

With the recent renaming of Polycystic Ovary Syndrome (PCOS) to Polyendocrine Metabolic Ovarian Syndrome (PMOS), there is now much greater emphasis on something we have known for a long time: PCOS is about much more than the ovaries.
For many women, fertility is the main reason they seek help with PMOS. But not everyone with PMOS is trying to conceive. You may have finished having children, or fertility may simply not be your main concern right now. Perhaps you are more worried about weight gain, energy levels, blood sugar, cholesterol or what it all means for your health in the years ahead.
This is where looking more closely at your metabolic health can be particularly useful.
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The new name puts the metabolic side of the condition much more firmly on the map.
Women with PMOS have a higher risk of insulin resistance, impaired glucose regulation and type 2 diabetes, regardless of their BMI. There can also be an increased risk of cardiovascular problems, making metabolic and cardiovascular health important areas to keep an eye on.
And importantly, you don’t have to be overweight to have metabolic issues.
It is possible to have a healthy BMI and relatively normal blood glucose while still having underlying insulin resistance. This is one reason we shouldn’t rely on weight or fasting glucose alone when looking at someone’s metabolic health
One relatively simple place to start is fasting insulin, alongside fasting glucose.
Your blood glucose may still sit within the normal range while your body is producing more insulin than it ideally should to keep it there. Looking at fasting insulin can therefore give us some additional information about how hard the body is working to regulate blood sugar.
Fasting glucose and fasting insulin can also be used to calculate HOMA-IR, an estimate of insulin resistance.
HOMA-IR isn’t a diagnostic test for PMOS and it has its limitations, but it can be a useful piece of the puzzle when considered alongside symptoms, medical history and other blood markers.
For some women with PMOS, this kind of assessment can be particularly helpful if fertility isn’t the main focus and the goal is instead to understand and improve long term metabolic health.
The “metabolic” part of PMOS also gives us a good reason to think beyond blood sugar.
Women with PMOS should have their cardiovascular risk considered, including a standard lipid profile looking at total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides.
For some women, it may also be worth going a little further.
An advanced lipid profile can provide additional information about cardiovascular risk. Depending on your individual circumstances, this might include markers such as ApoB and Lp(a).
ApoB gives us an indication of the number of potentially harmful lipoprotein particles in the blood, while Lp(a) is a largely genetically determined risk factor that isn’t included in a standard cholesterol test.
Again, these aren’t tests that everyone with PMOS automatically needs. They can be particularly relevant where there is a family history of cardiovascular disease, metabolic concerns or other risk factors.
There isn’t one specific PMOS diet and what works well for onemay not be appropriate for another.
For some, the focus might be improving blood sugar regulation. For another, it might be supporting healthy cholesterol levels, managing weight, improving energy or making sure the diet provides enough protein, fibre and essential fats.
Sleep, exercise, stress and alcohol intake can also have an impact on metabolic health, so these need to be considered alongside diet.
The aim isn’t to create a long list of foods you can and can’t eat. It is about understanding where the biggest opportunities are for you and making changes that are realistic enough to maintain.
One of the things we hope the new PMOS terminology will change is the perception that this condition is primarily a fertility issue. Of course, PMOS can have a significant impact on ovulation and fertility, and nutritional support can be extremely valuable for women trying to conceive.
But the condition doesn’t stop being relevant once fertility is no longer a priority.
Supporting insulin sensitivity, cardiovascular health, healthy blood lipids and overall metabolic health is important throughout a woman’s life.
If you want support with PMOS get in touch with us to find out more about how we can help or book an appointment with one of our nutrition team.