PMOS (Former PCOS) Causes and Treatment Options Detailed

Polycystic ovarian syndrome, now renamed polyendocrine metabolic ovarian syndrome (PMOS), affects up to 13 % of women of reproductive age. Research points to multiple contributing factors: genetics (19 identified genes), hormonal imbalances that raise androgen levels, insulin resistance that promotes both high insulin and androgen levels, chronic inflammation often linked to obesity, and excess body fat acting as an active hormone source.

Treatment strategies focus on weight loss and medication. A modest 5‑10 % weight reduction can restore ovulation. First‑line ovulation drugs include letrozole, which showed a 61.7 % ovulation rate and 27.5 % live‑birth rate in a large trial, outperforming clomiphene. Metformin improves insulin sensitivity and can boost ovulation, especially when combined with letrozole or clomiphene. For patients who do not respond to medication, assisted‑reproductive techniques such as IVF or in‑vitro maturation (IVM) offer higher chances of pregnancy and live birth.