Reproductive & Growth
PCOS / PMOS — Polycystic (Polymetabolic) Ovarian Syndrome
The commonest hormonal disorder in young women, and one of the most commonly mismanaged. Increasingly called polymetabolic ovarian syndrome (PMOS), because the metabolic problem — not the ovarian cysts — is what actually matters.
Symptoms that bring people in
- Irregular, infrequent or absent periods
- Excess hair on the face, chest or abdomen
- Persistent acne beyond the teenage years
- Hair thinning at the scalp
- Weight gain, particularly around the abdomen
- Difficulty conceiving
- Dark, velvety skin at the neck or armpits
Having one of these does not mean you have this condition — several overlap with far more common problems. It means the question is worth asking properly.
PCOS is a syndrome, not a single disease, defined by a combination of irregular ovulation, clinical or biochemical androgen excess and characteristic ovarian appearances. Insulin resistance sits behind much of it. Importantly, the name misleads: polycystic-looking ovaries on a scan do not by themselves make the diagnosis, and plenty of women labelled with PCOS on the strength of an ultrasound alone do not have it.
Why it is now being called PMOS
The condition is increasingly described as polymetabolic ovarian syndrome (PMOS), and the change of name is a useful one. It shifts attention away from the ovarian cysts — which are neither cysts nor the cause of the problem — and onto what actually drives the syndrome and determines its long-term consequences: insulin resistance, central weight gain, dyslipidaemia and fatty liver.
That reframing matters clinically. A woman told she has "cysts on her ovaries" reasonably concludes this is a gynaecological problem that ends once her periods are regular or her family is complete. Understood as a metabolic syndrome, it is clear why the follow-up continues for decades, and why weight, blood sugar, lipids and blood pressure are checked at every review. It is the same condition; PMOS simply names it after the part that needs treating.
Making the diagnosis properly
Two of the three criteria are required, and — this is the part often skipped — conditions that mimic PCOS must be excluded first: thyroid disease, raised prolactin, non-classical congenital adrenal hyperplasia and, rarely, Cushing's syndrome or an androgen-secreting tumour. Testing is timed to the cycle where that matters.
Treatment follows the complaint
Irregular periods. Cycle regulation matters not only for predictability but to protect the endometrium from years of unopposed oestrogen. Combined hormonal contraception or cyclical progestogen are both reasonable, depending on circumstances.
Hirsutism and acne. These respond, but slowly — hair growth cycles mean three to six months before change is visible, and treatment needs to be sustained. Anti-androgen therapy, contraception and cosmetic measures are combined as suits the individual.
Fertility. Most women with PCOS conceive. Weight reduction where relevant, ovulation induction, and referral for assisted reproduction where needed.
Metabolic risk. This is the long game and the reason PCOS belongs in an endocrine clinic. Screening for prediabetes and diabetes, lipids, blood pressure and fatty liver, repeated over time, because the risk is lifelong and largely modifiable.
Weight
Even a modest reduction can restore ovulation and regularise cycles, which is why it is discussed early — not as a moral instruction but because it is among the most effective single interventions available.
This page is general information. Doses and treatment choices in endocrinology are individual, and are decided at a consultation with your reports in front of us. Please do not start, stop or change a medicine based on this page.
Common questions
Before your first visit
How do I book an appointment?
Use the appointment form on this website and the clinic will telephone you to confirm a time, usually within one working day. For a same-day or urgent request, please ring the number in the page header instead — a phone call is always faster than a form.
Hospital OPDs at CMRI and Narayana Memorial are booked through the hospital's own reception. For district chambers, it is worth calling the chamber number listed on its page before travelling.
Which chamber should I choose?
Whichever is easiest for you to reach and return to. Endocrine conditions need review over months and years rather than a single visit, so the chamber you can get to comfortably every few months is nearly always the better choice than the one that seems most impressive.
That said: if your problem needs same-day tests, an ultrasound, or admission, a hospital OPD is the better setting. The Chambers page lists every location with its days and timings, and the weekly timetable shows them all side by side.
Do chamber timings ever change?
Yes — and this is worth taking seriously if you are travelling any distance. Several district visits run on a monthly rotation, such as the 1st and 3rd Saturday, and a hospital OPD can be rescheduled at short notice. Timings shown on this website are kept up to date and any known cancellation appears on the chamber's page, but please telephone ahead before a long journey.
What should I bring to the first consultation?
Bring everything you have, even if it seems old or irrelevant:
- all previous prescriptions, including from other doctors
- every blood report and scan you hold, in date order if possible
- the actual strips or boxes of the medicines you take, or a written list with doses
- your home blood sugar or blood pressure diary, if you keep one
- for a child, the growth chart and immunisation record
Old reports are genuinely useful. A five-year-old thyroid result or an earlier scan often changes the plan, because what matters in endocrinology is frequently the trend rather than today's number.
Consultation
Request an appointment
Tell us which chamber suits you and when. We will confirm your slot by phone.