PMOS isn't just about your ovaries: understanding the condition beyond the name
If you've recently been diagnosed with PMOS (Polyendocrine Metabolic Ovarian Syndrome), you may already know it was previously called PCOS (Polycystic Ovary Syndrome).
At first glance, the change in name may seem like little more than a medical update. In reality, it reflects something much more important: our understanding of the condition has evolved.
For many years, the name Polycystic Ovary Syndrome suggested that the ovaries were at the centre of the problem. We now know this isn't the case.
PMOS is a complex hormonal and metabolic condition involving several interconnected systems throughout the body. The ovaries are certainly affected, but they are responding to a much wider hormonal and metabolic environment rather than causing the condition themselves.
This broader understanding helps explain why PMOS can look so different from one woman to another, and why there is no single treatment that works for everyone.
PMOS looks different for every woman
One of the reasons PMOS can be so confusing is that there is no single "typical" presentation. Two women with the same diagnosis may have very few symptoms in common.
For some, the main issue is infrequent or absent ovulation, leading to irregular menstrual cycles and, sometimes, difficulty conceiving. Others continue to ovulate but experience symptoms related to elevated androgen ("male") hormones, such as acne, excess hair growth or thinning hair. Some develop insulin resistance and notice changes in their weight, appetite or energy levels, while others remain lean and experience very few metabolic symptoms.
Contrary to what the old name suggested, not every woman with PMOS has polycystic-appearing ovaries on ultrasound. Equally, many women have polycystic ovaries without having PMOS. The ovaries are only one piece of a much larger hormonal and metabolic picture.
This is one of the reasons PMOS can sometimes take years to diagnose.
Unlike many medical conditions, there isn't a single blood test that confirms PMOS. Instead, healthcare professionals make the diagnosis using internationally agreed criteria while excluding other conditions that can cause similar symptoms, such as thyroid disorders, elevated prolactin levels or congenital adrenal hyperplasia.
In most cases, the diagnosis is based on the presence of two of the following three features:
Irregular or absent ovulation
Clinical or biochemical signs of androgen excess, such as acne, excess hair growth or elevated testosterone levels
Polycystic ovarian morphology on ultrasound
This means that two women can both have PMOS without sharing the same symptoms. Understanding the diversity is important because it reminds us that treatment should always be tailored to the individual, rather than based solely on the diagnosis.
Managing PMOS: finding the right combination
Because PMOS presents so differently from one woman to another, there is no single treatment that works for everyone.
Depending on your symptoms, priorities and stage of life, your healthcare team may recommend lifestyle changes, medication, fertility treatment or a combination of approaches.
For some women, the contraceptive pill can be very effective at regulating menstrual cycles or improving acne. Others may be prescribed Metformin to improve insulin sensitivity and support metabolic health. These treatments have helped many women and remain an important part of PMOS management.
Like any medication, however, they can also cause side effects. For example, Metformin commonly causes digestive symptoms such as nausea, abdominal discomfort or diarrhoea, particularly when treatment begins, while hormonal contraception may not suit everyone's preferences, medical history or reproductive goals.
This doesn't mean one approach is better than another. Instead, it highlights the importance of finding a treatment plan that works for you.
Many women also choose to complement their medical care with nutritional support, regular movement, stress management and acupuncture. These approaches help to support symptoms, improve quality of life and promote long-term health.
A Traditional Chinese Medicine perspective
One of the fundamental principles of Traditional Chinese Medicine is that it treats the individual rather than the diagnosis.
From this perspective, PMOS is not viewed as a single condition requiring a standard treatment. Instead, practitioners look for the particular pattern of imbalance contributing to each woman's symptoms.
For one woman, treatment may focus on encouraging regular ovulation and supporting menstrual cycles. For another, improving digestion and metabolic function may take priority. Someone else may primarily need support for stress, sleep or fatigue.
Although all three women may have the same Western diagnosis, they are unlikely to receive exactly the same acupuncture treatment.
Traditional Chinese Medicine describes these patterns using terms such as Liver Qi stagnation, Dampness or Kidney deficiency. While these concepts may sound unfamiliar, they are simply different ways of describing patterns of function within the body rather than individual diseases.
