Polyendocrine metabolic ovarian syndrome (PMOS) – previously known as polycystic ovary syndrome (PCOS) – is one of the most common hormonal conditions affecting women in Australia, and is also one of the leading causes of fertility difficulties. For many women, PMOS is first picked up through irregular periods, skin problems, or weight changes long before fertility becomes a consideration. Understanding how the condition works is often the first step toward feeling more in control of it. Dr Mandana Master takes a whole-person approach to PMOS, looking beyond fertility alone to help you manage the condition and build a treatment plan suited to your goals.
PMOS is a complex hormonal and metabolic condition involving fluctuations in several interconnected hormones, including insulin and androgens (male-type hormones), which can affect ovulation, metabolism, skin, and overall wellbeing.
PMOS is also associated with an increased long-term risk of conditions such as type 2 diabetes, high cholesterol, and cardiovascular disease, making early diagnosis and management important for overall health, not just fertility.
Different women experience PMOS differently. Common PMOS symptoms include:
PMOS can affect fertility in several different ways, with the impact varying considerably from woman to woman depending on which features of the condition are most prominent.
PMOS commonly disrupts the normal hormonal signals required for regular ovulation, meaning eggs may be released infrequently or not at all. This is one of the most significant and direct ways PMOS affects fertility, often presenting as irregular or absent periods. Without an egg being released regularly and predictably, natural conception becomes difficult or impossible.
Many women with PMOS experience insulin resistance, which can worsen hormonal imbalances and further disrupt ovulation. Insulin resistance is also linked to higher rates of miscarriage in some women with PMOS.
There is evidence that the abnormal hormonal environment associated with PMOS may affect the quality of eggs that are released, even when ovulation does occur, which can influence the chances of successful fertilisation.
For some women, weight can be both a symptom and a contributing factor in PMOS-related fertility difficulties, as excess weight can further disrupt hormonal balance and ovulation. This isn’t the case for all women with PMOS, many of whom have a healthy weight.
The emotional toll of living with PMOS, including its impact on body image, mood, and self-esteem, can affect sexual wellbeing and intimacy, which may in turn affect the chances of conception.
Not every woman living with PMOS will experience significant fertility difficulties, and many go on to conceive naturally. However, it can be worthwhile to see Dr Mandana to gain a better understanding of your fertility after a diagnosis of PMOS, even if your family building plans are still some years away.
There is no single diagnostic test to confirm the presence of PMOS. Instead, testing for PCOS/PMOS is usually a combination of:
Including your symptoms such as menstrual patterns.
To assess androgen levels, insulin resistance, and other hormones relevant to ovulation and metabolic health.
To assess your ovaries and antral follicle count.
Through healthy lifestyle changes, which can meaningfully improve ovulation and hormonal balance for some women, even with modest reductions.
Such as letrozole, which is often used as a first-line treatment to encourage regular egg release, then followed by timed intercourse.
Sometimes used to improve insulin sensitivity, which can help restore more regular ovulation in some women; it is often used alongside ovulation induction medications.
Including IUI or IVF, which may be recommended where ovulation induction alone hasn’t been successful, or where other fertility factors are also present.
Because PMOS affects so much more than fertility alone, Dr Mandana takes care to address the bigger picture that considers your overall wellbeing, helping you find a treatment approach that fits your symptoms, priorities, and family-building goals.
If you need specialist advice and care for achieving your family building goals, you’ve come to the right place. Get in touch with Dr Mandana Master at Embrace Fertility today.
