PMOS May Raise Risk of Early Death, Yet Too Many Women Are Undiagnosed

Editor’s Note: In May 2026, the Endocrine Society and other international experts officially renamed polycystic ovary syndrome (PCOS) polyendocrine metabolic ovarian syndrome (PMOS). This change better reflects the condition’s nature as a systemic metabolic disorder. This article has been updated to reflect the new terminology.

“The data showed that women with PMOS died about one year earlier than other women,” says coauthor Terhi Piltonen, MD, PhD, of University of Oulu and Oulu University Hospital in Oulu, Finland. The findings highlight the need for improving treatment for PMOS to prevent related health issues that can shorten lives, says Dr. Piltonen.

PMOS Associated With Increased Risk of Dying From Heart Disease and Diabetes

It’s these effects that the research examined in relation to PMOS and early death.

How Did the Study Connect PMOS and Early Death?

To find out if PMOS may be linked with an increased risk of dying early, researchers studied data from the Finnish Care Register for Health Care using ICD codes (codes that healthcare providers input to report diagnoses and symptoms).

The investigators included records of over 80,000 women: almost 10,000 with PMOS and more than 70,000 without the condition (the control group), all matched based on their year of birth and where they lived.

The participants were followed from 1969 to 2019. During that time, 1,003 women in the control group and 177 women with PMOS died. Key findings of the study included the following:

• Women with PMOS had a 47 percent higher risk of overall mortality compared with women without PMOS.
• The relative risk of dying as a result of cardiovascular disease was 67 percent higher in the women with PMOS.
• The risk of mortality due to tumors was 38 percent higher in the women with PMOS than in those without.
• Women with PMOS had triple the risk of death compared to those without due to diabetes and lung infection.

“This is the first study to show cause-specific mortality in PMOS,” says Piltonen.

Fatima Daoud Yilmaz, MD, an obstetrician and gynecologist at Stony Brook Medicine in New York, who was not involved in the study, is unsurprised by its findings. “It's becoming more and more clear that PMOS is not just a disorder of the female reproductive system or something that exclusively affects the female reproductive system, but rather, it’s a metabolic disturbance, like diabetes or thyroid issues,” says Daoud Yilmaz.

The general public may view PMOS as a reproductive issue, but that couldn’t be further from the truth, she says. “It is absolutely a whole-body issue. Given the comorbidities that we frequently see with PMOS, the findings make sense,” she says.

Understanding the Increased Risk for Women With PMOS

The additional risk discussed in the study is relative risk, not absolute risk. The relative risk described here compares women with PMOS with women without PMOS, explains Daoud.

An example of what that means: If two people in a control group of 100 die during a study, and three people with a certain condition in a group of 100 die during that same period, that means that people with the condition have a 50 percent increased risk of dying.

Cautions About the Study

While the study showed some intriguing results and highlighted the importance of increasing diagnostic rates and identifying suitable treatments, other experts have cautioned that its findings don’t capture the full picture regarding PMOS and mortality.

“Other published studies have shown no increase in early death in women with PMOS,” says Sun Kim, MD, associate professor of medicine and endocrinologist at Stanford Health Care in Palo Alto, California. The findings of the current study need to be interpreted with caution, she says.

The Researchers Didn’t Factor In BMI

The study results are intriguing, but more information is necessary to put them in the appropriate context, cautions Kim.

She advises that the study doesn't include any information on participants' weight or body mass index (BMI), which is a crucial factor.

“Having overweight or obesity generally worsens symptoms of PMOS and is associated with other cardiometabolic abnormalities, including increased glucose, dyslipidemia, hypertension, nonalcoholic fatty liver disease [now known as metabolic dysfunction-associated steatotic liver disease], and sleep apnea, to name a few, which can increase risk for morbidity and mortality,” she says.

Other Factors Outside of PMOS May Explain Increased Mortality Risk

Women with PMOS aren’t all alike, says Kim. Although women with PMOS are generally considered to be more insulin resistant than their peers without PMOS, they can also be insulin sensitive. “In general, increased weight is associated with increased insulin resistance,” she says.

Women with PMOS who are most insulin resistant with associated cardiometabolic abnormalities are likely at the highest risk for early death, says Kim.

“We know, for example, that individuals with metabolic dysfunction-associated steatotic liver disease (formerly known as non-alcoholic fatty liver disease) are at high risk for cardiovascular disease. Women with PMOS may also be at higher risk for MASLD,” she says.

So one question Kim raises is, are women with PMOS at higher risk of cardiovascular disease (noted as disease of the circulatory system in the abstract) due to MASLD or insulin resistance?

“The current study may be comparing women with PMOS (who are more likely to be insulin resistant and with cardiometabolic abnormalities) with women without PMOS who may be insulin sensitive,” she says.

How Can Women With PMOS Best Protect Their Health?

“Women with PMOS should have a full evaluation of their cardiometabolic risk at diagnosis and have that reviewed regularly,” says Kim. If overweight is an issue, weight loss can improve insulin sensitivity and generally improve cardiometabolic abnormalities, she adds.

Because women with PMOS may have many other conditions that impact their health, Daoud recommends a team approach to care.

For example, your primary care doctor can probably help you manage high blood pressure and cholesterol, while an endocrinologist can provide appropriate care if diabetes develops, she says.

Certain medications can help you manage PMOS symptoms while also reducing your risk of some mortality-linked health conditions, including the following:

• Medications such as metformin and GLP-1 receptor agonists can help people with PMOS manage infertility while supporting healthier blood sugar levels and weight management
• Combination birth control pills, which can lower androgen levels and reduce endometrial cancer risk while helping you manage symptoms like irregular bleeding, acne, and unwanted hair growth
• Progestin therapy, which may also help prevent endometrial cancer but doesn’t affect androgen levels

• Eating fewer inflammation-linked foods and opting for whole, minimally processed options where possible
• Taking active steps to manage stress where possible
• Getting enough sleep

Speak to your doctor about which medications or interventions are right for symptoms like acne, unwanted hair growth, irregular periods, and fertility issues.