Polycystic Ovary Syndrome (PCOS)

Polyendocrine Metabolic Ovarian Syndrome (PMOS)

Polycystic ovary syndrome (PCOS), now referred to as polyendocrine metabolic ovarian syndrome (PMOS), is a common hormonal and metabolic condition that affects people of reproductive age. The new name reflects the growing understanding that the condition involves more than the ovaries. In fact, many people with PCOS do not have ovarian cysts, and ovarian cysts are not required for diagnosis.

PMOS can affect many aspects of health, including menstrual cycles, fertility, metabolism, skin, hair, and long-term cardiovascular health. By coordinating care with endocrinologists, dermatologists, gynecologists, fertility specialists, and dietitians, your team of Duke specialists can tailor care to your needs.

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About Polyendocrine Metabolic Ovarian Syndrome

PMOS most often begins around puberty, but may not be recognized until adolescence or adulthood. People with a family history of PMOS may be more likely to have the disorder. Because symptoms can mimic common issues women face throughout their lives, it’s important to talk to your provider when changes to your body occur so they can determine if PMOS is the cause.

Common Signs and Symptoms PMOS may cause include:

Irregular or absent menstrual periods
Difficulty becoming pregnant due to irregular ovulation
Acne or oily skin
Increased facial or body hair (hirsutism)
Hair thinning of female pattern hair loss (androgenetic alopecia)
Weight gain or difficulty losing weight
Insulin resistance, prediabetes, or diabetes
Ovaries with multiple small follicles seen on ultrasound

Not everyone experiences the same symptoms. Your care team will tailor your treatment plan to your individual needs, health goals, and long-term wellness.

Our Locations

Duke Health offers testing and treatment for PCOS at two locations in Durham and one in Raleigh. Find an option near you.

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Diagnosing Polyendocrine Metabolic Ovarian Syndrome

There is no single test for PMOS. Your provider will review your medical history, symptoms, family history, and perform a physical examination. Because PMOS can produce symptoms that impact many areas of your life, you’ll work with a team of specialists that may include experts in endocrinology, fertility, dermatology, and nutrition. Our providers may request the following tests to confirm whether you have PMOS.

Blood Tests

Individuals with PMOS may have elevated levels of androgens, a group of hormones that are naturally present in all people and play important roles in the body. Higher androgen levels can contribute to symptoms such as acne, increased facial or body hair growth, and thinning of scalp hair. A blood test can measure androgen levels and help evaluate the source of hormone changes.

Pelvic Ultrasound

A pelvic ultrasound uses a vaginal ultrasound probe to evaluate the ovaries and uterus. Some people with PMOS have ovaries containing many small follicles, sometimes called "polycystic ovaries," while others have a normal ultrasound. Ultrasound findings alone do not determine whether you have PMOS and are only one part of the diagnostic evaluation.

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Treatments for Polyendocrine Metabolic Ovarian Syndrome

Treatment is individualized based on your symptoms, reproductive goals, and overall health. Our goals are to improve symptoms, support fertility when desired, and reduce long-term metabolic and cardiovascular risks. Because PMOS is associated with increased metabolic risk, your provider may recommend lifestyle changes, regular health screenings, and medications to improve symptoms and reduce long-term health risks.

Medication

Depending on your symptoms and goals, medications may be recommended to:

Regulate menstrual cycles
Reduce acne and excess hair growth
Treat hair thinning
Improve insulin resistance
Support ovulation and fertility
Assist with weight management when appropriate

Your treatment plan will be individualized based on your health history and preferences.

Diet and Exercise

Healthy lifestyle changes are an important part of PMOS management and can improve metabolic health, hormone balance, menstrual regularity, energy levels, and overall well-being. A dietitian can help you create sustainable eating habits that emphasize nutrient-rich foods and support your individual health goals. Regular physical activity can also improve insulin sensitivity and support long-term health.

Weight Management Support

Weight management can be an important part of improving metabolic health for some people with PMOS. Achieving even modest weight changes can improve insulin resistance, hormone balance, menstrual regularity, and reduce the risk of conditions such as diabetes and cardiovascular disease.

Your Duke care team can support your health goals through individualized nutrition guidance, physical activity recommendations, and medications when appropriate. For people who are interested in additional support with weight management, Duke offers a multidisciplinary Weight Management Clinic and weight loss programs.

Fertility

PMOS does not mean that you cannot become pregnant, but irregular ovulation can make conception more difficult. Improving metabolic health and restoring more regular ovulation may support fertility goals. Your care team can discuss treatment options to support fertility based on your individual goals.

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Duke University Hospital is proud of our team and the exceptional care they provide. They are why we are recognized as the best hospital in North Carolina, and nationally ranked in 8 adult and 10 pediatric specialties by U.S. News & World Report for 2026–2027.

Skin and Hair Conditions Related to PMOS

Polyendocrine metabolic ovarian syndrome can change hormone levels (known as hyperandrogenism) and cause common hair disorders like unwanted growth on your body or unexpected loss. These are normal side effects that can be treated in collaboration between our endocrinologists and experts in dermatology, who specialize in treating skin and hair conditions related to PMOS. If you’re impacted by female pattern hair loss, excess hair on your face, chest, or back (hirsutism), acne, or other skin conditions, we can recommend medications or treatments to minimize these changes and make you feel more comfortable.

Long-Term Health

Because PMOS is also a metabolic condition, people with PMOS have a higher risk of developing:

Prediabetes and type 2 diabetes
High blood pressure
High cholesterol
Metabolic dysfunction-associated steatotic liver disease (MASLD)
Obstructive sleep apnea
Cardiovascular disease

Regular follow-up allows your care team to monitor for these conditions and recommend preventive strategies to support lifelong health.

This page was medically reviewed on 08/19/2026 by

Carly E. Kelley, MD, MPH, ECNU | Endocrinologist