
Could PMOS be relevant to you?
Following the renaming, the diagnostic criteria have been updated and refined. A diagnosis of PMOS now requires 2 out of 3 of the following:
Irregular or absent periods
Clinical or biochemical signs of elevated androgens — think acne, excess hair growth (hirsutism), or elevated testosterone on blood tests
Polycystic ovarian morphology — now assessed via AMH blood test or ultrasound, not just a scan
On top of the more obvious signs, some of the subtler ones that often get overlooked include sugar cravings, dark patches of skin around the armpits or groin, stubborn weight gain around the middle, thinning hair, premenstrual acne flare ups, and anxiety or low mood.
Sound familiar? It's worth having a conversation with your GP and if you feel like you're not getting the full picture, it's absolutely okay to ask for more.
What might show up on your blood tests?
This is where it gets really interesting and where many women feel like they've been left in the dark. Standard blood tests don't always tell the whole PMOS story, and results can vary depending on where you are in your cycle. If you are testing day3 will show the optimal snapshot. That said, here are some patterns worth knowing about:
LH and FSH - are they in balance? These are the two hormones that drive your cycle and they work best as a team. In a healthy cycle they're roughly equal, but in PMOS, LH is often significantly higher than FSH, which throws ovulation completely off course. When this ratio tips too far in one direction, ovulation simply can't happen the way it should.
Testosterone - is it too high? Elevated testosterone is one of the most common features of PMOS and sits behind many of the most visible symptoms, such as acne, unwanted hair growth, and hair thinning. Ask your GP to check both total and free testosterone levels, not just one or the other.
SHBG - is it too low? Think of SHBG as a mop for excess testosterone, it binds to it and keeps it in check. In PMOS, SHBG is often low, which means more testosterone is left free to circulate and cause havoc. Low SHBG is often one of the most telling markers that something hormonal is going on, and one that's easy to miss if nobody's looking for it.
Fasting insulin and blood glucose - the ones that often get missed These aren't always tested as standard but they really should be. Elevated fasting insulin is one of the strongest indicators of insulin resistance, even when blood glucose looks completely normal. If insulin resistance is at the root of your PMOS, knowing this changes everything about how you approach managing it.
AMH - what it does and doesn't tell you - AMH is often elevated in PMOS because of the higher number of follicles in the ovaries. A high result can feel reassuring, but it's worth knowing it only tells you about egg numbers, not egg quality -one piece of the puzzle, not the whole picture.
Prolactin and thyroid function - worth ruling out - Both are worth checking to make sure other conditions that can mimic PMOS symptoms, especially irregular cycles and hair loss, aren't being missed.
One really important thing to remember, completely normal blood results don't rule out PMOS, and abnormal ones don't always confirm it. If something feels off and you're not getting answers, keep pushing. You know your body better than anyone.
On the fertility front
PMOS disrupts ovulation which makes predicting a fertile window really tricky, though it's not all bad news. Women with PMOS over 40 often have higher AMH levels and tend to retain their fertility for longer, and go on to have healthy babies later in life. So while PMOS and fertility can be complicated, it's far from the whole story.
So what's actually going on?
At the root of PMOS is a breakdown in communication between the brain and the ovaries - what's known as the HPO (hypothalamic-pituitary-ovarian) axis. Elevated androgens like testosterone interfere with this process and get in the way of ovulation happening properly.
Underpinning a lot of this often tends to be insulin resistance, where the body's cells stop responding to insulin the way they should. Chronic stress, poor sleep, and even over-exercising can all drive up cortisol and feed into this picture too.
The pill is often prescribed for PMOS and can help manage symptoms, but honestly, it's a plaster rather than a fix. It doesn't get to the root of why it's happening. The really encouraging thing though? PMOS is heavily influenced by lifestyle, which means you genuinely have the power to work with it and in many cases reverse it.
What can actually help
Nutrition
Keeping blood sugar steady is honestly everything when it comes to PMOS. Whole, unprocessed foods, good quality protein, healthy fats, and plenty of colourful vegetables at every meal. A Mediterranean-style way of eating is widely considered one of the most supportive dietary approaches. Cutting back on sugar, refined carbs, and alcohol makes a real difference, as does eating breakfast every day and not leaving long gaps between meals.
Stress management
Cortisol drives up insulin, which makes PMOS harder to manage, so finding genuine ways to reduce stress isn't optional here, it's actually central to the whole picture. Daily practices like slow breathing, time outdoors, or gentle movement all help bring the nervous system back to a calmer place. Even small consistent habits add up over time.
Exercise
Movement is great, but more isn't always better with PMOS. Over-exercising can actually drive up cortisol and worsen inflammation, which is worth knowing if you're someone who trains hard. A mix of moderate exercise alongside more restorative movement like yoga, walking, or Pilates tends to be the sweet spot.
Sleep
Good sleep regulates insulin, cortisol, and inflammation all at once, making it one of the most powerful and underrated tools for managing PMOS. It's also one of the easiest things to let slip when life gets busy, so it's worth being really intentional about protecting it.
Reducing inflammation
PMOS goes hand in hand with chronic low-grade inflammation, which over time is linked to a higher risk of autoimmune conditions. An antioxidant-rich diet, cutting back on environmental hormone disruptors - plastics, pesticides, synthetic products, and solid lifestyle foundations all help bring inflammation down. Small, consistent swaps really do add up.
How can acupuncture help?
PMOS is fundamentally about a breakdown in communication between the brain and the ovaries, acupuncture is a really effective way of helping the body start talking properly again. Research shows it can positively influence the HPO axis - the very root of PMOS, alongside the stress response and inflammation too. It's not a quick fix, but as part of a consistent approach it can genuinely make a difference.
If you'd like to find out more about how acupuncture could support you with PMOS, please do get in touch - I'd love to hear from you.