Regular periods? You might still have PMOS says gynaecologist and reveals the hidden risks that no one talks about

Explore essential insights on managing PMOS, understanding symptoms, and the importance of lifestyle changes in reducing long-term health risks for women.

Polycystic ovarian syndrome is a common hormonal disorder, affecting the ovaries of women in their reproductive age group, i.e. menarche to menopause. It has an impact on hormone levels, ovulation and metabolism, now known as PMOS (polyendocrine metabolic ovarian syndrome). Diagnosis of PMOS is based on symptoms, hormonal levels and ultrasound.

Women with painful periods are more likely to suffer heart attacks compared to others. (Shutterstock)

By Tavishi Dogra

Tavishi Dogra is a Deputy Chief Content Producer, Health & Wellness, at Hindustan Times. She has over 9 years of experience writing about fitness, nutrition, and mental well-being, translating medical research and expert insights into practical advice readers can trust.

Career journey and experience
Tavishi began her health journalism journey in 2017, and has since reported for RSTV, Financial Express, Jagran, HT Media Labs and Zee. She joined Hindustan Times to simplify wellness subjects by cutting through jargon.

From decoding health trends and interviewing doctors to testing fitness routines herself, Tavishi always approaches content with one filter: “Will this help someone make a better decision today?”

Subject expertise
With 9+ years tracking India’s health conversations, Tavishi knows the gap between clinical advice and daily life. She knows fads from fundamentals and curates science-backed, expert-recommended solutions.

In fitness, she breaks down bodyweight training, recovery, and posture fixes for desk-bound readers. In nutrition, she translates guidelines into affordable, desi meal tweaks. In mental well-being, she focuses on stigma-free, actionable tools — all backed by research, expert input, and lived context.

Education and professional background
Tavishi holds a Master’s degree in Journalism and Mass Communication and began her career reporting on public affairs for broadcast. Those early years in policy and TV shaped how she writes today: fast, factual, and human-first.

Editorial Philosophy
I write with one single goal: To simplify health in a world full of noise by finding what’s actually doable, safe, and evidence-based for my readers. I test claims against research and user experiences. When all else fails, I speak to the expert who sees 50 patients a day, not the one with the most followers.

Read moreRead less

Is it possible to have PMOS with regular periods and no cysts?

“Women may present with multiple symptoms such as menstrual problems like irregular cycles or scanty period flow indicating oligo-ovulation or anovulation, hyperandrogenism (hormonal) like hirsutism (excess facial hair growth), acne, and hair loss” Gynaecologist Dr Kiran Coelho, Lilavati Hospital And Research Centre tells Health Shots. Also, they may complain of weight gain, fatigue and infertility or subfertility. Those experiencing these issues should consult their gynaecologist.

Which test is for 3 months of sugar?

The expert will first take a detailed history and perform a physical examination, including BMI calculation, blood pressure check, and waist circumference measurement. Blood investigations will include a full blood count, glycaemic status (blood sugar), lipid profile, and hormone checks such as thyroid function tests, prolactin levels, testosterone, DHEA, and 17-hydroxyprogesterone, to rule out other endocrine disorders. If a patient presents with amenorrhoea, a pregnancy test will be performed, as pregnancy must be ruled out. Most importantly, an ultrasound will be carried out to assess the ovaries for a polycystic appearance.

What is the Rotterdam criteria for PMOS?

PMOS is diagnosed based on the above points, known as the Rotterdam criteria. Diagnosis requires any two of these irregular cycles (suggesting anovulation), Hyperandrogenism (facial hair growth, acne, hair loss), or Ultrasound Findings (polycystic ovaries). The common clinical associations for PMOS are infertility or subfertility, obesity or insulin resistance, dyslipidaemia, increased risk of endometrial hyperplasia from prolonged anovulation or increased long-term metabolic risk.

What is ovulating dysfunction?

Various parameters are used when ovulatory dysfunction is suspected. In adults, it is when the cycle is less than 21 or more than 35 days, one gets 8 cycles per year, or any cycle is more than 90 days. In adolescents, diagnosis is more cautious because irregular cycles and multifollicular ovaries can be physiological.

Here’s how one can manage PMOS:

Make lifestyle changes and follow a healthy lifestyle alongside medications. Lifestyle management includes:

• Lifestyle: Healthy diet, regular exercise, weight management, sleep and psychological wellbeing
• Mental wellbeing: Anxiety, peer pressure, depression, eating disorders, and body image concerns should be addressed, and help should be sought.
• Discuss long-term risks, such as diabetes mellitus, cardiovascular risks, and endometrial hyperplasia.

Counselling for patients to navigate PMOS

• Shared decision-making: Communication between doctor and patients to develop individualised treatment based on symptoms, reproductive goals, and preferences.
• Medical management includes: Combined oral contraceptive pills can be taken to regularise periods, as this will also help with acne or hirsutism.
• Cyclical progesterone will help balance estrogen: Prolonged amenorrhoea requires endometrial protection; therefore, progesterone in the form of iUS- LnG is used for women not seeking pregnancy.

How can a girl reduce androgens?

Antiandrogens can be added for hirsutism or acne if it does not respond to contraceptive pills. Consider this if BMI is>25 or if there is impaired glucose tolerance or insulin resistance. It is also indicated if there are any metabolic risks or if contraceptive pills are contraindicated, that is, if she is planning pregnancy.

Can you use clomiphene and letrozole together?

If the patient is seeking pregnancy, ovulation induction with Letrozole is advised; alternatively, clomiphene citrate can be used, with Metformin and gonadotropins as adjuvants. Surgical procedures that can be undertaken include laparoscopic ovarian drilling.

IVF is considered only as a last resort

Other adjuvants are for psychological support, weight loss, and management of sleep or eating disorders. Treat vitamin deficiencies, such as vitamin D. Overall, PMOS can be managed with multidisciplinary, long-term care. The motto is to treat the woman and not just her symptoms.

(Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.)