What You Need to Know About Polyendocrine Metabolic Ovarian Syndrome (PMOS) and Fertility

Polyendocrine metabolic ovarian syndrome (PMOS) affects your skin, hormones, metabolism, and reproductive system. This condition — formerly known as polycystic ovary syndrome (PCOS) — is also one of the most common causes of infertility (difficulty getting pregnant) in women.

The good news is that pregnancy is possible for women with PMOS. And there are many effective fertility treatments available when needed.

What is PMOS (formerly PCOS)?

PMOS is a hormone and metabolic condition that affects about 1 in 10 women of reproductive age. It’s usually diagnosed during the reproductive years, but its effects can continue through menopause and beyond. 

People with PMOS often have higher-than-normal levels of androgens. You may hear androgens called “male hormones,” but it’s normal for female bodies to make them too. Higher androgen levels can contribute to irregular periods and other PMOS symptoms.

PMOS is typically diagnosed when someone has at least two of these three features: 

• Irregular or absent periods (ovulatory dysfunction)

• Signs of higher androgen levels (like acne or excess facial hair)

• A higher-than-normal number of small follicles in the ovaries 

PMOS is associated with other health conditions, too, like: 

• Type 2 diabetes

• Obstructive sleep apnea

• Excess weight

• High blood pressure 

• Stroke 

PMOS symptoms

PMOS symptoms are linked to hormone imbalances and insulin resistance. Insulin helps control your blood sugar (glucose) levels. Insulin resistance means your body doesn’t respond to insulin as well as it should. As a result, your body may need to make more insulin to keep glucose levels in a healthy range. Over time, this can increase your risk of Type 2 diabetes. 

Common symptoms of PMOS include:

• Irregular periods, no periods, or heavy periods

• Fertility problems (trouble getting pregnant)

• Increased hair growth on the face, chest, stomach, or upper thighs (called hirsutism)

• Acne that can be severe and hard to treat

• Excess body weight (especially around the waist) or difficulties losing weight

• Oily skin

• Patches of thick, dark, velvety skin, usually around the neck, armpits, or genitals (called acanthosis nigricans)

How does PMOS affect fertility?

PMOS can make it harder to get pregnant because it interferes with ovulation. During normal ovulation, ovaries develop and release an egg once every menstrual cycle, or about every 28 days. 

With PMOS, hormone imbalances can disrupt normal egg development and ovulation. As a result, you may ovulate less often or not at all. This means there are fewer opportunities for an egg to be fertilized, which can make it harder to get pregnant. 

Quiz: Could I Have PCOS?

Risks during pregnancy with PMOS

Most people with PMOS can have healthy pregnancies. But PMOS can increase the risk of certain pregnancy complications, including:

• Miscarriage (losing the pregnancy early)

• Gestational diabetes (diabetes that develops during pregnancy)

• High blood pressure during pregnancy and preeclampsia (sudden increase in blood pressure late in the pregnancy that can cause damage to other organs)

• Preterm birth (infant born before 37 weeks of pregnancy)

Because of these risks, your healthcare team may recommend additional monitoring during pregnancy. 

What treatments are available to help with fertility in people with PMOS?

There are several ways to improve fertility in people with PMOS. Treatment depends on your overall health, whether you’re ovulating, and whether there are other factors affecting fertility. Here are some options to consider. 

Are fertility treatments for people with PMOS covered by insurance?

It depends on your insurance plan and where you live. Currently, 25 states have laws addressing insurance coverage for infertility. And 15 states require certain plans to cover IVF. But what’s covered — and who qualifies — varies by state and insurance plan. 

State requirements don’t apply to every health plan. For example, self-funded employer plans are exempt from state insurance laws. Other exemptions may also apply. 

Here’s how to find out what your plan covers:

• Call your insurance company or check your plan documents. 

• Ask your employer’s human resources (HR) or benefits department. 

• Check RESOLVE’s state-by-state guide to learn about infertility insurance laws where you live. 

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Written by:

Maria Robinson, MD, MBA

Maria Robinson, MD, MBA, is a board-certified dermatologist and dermatopathologist who has practiced dermatology and dermatopathology for over 10 years across private practice, academic, and telehealth settings. She is a fellow of the American Academy of Dermatology and the American Society of Dermatopathology.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. A pulmonologist and hospitalist, she practiced and taught clinical medicine at hospitals in London for a decade before entering a career in health education and technology.

Reviewed by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

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