Valérie Namer: Key Recommendations for Women with PMOS and the Healthcare Professionals Who Support Them
Valérie Namer, Postgraduate Expert Teacher at Ostéonex Barcelona, shared on LinkedIn:
“Evidence-Based PMOS Guideline (2023)
Key recommendations for women with PMOS and the healthcare professionals who support them.
The 2023 international evidence-based guideline provides updated recommendations to improve the diagnosis, assessment, and management of polyendocrine metabolic ovarian syndrome (PMOS).
Diagnosis
PMOS is diagnosed in adults when 2 of 3 criteria are present (after excluding other causes):
- Hyperandrogenism (clinical or biochemical)
- Ovulatory dysfunction (irregular or absent periods)
- Polycystic ovaries on ultrasound or elevated AMH
If irregular periods and hyperandrogenism are both present, ultrasound or AMH are not required.
In adolescents, both hyperandrogenism and ovulatory dysfunction are required; ultrasound and AMH are not recommended.
Comprehensive care
Assessment should include reproductive, metabolic, cardiovascular, dermatologic, sleep, and mental health, with regular screening for diabetes, cardiovascular risk, pregnancy complications, and endometrial cancer risk.
Mental health matters
Anxiety, depression, eating disorders, body image concerns, and reduced quality of life are common. Routine screening and appropriate psychological support are recommended.
Lifestyle remains first-line
Healthy eating, regular physical activity, prevention of weight gain, and sustainable weight management are the foundation of lifelong PMOS care. No single diet or exercise approach has proven superior.
Treatment options
- Combined oral contraceptives: first-line for menstrual irregularity and hyperandrogenism.
- Metformin: primarily for metabolic health; generally more effective than inositol and not routinely recommended during pregnancy.
- Laser therapy may help reduce excess hair growth.
- Anti-obesity medications and bariatric surgery may be considered when appropriate.
Fertility
Letrozole is the preferred first-line treatment for ovulation-related infertility. Other treatments, including IVF, may be considered if initial therapies are unsuccessful.
Patient-centred care
Shared decision-making, evidence-based education, and coordinated multidisciplinary care are essential throughout life.
Looking ahead
More high-quality research and investment are needed to improve outcomes and strengthen future PMOS care worldwide.”
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