Liver Qi stagnation
Women whose symptoms fit this pattern often notice that stress has a profound impact on their health.
They may describe feeling emotionally tense or easily overwhelmed, with symptoms that fluctuate according to what's happening in their lives. Premenstrual irritability, breast tenderness, headaches, bloating or digestive discomfort are common, and menstrual cycles may become more irregular during particularly stressful periods. Sleep is often affected too, especially when the mind struggles to switch off at night.
Dampness
Another woman may present with what Chinese medicine calls Dampness.
She may experience persistent fatigue, especially after eating, bloating, sluggish digestion, brain fog or a feeling of heaviness in the body. Weight may be difficult to lose despite healthy habits, and she may notice fluid retention or a tendency towards elevated blood sugar levels or insulin resistance.
From a Chinese medicine perspective, treatment focuses on supporting digestion and helping the body transform and move fluids more efficiently.
Kidney deficiency
Despite its name, this pattern does not mean there is anything medically wrong with the kidneys.
In Chinese medicine, the Kidneys are considered the foundation of growth, reproduction and long-term vitality. Women presenting with this pattern may have longstanding menstrual irregularities, reduced ovarian reserve, recurrent pregnancy loss, profound fatigue or simply the feeling that their body struggles to recover after periods of stress or illness.
Treatment aims to nourish and strengthen these deeper reserves while supporting the body's reproductive function.
Of course, very few women fit neatly into a single pattern. Most present with a combination of several patterns that evolve over time, which is why acupuncture treatment is continually adapted as symptoms change.
Interestingly, this individualised approach reflects what modern medicine increasingly recognises: PMOS is not one uniform condition but a syndrome with many different presentations. Two women may share the same diagnosis yet require very different treatment.
Although the language is different, both approaches acknowledge something important: understanding the individual behind the diagnosis is often just as important as understanding the diagnosis itself.
Bringing both perspectives together
I believe one of the strengths of combining modern medicine with Traditional Chinese Medicine is that they ask slightly different questions.
Modern medicine helps us understand the hormonal, metabolic and reproductive mechanisms involved in PMOS. Chinese medicine looks at how those imbalances are experienced by the individual sitting in front of us.
Together, they offer a broader understanding of health that is both evidence-informed and highly personalised.
Whether your priority is regulating your menstrual cycle, improving your fertility, managing acne, supporting your energy levels or simply feeling more like yourself again, treatment should begin with understanding your unique presentation rather than assuming every woman with PMOS needs the same approach.
Interested in learning more?
If you've been diagnosed with PMOS or are wondering whether acupuncture could support your symptoms, you may also like to read my page on Acupuncture for PMOS (formerly PCOS). It explains how acupuncture may help support menstrual health, ovulation, fertility, metabolic health and emotional wellbeing, alongside conventional medical care, and what you can expect if you decide to seek treatment.
References
International PMOS Guideline Development Group. International Evidence-Based Guideline for the Assessment and Management of Polyendocrine Metabolic Ovarian Syndrome (PMOS). Monash University, ASRM, ESHRE and international collaborators. 2026.
Teede HJ, Tay CT, Laven JSE, et al. Recommendations From the 2023 International Evidence-Based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. Human Reproduction. 2023;38(9):1607-1631.
International Evidence-Based Guideline for the Assessment and Management of Polycystic Ovary Syndrome 2023. Monash University. Available at: https://www.monash.edu/medicine/mchri/pcos
Escobar-Morreale HF. Polycystic ovary syndrome: definition, aetiology, diagnosis and treatment. Nature Reviews Endocrinology. 2018;14:270-284.
Azziz R, Carmina E, Chen Z, et al. Polycystic ovary syndrome. Nature Reviews Disease Primers. 2016;2:16057.
Goodman NF, Cobin RH, Futterweit W, et al. American Association of Clinical Endocrinologists, American College of Endocrinology and Androgen Excess and PCOS Society Clinical Practice Guidelines for Polycystic Ovary Syndrome. Endocrine Practice. 2015;21(11):1291-1300.