What is PMOS?
Polyendocrine metabolic ovarian syndrome (PMOS) — formerly known as polycystic ovary syndrome (PCOS) — is one of the most common hormonal disorders in women of reproductive age, affecting approximately 10% of them. It is also the leading cause of infertility due to anovulation (absence of ovulation) worldwide.
Despite its frequency, PMOS remains often under-diagnosed or diagnosed late. In Marseille, Dr. Yasmine Maazouzi offers a full hormonal assessment and personalised support for all women affected by this syndrome.
Understanding the mechanisms of PMOS
PMOS is characterised by a complex hormonal imbalance:
- Androgen excess (male hormones): elevated testosterone, DHEA
- Insulin resistance in nearly 70% of cases, aggravating the hormonal disturbances
- Ovarian dysfunction: follicles begin to mature but fail to ovulate, accumulating on the surface of the ovaries as small cyst-like structures
Recognising the symptoms
PMOS presents very differently from one woman to another:
- Irregular or absent cycles (oligomenorrhoea or amenorrhoea)
- Persistent acne despite topical treatments
- Excess hair growth (hirsutism): face, abdomen, back, thighs
- Weight gain or difficulty losing weight, particularly in the abdominal area
- Hair loss (androgenic alopecia at the temples and crown of the head)
- Difficulties conceiving due to irregular or absent ovulation
Diagnosis: the Rotterdam criteria
The diagnosis is based on the presence of at least 2 of the following 3 criteria (Rotterdam criteria):
- Oligo-anovulation: cycles longer than 35 days or absence of periods
- Hyperandrogenism: clinical signs (acne, hirsutism) and/or biochemical (abnormal hormonal panel)
- Ultrasound appearance: polycystic ovaries (≥ 12 follicles of 2 to 9 mm per ovary)
During the consultation with Dr. Maazouzi, a full hormonal panel is requested: FSH, LH, oestradiol, free and total testosterone, SHBG, DHEAS, 17-OHP, prolactin, TSH, blood glucose, and fasting insulin.
Treatments for PMOS: a holistic approach
Management of PMOS is always personalised according to your profile and life plans.
1. Lifestyle measures: the foundation of treatment
For women with insulin resistance, lifestyle modification is the most effective intervention:
- Low glycaemic index diet: reducing fast sugars and ultra-processed foods
- Regular physical activity: at least 150 minutes per week of moderate activity
- Weight loss if overweight: a reduction of 5 to 10% of body weight is often sufficient to restore spontaneous ovulation
2. Medical treatment without a desire for pregnancy
- Combined hormonal contraceptive: regularises cycles, reduces acne and hirsutism
- Anti-androgens (spironolactone, cyproterone acetate): reduce signs of hyperandrogenism
- Metformin: improves insulin sensitivity, particularly useful in cases of glucose intolerance
3. Treatment when pregnancy is desired
For women wishing to conceive, options are introduced progressively:
- Ovulation induction with letrozole (first-line) or clomiphene citrate
- Gonadotrophin injections as second-line, with ultrasound monitoring
- IVF with antagonist protocol as third-line, if other treatments have failed
4. Long-term prevention
PMOS is associated with an increased risk of type 2 diabetes, cardiovascular disease, and endometrial hyperplasia. Regular follow-up with Dr. Maazouzi allows these risks to be monitored and treatment to be adapted over time.
Specialist follow-up in Marseille
Dr. Yasmine Maazouzi provides comprehensive gynaecological and endocrinological follow-up for PMOS at the Hôpital Privé Beauregard, from the first consultation through to post-menopausal review. Each patient benefits from an individualised treatment plan, clearly explained and adjusted according to her progress.
Do you have irregular cycles, acne, or difficulties conceiving? Consult Dr. Yasmine Maazouzi in Marseille for a full PMOS assessment.