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Managing PMOS Symptoms: Expert Tips From a Women’s Health GP-image

Managing PMOS Symptoms: Expert Tips From a Women’s Health GP

Managing Polyendocrine Metabolic Ovarian Syndrome (PMOS) (formerly Polycystic Ovary Syndrome, PCOS) starts with a simple question: which symptoms matter most to you right now? There’s no single treatment, because the condition affects everyone differently. The right approach depends on your symptoms, your wider health, whether you need contraception and whether you’re trying to conceive. Living with PMOS can mean juggling several symptoms at once: irregular periods, acne, unwanted facial hair, thinning hair, fatigue, or changes to your weight and metabolism. Or it might be just one or two that really bother you. Either way, PMOS rarely needs to be tackled all at once. Here, Dr Yewande, a Women’s Health GP at Hertility, shares practical, evidence-based ways to manage some of the most common PMOS symptoms, and the treatments and support that can help. For a full overview of the condition, read our guide to everything you need to know about PMOS (PCOS). Quick facts 1. Keep track of your periods, even if they have always been irregular If your periods have always been unpredictable, it’s tempting to accept long gaps as normal for you. But with PMOS (PCOS), how often you bleed matters as much as how predictable your cycle is. A typical cycle lasts 21 to 35 days. With PMOS (PCOS), periods often come less frequently, stop altogether (amenorrhoea) or arrive erratically, because PMOS can disrupt ovulation. Why frequency matters. After you ovulate, your body makes progesterone. If you rarely ovulate, your womb lining is exposed to oestrogen without that regular progesterone. Over time, this can make the lining thicken too much, a condition called endometrial hyperplasia. The relative risk of endometrial cancer is also higher with PMOS, although the absolute risk stays low meaning that even though the chance of developing endometrial cancer with PMOS is higher than if you didn’t have PMOS the actual risk of it occurring is low. That’s why long gaps in periods are still worth acting on rather than ignoring. What can help? If you regularly go several months without a period, speak to your GP. Depending on your history and whether you need contraception, options may include hormonal contraception like the pill, a hormonal coil such as the Mirena, or intermittent courses of a progestogen to bring on a withdrawal bleed. If you’re trying to conceive, your options will be different, because the focus shifts to understanding and supporting ovulation. Don’t wait for your cycles to settle before mentioning them. Keep a record for 2-3 months before your appointment of your cycle length (first day of one period to first day of the next), how long bleeding lasts, how painful it is, and flow (light, medium, heavy), so you can tell your doctor exactly how often you’re bleeding.  Want to understand what’s happening with your hormones? Hertility’s Advanced Hormone and Fertility Test helps you build a clearer picture of your hormones and cycle, with results reviewed alongside your symptoms and health history. 2. Stop searching for the perfect “PCOS diet” There’s no single diet proven to be best for PMOS (PCOS). Low-carb diets, keto, intermittent fasting and other eating plans are often promoted for PMOS (PCOS)., but the international guidelines doesn’t recommend one diet over another. Rather than following strict rules, focus on an eating pattern that supports your health and that you can realistically keep up. For many people, that means: If insulin resistance is a concern, eating carbohydrates alongside protein, fibre and healthy fats can make meals more filling and help keep your blood sugar steady. But eating well with PMOS (PCOS), shouldn’t mean constant dieting or feeling guilty about food. The best approach fits your health, culture, budget, preferences and relationship with food. Read our guide on There a Best Diet for PMOS (PCOS)?. If nutrition feels confusing, a Hertility Nutrition Consultation can help you build a plan around you, rather than another generic PMOS (PCOS)  meal plan. 3. Exercise for your health, not just the number on the scales Exercise is one of the most useful tools for managing PMOS (PCOS)., even if your weight doesn’t change. Regular activity supports insulin sensitivity, heart health, sleep, mood and metabolic health. There’s no single “best exercise for PCOS”: current recommendations suggest around 150-300 minutes of moderate activity a week (or 75-150 minutes of more vigorous activity). Either way, add muscle-strengthening activity on at least two days a week. This is in line with UK physical activity guidelines. That doesn’t have to mean intense workouts. Walking, cycling, swimming, Pilates, resistance training or a combination of these are all good options, and the best type is the one you’ll actually keep doing. If you’re currently doing very little, jumping straight to 10,000 steps and five gym sessions a week can make exercise feel impossible. Start smaller. A 15 to 20 minute walk most days is better than an ambitious plan you give up on after a fortnight. 4. If you’re constantly exhausted, don’t automatically blame PCOS Fatigue is common with PMOS (PCOS), but it has many possible causes. Depending on your symptoms, your doctor may check for: PMOS (PCOS) is also linked with a higher rate of obstructive sleep apnoea, regardless of your weight. So if you snore heavily, wake up unrefreshed, get morning headaches or feel unusually sleepy during the day, mention it to your doctor. Sleep apnoea is treatable, and it’s often missed. 5. Your skin symptoms might be hormonal, and topical treatment may not be enough Persistent acne or oily skin can be a visible sign of the hormonal changes linked to PMOS (PCOS). Higher androgen activity (including testosterone) can increase oil production and contribute to acne. This is particularly likely when it appears alongside irregular periods, excess facial or body hair, or scalp thinning. Topical treatments. These can still be very effective. Depending on severity, options include benzoyl peroxide, azelaic acid, topical retinoids or other prescription treatments. When acne keeps coming back. If your acne keeps returning or isn’t improving despite the right treatment, that’s a clue […]

