The skin manifestations of PMOS/PCOS are driven by hormonal imbalance and inflammation.

Common concerns include:

• Hormonal Acne (often cystic and located around the chin and jawline)
• Excess oil production (leading to clogged pores and persistent congestion)
• Post-inflammatory pigmentation and scarring (after breakouts heal)
• Increased sensitivity and inflammation (flare-ups and slower healing)
• Dryness or barrier impairment (especially from harsh conventional treatments)

Polyendocrine Metabolic Ovarian Syndrome (PMOS, formerly PCOS) is fundamentally an endocrine condition, meaning it affects the hormonal balance of the body. Because hormones regulate so many systems, the symptoms of PMOS can appear across multiple body systems, not just the skin. Each person’s experience is unique, but there are common patterns that can help identify the condition. These include reproductive changes, metabolic shifts, and emotional or mental health impacts. Understanding the broader picture of PMOS can support more effective, individualized management strategies.

Common systemic symptoms include:

・Irregular or absent menstrual cycles
・Painful or heavy periods
・Infertility or difficulty conceiving
・Weight fluctuations or difficulty losing weight
・Insulin resistance or blood sugar imbalances
・Fatigue or low energy
・Mood changes, anxiety, or depression

Polyendocrine Metabolic Ovarian Syndrome (PMOS) is currently diagnosed using the Rotterdam criteria, which is the standard framework used by clinicians. A diagnosis is made when two out of the following three features are present:

1. Irregular or absent menstrual cycles – showing that ovulation is not occurring regularly.
   
2. Signs of hyperandrogenism – such as acne, excess facial or body hair, or thinning scalp hair, reflecting elevated male hormones.
   
3. Polycystic ovaries on ultrasound – ovaries may appear enlarged or contain multiple small follicles (cysts). Cysts alone are not sufficient for diagnosis.

Because PMOS can present uniquely in each person, diagnosis also involves looking at the broader hormonal and metabolic picture. This ensures that assessment captures the full range of symptoms and underlying imbalances, allowing for a more individualised and effective approach to management.

Conventional management often focuses on suppressing symptoms rather than addressing root causes. Typical options include:

• Oral contraceptive pill (to regulate hormones)
• Metformin (to address insulin resistance)
• Spironolactone or other anti-androgen medications (to reduce breakouts)
• Topical retinoids or antibiotics (for acne management)

These treatments can be helpful for some, but many women find them too harsh, short-term, or unsustainable. They can also further disrupt the skin barrier, causing dryness, flakiness, or sensitivity.

Conventional treatments can be helpful for managing symptoms, but they often focus on suppression rather than supporting the body’s natural balance. Many women seek gentler, long-term strategies that work with their hormones, metabolism, and skin health rather than against them. Exploring the underlying drivers of PMOS and adopting holistic lifestyle, skincare, and wellness practices can empower you to manage symptoms more sustainably -  and support overall wellbeing.