- Dr. Revathi S. Rajan, Obstetrician and Gynaecologist, Consultant Maternal Fetal Medicine, Apollo Clinic
- Dr Preeti Rastogi, Director & HOD, Institute of Obstetrics and Gynaecology, Medanta
- Dr. Nidhi Rajotia (Goel), Unit Head - Obs & Gynae, Artemis Hospitals
- Dr David Chandy, Director of Endocrinology and Diabetology at Sir HN Reliance Foundation Hospital
- Dr Vinutha Arunachalam, Senior Consultant Obstetrics & Gynecology & Reproductive Medicine, Apollo Women’s Hospitals
- Dr. Kanika Jain, Senior Consultant, Gynaecologist, Endoscopy, Sir Gangaram Hospital
- Dr. Rashmi Rekha Bora, Head and senior consultant - Gynaecologic oncology, Dharamshila Narayana Superspeciality Hospital
- Dr. Smrithi D Nayak, Consultant - Obstetrics & Gynaecology, Aster RV Hospital
Polycystic Ovary Syndrome is now known as Polyendocrine Metabolic Ovarian Syndrome. The earlier term, PCOS, often led both patients and doctors to focus only on ovarian or reproductive health, causing confusion and delays in diagnosis.The new term reflects a broader understanding of the condition as a complex metabolic and endocrine disorder. PMOS now includes screening for insulin resistance, diabetes, obesity, cardiovascular disease, psychiatric conditions, and sleep disorders, in addition to reproductive concerns. Management will involve multidisciplinary care with gynecologists, endocrinologists, dermatologists, nutritionists, and mental health professionals working together.Here are answers to the most commonly asked questions about PMOS from experts across leading hospitals.
Is PCOS different from PMOS?
PCOS and PMOS refer to the same condition. The difference lies in how the condition is understood medically. PMOS better reflects the endocrine and metabolic nature of the disorder beyond ovarian cysts alone. PMOS is a whole-body, lifelong disorder affecting multiple systems, including hormones and metabolism.Dr Rashmi Rekha Bora explained that PMOS diagnosis involves a more comprehensive evaluation, including menstrual history, signs of hormonal imbalance, insulin resistance, body composition, metabolic markers, and ultrasound examination when required. Blood tests may include glucose tolerance, lipid profile, and hormone levels to detect underlying metabolic dysfunction even in women without classic ovarian cyst patterns.
What was limiting about the term “Polycystic Ovary Syndrome”?
Dr David Chandy said many people assumed the condition only involved ovarian cysts, which is medically inaccurate. Many women with PCOS do not have ovarian cysts at all.The experts clarified that the “cysts” are actually immature ovarian follicles that fail to rupture and accumulate along the outer layer of the ovary, disrupting hormonal balance.Dr Vinutha Arunachalam added that PCOS made both doctors and patients focus mainly on the ovaries, while important risks such as insulin resistance, type 2 diabetes, fatty liver disease, and cardiovascular complications often went unnoticed.
How is PMOS diagnosed?
Dr Nidhi Rajotia (Goel) said diagnosis is based on symptoms, medical history, and clinical examination. Common investigations include hormone level testing, blood sugar and insulin resistance testing, lipid profile, ultrasound examination, body mass index (BMI), waist circumference, and blood pressure assessment.Signs such as acne and excess hair growth may also be assessed. Lifestyle factors such as diet, exercise, sleep, and stress are also considered because of PMOS’ strong metabolic link.Dr. Kanika Jain noted that PMOS will continue to be evaluated based on Rotterdam's criteria or the international PCOS consensus guidelines. Diagnosis generally requires two out of three features, such as ovulatory dysfunction or irregular periods; hyperandrogenism (clinical or biochemical); and ultrasound evidence of polycystic ovaries.Clinical hyperandrogenism may include acne, hirsutism, or hair loss, while biochemical signs include elevated testosterone levels. On ultrasound, ovaries may show a “string of pearls” appearance caused by multiple immature follicles arranged along the ovarian cortex.
What fertility myths need to end?
One major myth is that only overweight women develop PMOS. Thin women can also have the condition and experience insulin resistance.Another misconception is that ovarian cysts are necessary for diagnosis. Some women with PMOS have no cysts, while some women with polycystic ovaries do not have the syndrome.The experts also stressed that PMOS affects much more than fertility or menstrual cycles. It can impact metabolism, skin health, mood, body weight, and cardiovascular health while increasing diabetes risk.
Are supplements genuinely effective?
Experts said some supplements may support PMOS management, but they are not substitutes for medical treatment or lifestyle changes.Dr Preeti Rastogi noted that supplements such as Myo-inositol, omega-3 fatty acids, vitamin D, and NAC (N-acetyl cysteine) may help improve insulin sensitivity, hormone balance, fertility, and inflammation. However, many online supplements lack scientific evidence. Self-medication may also interfere with prescribed treatments.Vitamin D3 supplementation may help if deficiency is present, while CoQ10 has shown benefits for egg quality and metabolic health.Experts warned against unregulated “hormone balance” teas, detox products, and herbal blends that lack clinical proof.
What are the earliest signs women often ignore?
Doctors said early PMOS symptoms are frequently mistaken for stress, puberty, or normal body changes.Common early signs include menstrual cycles longer than 35 days, persistent acne around the jawline and neck, unexplained abdominal weight gain, excess facial hair, hair thinning, and fatigue and sleep disturbances. These symptoms may indicate hormonal imbalance and metabolic dysfunction.
Can women with PMOS still get pregnant?
Yes, said the experts, stressing that PMOS does not mean infertility. It mainly affects ovulation timing and egg release. Many women conceive naturally, while others may benefit from ovulation-inducing medications or IVF treatment.Another myth is that regular periods automatically mean normal fertility. Some women may bleed regularly but still not ovulate consistently.Further, weight loss can improve symptoms and restore ovulation in many women, but it is not a universal cure, especially for lean women with PMOS driven by different hormonal pathways.
What diet and lifestyle changes work best?
Most experts recommend a Mediterranean-style diet focused on high-fibre foods, lean protein, healthy fats, whole grains, fruits, and vegetablesDr Smrithi D Nayak highlighted strategies such as: strength training and regular movement, high-protein, high-fibre meals, and better sleep quality, stress reduction, limiting ultra-processed foods, and sustainable weight management.Instead of eliminating carbohydrates, doctors recommend combining them with protein or healthy fats to reduce blood sugar spikes. For example, pairing rice with dal, curd, or another protein source may help improve insulin response.
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