PMOS: when hormones and the plate speak the same language

Do you ever feel that your body is sometimes playing by completely different rules than it should? If you are struggling with irregular menstruation or acne, or are troubled by a diagnosis called PMOS (polyendocrine-metabolic-ovarian syndrome), you may have wondered what is actually happening inside your body and why your diet should matter specifically.

PMOS (formerly PCOS) is an endocrine disorder affecting 6–20% of women of reproductive age. It is associated with several metabolic disorders, including insulin resistance, obesity and dyslipidemia. These conditions are also linked to a higher risk of type 2 diabetes and cardiovascular disease. One of its main characteristics is insulin resistance, which contributes to hyperandrogenism—this can lead to acne or ovulatory dysfunction.

The exact causes of PMOS are not yet fully understood. Both endogenous and exogenous factors are thought to contribute to its development.

PMOS is by no means just an “ovarian problem.” It is a complex condition connected to metabolism, hormones and the overall balance of the body. Let’s take a closer look at how diet, insulin and hormones are closely interconnected—and why it makes sense to take control of your nutrition.

1. What is happening inside our bodies?

Imagine the brain as a conductor and the ovaries as an orchestra. In PMOS, this communication is disrupted, and the conductor sends the orchestra instructions that are too wild and too fast.

• The main messenger, luteinizing hormone (LH), is often elevated and forces the ovaries to produce more male sex hormones (androgens), which can lead to acne or excessive hair growth.
• The hormone FSH is responsible for supporting the egg as it develops toward ovulation. In PCOS, however, there is not enough of it. The follicles (sacs containing the eggs) are activated but fail to mature—rather than ovulating, they degenerate and accumulate in the ovaries. The LH-to-FSH ratio is therefore often imbalanced, and LH levels may be more than 2.5 times higher.
• Estrogen levels become stuck at those typical of the beginning of the cycle. The body does not receive the signal to ovulate, and it also produces estrogen itself—both in adipose tissue from excess androgens and directly in the overactive ovaries.

2. The hidden problem: insulin resistance

Another key player is closely linked to PMOS: insulin. Up to 75% of women with this syndrome experience insulin resistance.

Your cells stop responding properly to insulin, so the pancreas has to produce much more of it to keep blood sugar within the normal range. This persistent excess of insulin is literally fuel for PMOS:

1. It forces the ovaries to produce even more male hormones.
2. It prevents the natural maturation of eggs, leading to anovulation.
3. It switches off the production in the liver of proteins that would normally bind testosterone in the bloodstream. The result is more free, active testosterone circulating throughout the body, which further deepens the overall imbalance.
4. Why is diet so important?

Because PMOS increases the risk of developing further complications, such as type 2 diabetes, cardiovascular disease, metabolic syndrome, depression and anxiety, timely care and lifestyle play a major role.

Research shows that an inappropriate diet—typically high in calories and saturated fats and low in fibre—can significantly worsen clinical symptoms and metabolic disorders. For example, studies such as Szczuko et al. (2017) confirm a direct connection between a poor diet and impaired ovarian function.

The gold standard: the Mediterranean diet

The Mediterranean diet is increasingly being discussed in the context of PMOS prevention and treatment. Its magic formula consists of:

• regular intake of healthy unsaturated fats
• sufficient high-quality protein and fibre
• foods with a low glycaemic index
• powerful antioxidants and vitamins

Science is also investigating specific nutrients that may modulate insulin sensitivity, oxidative stress and inflammation—from omega-3 fatty acids, vitamin D, magnesium and zinc, and molecules such as myo-inositol to phytochemicals and polyphenols.

Regular physical activity is another important pillar. It should be performed at least three times a week, combining aerobic and strength training.

What should you take away from this?

PCOS is not your fault, nor is it a sign that your body is “lazy.” It is a complex condition in which hormones and metabolism are playing a game of hide-and-seek. The good news, however, is that every bite on your plate is a signal you can send to your hormones. Adjusting your diet and focusing on stable blood sugar levels are among the most powerful tools for calming the body and restoring its balance.