For decades, polycystic ovarian syndrome (PCOS) was viewed primarily as a reproductive condition. Its recent renaming to polycystic metabolic and ovarian syndrome (PMOS) signals a deeper reckoning: this is a systemic disorder touching metabolism, mental health, and long-term cardiovascular risk. Dr Reji Mohan, associate professor in reproductive medicine at government medical college, Thiruvananthapuram, talks to Unnikrishnan S about early detection, care gaps, and the road ahead. Edited excerpts:
How early should girls be screened for PMOS?
Screening should ideally begin around age 10 for girls showing early warning signs — irregular periods, excess hair growth, persistent acne, or unexplained weight changes. Parents and teachers often dismiss these as typical teenage issues, but they can signal underlying hormonal imbalance. Girls with obesity, a family history of PMOS, or early puberty changes are at high risk. Timely identification can prevent serious outcomes like diabetes, cardiovascular disease, and infertility.
Why does diagnosis take time?
PMOS symptoms — weight gain, irregular cycles, excess hair — closely resemble those of thyroid disorders, adrenal conditions, or simple obesity. This overlap causes frequent misdiagnosis, leaving women untreated during a critical window when early intervention could have made a real difference. The result is years of fragmented or incorrect care before a woman reaches the right specialist.
PMOS has strong links to insulin resistance, thyroid disorders, and mental health conditions like anxiety and depression. Is integrated, multi-speciality care available?
Integrated care is still evolving. Some hospitals now offer multidisciplinary clinics where gynaecologists, endocrinologists, dietitians, dermatologists, and mental health professionals collaborate. But many systems continue to operate in silos, forcing patients to navigate multiple specialists without coordinated oversight. “One-stop” PMOS clinics represent a promising model — one that needs urgent and wider adoption to ensure reproductive, metabolic, and psychological dimensions of the condition are addressed together.
Fertility is often the first reason women seek help for this condition. What are the health risks that go undiscussed?
Many women first seek medical help for PMOS/PCOS because of fertility concerns, but the condition carries far broader health implications that often go under-communicated. Irregular cycles and chronic anovulation raise the risk of endometrial hyperplasia and cancer. Metabolic disturbances — central obesity, impaired glucose tolerance, dyslipidaemia — increase the likelihood of heart disease and type-2 diabetes. Anxiety and depression are also common, yet psychological support is rarely integrated into routine care. PMOS must be understood as a lifelong systemic condition, not just a reproductive one, with proactive counselling on all associated risks.