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Your Questions Answered | Fertility & Hormone Health FAQs-image

Your Questions Answered | Fertility & Hormone Health FAQs

Whether you’re trying to conceive, living with PMOS ( formerly known as PCOS), considering egg freezing, navigating perimenopause, or simply trying to understand what your hormones are doing, you are not alone. Reproductive health can feel confusing, especially when symptoms are dismissed, cycles become unpredictable, or you’re told to “just wait and see” without clear answers. But your questions deserve more than vague reassurance. They deserve clinical context, personalised support and practical next steps. Welcome to Your Questions Answered with Hertility,  our expert-led series answering the reproductive health, hormone and fertility questions you really want answered. I’m Zoya Ali, Hertility’s Senior Scientific Research Associate, and in this series I’ll be helping to break down complex fertility and hormone topics in a way that feels clear, clinically grounded and easy to understand. From irregular periods and PMOS to egg freezing, perimenopause and trying to conceive, my goal is to give you evidence-based information without shame, confusion or medical jargon. In this edition, we’re answering some of the most common questions we hear from the Hertility community, including what to do if you feel dismissed by your GP, whether egg freezing in your early thirties is worth it, why a PMOS diagnosis matters, and whether pregnancy is still possible during perimenopause. Have a question you’d like answered in a future edition of Your Questions Answered with Hertility? Submit your question here. Q: We’ve been trying to conceive for over a year. My GP told me to lose weight and said ovulation can happen at any time. I only get a period once every three months. I feel pushed aside. What can I do? First, I’m really sorry you’ve been made to feel like this, your concerns are completely valid. After 12 months of trying to conceive, you are entitled to a comprehensive fertility assessment. Being told to lose weight and come back later, with no investigations or plan is not adequate care and you deserve more than that. Now, let’s talk about what’s actually going on with your body, because irregular periods every three months are telling us something important. That pattern is known as oligomenorrhoea and it is a sign that your body may not be ovulating regularly. Ovulation is the event that makes conception possible, and if it’s only happening sporadically, or not at all, trying to conceive can become significantly harder. Weight can be one piece of this picture, and it’s worth being honest about that. Weight can affect how the body manages insulin and inflammation, both of which influence reproductive hormones and ovulation. But weight is one factor in a much larger story, and it should never be used as a reason to withhold investigations. The most common cause of irregular, infrequent periods is PMOS ( previously known as PCOS ) which is a hormonal and metabolic condition affecting how the ovaries function. But thyroid imbalance, raised prolactin, insulin resistance and stress can all produce a very similar picture. You cannot know which of these is driving your symptoms without testing. If you feel your GP is still not listening, you are entitled to ask for a referral to a gynaecologist or fertility specialist, or to seek a second opinion. At Hertility, our Advanced At-home Hormone and Fertility Test can give you clinical-grade results, insight into your egg count and screening for up to 18 reproductive health conditions, alongside a doctor-written report, personalised Care Plan and a Clinical Result Review Call. We also offer Fertility Nutrition Consultations that can support ovulation, hormone and metabolic health without shame, blame or crash dieting. You don’t have to wait to be taken seriously. Q: What is the success rate for egg freezing if you freeze your eggs in your early thirties? This is one of the most common questions I hear from people considering egg freezing, and I understand why, you want a number, something reassuring and concrete. The honest answer is that there isn’t one single success rate, let me explain why, and what the picture actually looks like. Age is genuinely one of the most important factors in egg freezing. Freezing in your late twenties to early thirties is the most recommended, because egg quality and quantity are typically the best. But age alone doesn’t determine your outcome, two women who are both 31 can have very different responses to fertility treatment depending on factors like their AMH levels and antral follicle count. When we talk about success rates, we’re really talking about a chain of events, and at each link in that chain, some eggs are naturally lost. First, your frozen eggs need to survive the thawing process, thaw survival rates are typically around 80 to 90%. Then, not every thawed egg will fertilise successfully. Not every fertilised egg will develop into a good-quality embryo. And not every embryo will implant and lead to a pregnancy. Sperm quality and uterine health both play a role at that final stage too. Most clinics recommend aiming for around 15 mature eggs to give yourself a reasonable chance of a future live birth, with some recommending closer to 20 if you’re hoping for more than one child. Depending on how your ovaries respond to stimulation, some people collect enough eggs in one cycle; others need two or more. This is why egg freezing planning really is personal, it’s not a one-size approach. An AMH blood test and pelvic ultrasound to check our Antral Follicle Count (AFC) are the best starting points for understanding your ovarian reserve. They can’t tell us about egg quality directly, that remains something we can only assess once eggs are fertilised, but they give us a meaningful picture of quantity and potential response to fertility medications. At Hertility, our Advanced At-home Hormone and Fertility Test includes insight into your egg count alongside a full hormone profile. We can also arrange a Pelvic Ultrasound Scan to assess your antral follicle count and pelvic structures, and we work with HFEA-accredited partner clinics to support a smooth referral process […]

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