PMOS is not just a period problem; here's why doctors prescribe diabetes pills

Before the historic name change, the Polyendocrine metabolic ovarian syndrome (PMOS) fell short of an adequate clinical vocabulary which could represent its symptoms in totality.

The complex metabolic condition which affects one in eight women for long is limited to ovarian symptoms, downsizing the metabolic load of the disorder which affects multiple systems in the body.

As per the Endocrine Society, the older name PCOS (Polycystic ovarian syndrome) reduced a long-term metabolic disorder to a fertility problem. 

Over a decade, the presence of ‘ovarian cysts’ was taken as a signature presentation of the disease.

Upon better understanding of the disease, it was found that there were no actual cysts in the ovaries but a batch of premature cells that resembled them.

As per an article published in the Lancet, the inaccurate terminology led to delay in diagnosis, fragmented treatment and stigma around the condition.

Not just a period problem

The disadvantage of using a misnomer was not limited to patients alone but also to specialists who struggled to explain the condition to them.

Apart from the frontline symptoms like irregular periods, receding hairline, excessive body hair and elevated male androgens (testosterone), people having PMOS are at high risk of metabolic dysfunction, including diabetes, high levels of lipids, hypertension, fatty liver and other cardio-metabolic disorders.

However, the limited acronym which made it a ‘cyst’ disease was insufficient in explaining the metabolic load of the disorder. 

As per experts, this made patients take their symptoms less lightly and in some cases stop treatment after childbirth.

Speaking to DH, Dr. Vaishali Sharma, a senior gynaecologist and fertility specialist at AIIMS said, “They only come to us for getting their periods regularised or when they want to build a family. In their mind, as the name suggests, it is a period problem and this is where it became scary. The limited vocabulary made it hard for us to explain to them the complete profile of the disorder of which ovarian symptoms are just a small part.”

People having PMOS are also prone to insulin resistance, a condition that makes the body insensitive to its action. With the hormone reserves increasing on the production, the metabolic state runs a high risk of developing into type 2 diabetes. 

As per experts, many women are prescribed tablets like metformin (a diabetes pill) to balance their hormones. The pill is needed for them even when they are not diabetic on reports and this creates confusion in their mind.

“At some point, we all have struggled to explain to our patients why we are putting them on certain pills, why we are asking them to seek help from a nutritionist, why we are asking them to get certain tests done. Even if we tell them, the diagnostic terminology will not sit well with its description and they will feel more confused,” said Dr Sharma.

While most medical doctors felt optimistic about the change of name, a few felt the acronym could have been preserved for practical purposes.