How Is Polyendocrine Metabolic Ovarian Syndrome (PMOS), Formerly Known as PCOS, Treated?

Editor’s Note: As of May 2026, the Endocrine Society and other international experts officially renamed polycystic ovary syndrome (PCOS) to 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 unfortunate truth is that there is no cure for PMOS. But because the disorder can have a profound effect on your health and well-being, treatment is a must. Because the cause of PMOS is still unknown, appropriate therapies are based on your specific concerns, such as excess hair growth or irregular periods.

“There is no boilerplate treatment,” says Andrea E. Dunaif, MD, professor of molecular medicine at the Icahn School of Medicine at Mount Sinai in New York City.

One option for PMOS treatments is to take a medication to target specific symptoms. It’s important to know that there are no drugs that the U.S. Food and Drug Administration has approved specifically for PMOS, she adds, meaning these options are prescribed off-label. Here are the ones you might talk about with your healthcare team:

Metformin (Fortamet)

Metformin is one of the main treatments to target insulin resistance if you have prediabetes or diabetes, including because of PMOS. The advice is controversial, but some physicians believe that PMOS always requires metformin, notes Dr. Dunaif. “There’s no reason to give every woman with PMOS metformin. It’s a good and safe drug, but there’s no point in taking it if you don’t need it,” she says. And it’s not a good way to reduce the male hormone symptoms, like excess hair growth, or as a first option for weight loss.

Spironolactone (Aldactone)

Spironolactone was originally developed as a blood pressure medication and diuretic for hormonal forms of high blood pressure (hypertension) and fluid retention. “Turns out, in high doses, it’s very good at blocking male hormones,” explains Dunaif. For that reason, it’s used to target excess hair growth, a symptom of PMOS that can be particularly embarrassing. This drug is sometimes prescribed in combination with hormonal birth control pills, which may also be used on their own (discussed below). Dunaif says these medications seem to work even better together.

Spironolactone is not safe in pregnancy, as it can cross the placenta and harm a fetus. Before prescribing this medication to a woman who is in her childbearing years, a doctor will explain this and make sure the patient is using reliable birth control.

Another note: “It takes about six months before the effect of these medications is seen on hair growth,” says David A. Ehrmann, MD, professor and director of the University of Chicago Center for PCOS in Illinois. This is because one hair growth cycle takes two to three months. “When patients don’t know that, they get frustrated when they don’t see results quickly,” he says. Talk to your doctor about what you can realistically expect and when.

Hormonal Birth Control Pills

Combination birth control pills — those with estrogen and progesterone or progestin — are frequently prescribed to women with PMOS who don’t want to get pregnant. If the main concern is irregular periods and the resulting potential health risks, this is a great option. “Birth control pills are very good for protecting the lining of the uterus in women who are chronically anovulatory,” says Dunaif.

A woman should shed this lining at least four times a year, says Dunaif. One option is to take progesterone (often called a “progesterone challenge”), though the resulting bleeding can be heavy for some women.

If a woman doesn’t want to take birth control pills, she has other options to introduce progesterone into their system, like a progesterone-releasing intrauterine device (IUD).

One complication with birth control pills is that they can make insulin resistance worse, something that would appear to be particularly harmful for women with PMOS. Insulin resistance is the hallmark of type 2 diabetes, and women with PMOS are already believed to be at a higher risk of this form of diabetes. “There’s no data to support that taking [birth control pills] increases the risk of diabetes,” says Dunaif. “This is a good therapeutic option for young women.”

Finasteride (Propecia)

Clomiphene (Clomid) or Letrozole (Femara)

With all of these options, it’s vital to emphasize that a woman will be making a choice about what’s most important to her in the moment. If a woman wants to get pregnant, she can’t also treat male hormone problems (such as excess hair growth, hair loss, or acne) simultaneously, as these are two conflicting goals. This scenario does have a bright spot: Once she does get pregnant, the high levels of estrogen in her system help suppress hair growth, notes Dunaif.

Individualized treatment plans can also include options in addition to medications to treat various PMOS symptoms.

Laser Hair Removal

Lifestyle Changes

Some experts suggest taking more of a lifestyle treatment approach rather than medication, which some call a “Band-Aid” to symptoms. Amy Medling is a certified health coach based in Cary, North Carolina, and founder of PCOS Diva and author of Healing PCOS: A 21-Day Plan for Reclaiming Your Health and Life With Polycystic Ovary Syndrome. She stresses that some women don’t feel well on some of these drugs (she was one of them), so looking at other ways to manage PMOS will get them to a more balanced place. “I hear from many women who are frustrated and hopeless and feel underserved by the mainstream way of managing PMOS,” says Medling.

Of course, these lifestyle changes can also help women who are taking prescription medicine for PMOS — your approach does not have to be either/or. Talking to your healthcare team about your concerns and options is the best way to get to a treatment plan that is tailored to your needs.

Changing your eating habits means making tweaks and adopting a balanced diet that you can stick with long-term. The key to making lasting changes is shifting your mindset on the way you view food, says Medling. Do this by packing your diet with nourishing foods, which will naturally crowd out the unhealthy stuff without making you feel deprived.