There is no cure for polyendocrine metabolic ovarian syndrome (PMOS). But you can manage the symptoms.
Lifestyle changes
Lifestyle changes can make big improvements to symptoms of PMOS and your long-term health.
If you carry excess weight, losing weight can help improve your PMOS symptoms.
Non-urgent advice: Contact your GP or practice nurse if:
- you have PCOS and find it hard to lose weight
Your GP may refer you to a dietitian.
Eating low glycaemic index (GI) foods may also help your PMOS. Low GI foods are absorbed by your body more slowly. This means your blood sugar stays stable.
Examples of low GI foods include:
- wholemeal bread
- pasta
- brown rice
- most fruits, vegetables and pulses
Medicines for PMOS
You may need to take medicines to treat different symptoms of PMOS.
Medicine for irregular or absent periods
Having no periods for a long time if you are not taking hormonal contraception can be a risk factor for endometrial cancer (womb cancer).
To get regular periods, you may need:
- the combined contraceptive pill
- progestogen tablets
These medicines will lower your chances of getting endometrial cancer.
Other hormonal contraception may lower your chances of getting endometrial cancer by keeping your womb lining thin. For example, an intrauterine system (IUS). But you may not get your period while using it.
Medicines for fertility problems
PMOS can sometimes cause problems getting pregnant. Some women may need treatment to help them get pregnant.
If you are trying to get pregnant, you may get a short course of tablets known as clomiphene. You take clomiphene at the start of each menstrual cycle for a few months. It stimulates ovulation.
Clomiphene is commonly used for most women with PMOS. A fertility specialist can prescribe it.
If clomiphene is not successful, you may need injections or in vitro fertilisation (IVF).
Other medicines you may be prescribed include:
- metformin - this can help lower your insulin levels and stimulate fertility
- letrozole - sometimes used instead of clomiphene
- gonadotrophins - you get this by an injection but it may overstimulate your ovaries and cause multiple pregnancy
If you are using metformin to regulate your insulin and do not want to get pregnant, use contraception.
Important
All treatments for fertility problems must be supervised by a fertility expert who offers regular ultrasound checks. Do not take any of these medicines unsupervised.
Medicine for unwanted hair growth and hair loss
Medicines to control excessive hair growth (hirsutism) and hair loss (alopecia) include:
- oral contraceptive tablets
- cyproterone acetate
- spironolactone
- finasteride
These medicines block the effects of male hormones, such as testosterone. Some also stop your ovaries from making male hormones.
Eflornithine is a cream that can slow down the growth of unwanted facial hair.
It does not:
- remove hair
- cure unwanted facial fair
You can use it with a hair removal method. You may see improvements between 4 to 8 weeks after using the medicine.
Hair removal methods will remove excess hair growth. They include plucking, shaving, threading, hair removal creams or laser hair removal.
Medicine for other PMOS symptoms
Medicines can treat some of the other PMOS symptoms.
These include:
- weight loss medicine if you have overweight or obesity
- medicine to lower your cholesterol - such as statins
- acne treatment
Surgery for PMOS
Laparoscopic ovarian drilling (LOD) is a minor surgery. It may be an option if fertility medicines do not improve your PMOS.
Your doctor will make a small cut in your tummy and pass a laparoscope (thin microscope) into your tummy. This is done under general anaesthetic (when you are asleep).
Your ovaries will be treated using heat or a laser by putting 4 to 5 small openings on the surface of 1 of your ovaries.
LOD can:
- lower your testosterone and luteinising hormone (LH) levels
- raise your follicle-stimulating hormone (FSH) levels
This balances your hormones and makes your ovaries work properly.
Pregnancy risks and PMOS
If you have PMOS, you have a higher risk of pregnancy complications.
These include:
These risks are higher if you have obesity. If you have excess weight or obesity, you can lower your risk by losing weight before trying for a baby.
Content supplied by the NHS and adapted for Ireland by the HSE
