Take on your diagnosis one step at a time with these gynecologist-backed tips.
Reviewed by Dietitian Madeline Peck, RDN, CDN
Key Points
- Managing PMOS combines nutrition, lifestyle interventions and medications.
- Work with your health care providers to support insulin sensitivity and getting a regular period.
- Discuss fertility plans early to manage ovulation changes and support future pregnancy goals.
A new diagnosis can bring up feelings of uncertainty, especially when it involves your reproductive health. Polyendocrine metabolic ovarian syndrome (PMOS), formerly known as polycystic ovary syndrome (PCOS), is a common condition that affects an estimated 5% to 26% of women of reproductive age. It is characterized by hormonal and metabolic changes that affect menstruation, ovulation, androgen levels and insulin sensitivity. As a result, symptoms may include irregular periods, abnormal hair growth, changes in weight and even infertility.
While taking the first steps after receiving a PMOS diagnosis can feel daunting, gynecologists emphasize that it is entirely possible to manage this condition. “Knowledge is power. Managing PMOS isn’t just about your period. It’s about protecting your health and lowering your long-term risk of complications,” says Nicole Kerner, MD, FACOG, MSCP. With the right care and lifestyle changes, you can take the necessary steps to manage the condition and protect your overall health. Here’s what gynecologists recommend doing first.
Prioritize Insulin Sensitivity
One of the first things to focus on after a PMOS diagnosis is supporting insulin sensitivity. Insulin resistance is common among those with PMOS and occurs when your cells become less responsive to insulin. As a result, insulin levels can rise, which may contribute to hormonal changes that negatively impact ovulation, menstruation and energy levels. To improve how your body responds to insulin, Kerner recommends prioritizing nutrition and exercise. Your doctor may also recommend pairing these lifestyle changes with certain medications that can support insulin sensitivity.
Start by building meals around nutrients that support stable blood sugar levels, such as fiber-rich fruits and vegetables, lean proteins, healthy fats and whole grains. Fiber, in particular, has been shown to have positive metabolic benefits, helping to improve insulin resistance, blood sugar and the gut microbiome. Caledonia Buckheit, M.D., highlights that these nutrients are important for people with PMOS because they may help reduce the metabolic and endocrine risks associated with the condition, such as type 2 diabetes, hyperlipidemia, heart disease and obesity.
Physical activity can also make a meaningful difference. Buckheit shares that regular moderate- to high-intensity exercise can significantly improve insulin sensitivity by helping muscle cells respond better to insulin. In turn, these cells are able to take up glucose from the bloodstream more efficiently. Buckheit also recommends lifting weights several times a week to help maintain adequate muscle mass, support bone health and improve overall metabolic health.
Protect Your Uterine Lining
A period that doesn’t come every month can be easy to brush off, especially when irregular cycles are one of the main symptoms of PMOS. But going months without a period can be more serious than it may seem. “People with PMOS often do not have regular menstrual cycles because they may not ovulate regularly,” says Buckheit. Without regular cycles, Kerner adds that the lining of the uterus can grow unchecked, which raises the risk of developing endometrial hyperplasia and, over time, cancer.
“Because of this, as a gynecologist, I always explain to patients with PMOS that they need to have a plan for protecting their uterus from excess cancer risk,” Buckheit emphasizes. She explains that this is especially important when cycles are more than 60 to 90 days.
Fortunately, your gynecologist can help determine the right approach to protect your uterine lining and ensure it sheds regularly. “For those wanting to avoid pregnancy, a birth control pill, either combined estrogen and progestin pills or progestin-only pills, can accomplish both endometrial protection and pregnancy prevention nicely,” says Buckheit. She shares that a progestin-containing IUD can also another option for preventing pregnancy and protecting the uterine lining. However, if a patient prefers not to use a birth control method, she recommends cyclic use of progestins. The goal is to get a plan in place early to maintain a healthy uterine lining.
Consider Your Fertility Goals
If you’re planning to become pregnant, it’s also important to consider how a new PMOS diagnosis may affect your fertility. PMOS is among the most common but treatable causes of infertility. PMOS can change how your body ovulates, which means ovulation may occur less often or become less predictable. This does not mean you can’t get pregnant, but it can make it harder to pinpoint your fertility window.
Even if pregnancy isn’t in your plans right now, discussing your reproductive health with your gynecologist can help you make informed decisions that can support your fertility in the future. “Irregular ovulation can lead to a longer time to conception, and possibly a need for ovulation-inducing medications,” Buckheit explains. “I advise my patients to keep this in mind when they are thinking about their fertility timeline and encourage them to stay established with a gynecologist who can help them achieve their goals.”
Our Expert Take
PMOS can affect your hormonal and metabolic health in several ways, but there are ways to address those changes and reduce your risk of complications. The first step is supporting insulin sensitivity through nutrient-rich meals and regular physical activity. It’s also important to talk to your health care providers about ways to protect your uterine lining and, if pregnancy is part of your plan, to discuss fertility and reproductive options. With the right support and a plan tailored to your unique needs, you can manage PMOS while improving your long-term metabolic health.