Nurses hope PMOS renaming will provide ‘fresh focus’ on the condition

Nurses hope the recent renaming of polycystic ovary syndrome (PCOS) to polyendocrine metabolic ovarian syndrome (PMOS) will provide a ‘fresh focus’ on the condition and result in faster diagnosis and reduced fragmented care.

The renaming was announced last month at the European Congress of Endocrinology and aims to reflect that the condition is a whole-body endocrine and metabolic disorder, rather than one solely limited to ovarian cysts.

The renaming was the result of a 14-year process, with input from more than 14,000 patients and health professionals, spearheaded by Professor Helena Teede, an endocrinologist and director at Monash University in Australia.

According to a study, PMOS impacts roughly one in eight women and causes fluctuations in hormones, triggering a wide array of symptoms including acne, excess body hair, irregular periods, infertility, and mental health disorders.

Changing the name to PMOS is hoped to encourage healthcare providers to look beyond reproductive symptoms and treat the body holistically as well as providing guidance for better treatment management.

‘This is an important step forward’

Advanced nurse practitioner Ruth Bailey said the name change was the ‘culmination of years of collaborative work between patients and professionals working together to better under the impact of this complex condition’.

‘The name change is important in underlining the complexity of the condition and helping us recognise its individualised nature,’ she told Nursing in Practice.

‘I think this is an important step forward as it demonstrates better collaboration between patients and professionals.

‘It has given fresh focus to a common condition that affects so many women and has revitalised our understanding of PMOS so that we can better support the women in our care.’

She explained how it was the role of nurses to ‘identify the issues that the patient is experiencing and ensure they are taken seriously and fully assessed’.

‘Many women with PMOS have normal ovaries, they may have very heavy periods rather than irregular or scanty bleeding, they may not struggle with weight management, so the experience of symptoms varies widely,’ she noted.

Ms Bailey added that a PMOS diagnosis can be ‘devastating’ for patients and that general practice nurses (GPNs) should be aware of emotional and ongoing support requirements.

She said: ‘It is associated with higher risk of cardiovascular disease, diabetes, depression, cancer, and can have an impact on fertility.

‘GPNs are pivotal in supporting the patient through this. Providing emotional support and time and space to answer questions and signpost to ongoing support can have a huge impact.’

Nurses should be aware of symptoms, risks, and local referral pathways

Royal College of Nursing’s (RCN) associate director of nursing practice Patricia Hughes added that nurses have a ‘unique role’ to help patients dealing with PMOS, stating that it is a ‘strength of nursing’ to treat a patient holistically.

She said that it was important for nurses to be educated in PMOS, understanding the symptoms, risks, and local referral pathways.

‘We are the closest to the patient, we are continually the most trusted profession, and it is about the holistic care and building that relationship,’ she said.

‘That’s why it’s really important to educate nurses to be aware of what the symptoms might be, but also for there to be a good relationship between nurses and women and the people they look after, so that they can really take that time to listen and differentiate between different conditions.’

Calls for better education and investment

Reflecting on the name change for PMOS, Ms Hughes said she was ‘fully supportive’ and hopes it will support ‘faster diagnosis of the condition and reduce fragmented care’.

She said: ‘Some women [wait] years before they get answers to what is happening.

‘Addressing PMOS appropriately is not only a health issue, but an equality, diversity, and inclusion concern as well.

‘If your first language isn’t English, and you’ve not been able to articulate, there can be some barriers there.

‘[There are] financial resources as well such as the weight management programmes or laser hair removal. [They] can be costly and are often inaccessible without financial assistance.

‘So, recognising PMOS as a condition that warrants appropriate healthcare support would help ensure that those affected can access the services they need, and we are really passionate around reducing those inequalities and improving overall wellbeing.’

Ms Hughes added: ‘However, we do know the name change alone will not improve outcomes, it’s got to be matched with better education, meaningful investment in primary women’s health services, and that real multidisciplinary support to ensure it leads to equitable access to care, and it’s recognition as a complex metabolic, reproductive, and psychological condition.’

Also discussing the role of GPNs in this space, the RCN’s professional lead for midwifery and women’s health Maria Symeonaki said practice nurses should take a ‘broader assessment approach’.

She said: ‘The name change ensures that a PMOS is seen as a multi-organ system and a lifelong condition, rather than a gynaecological condition – it doesn’t just involve ovaries.

‘It needs to be a multidisciplinary team approach (MDT) between primary care, gynaecological care, endocrinology, fertility, mental health, [and] dietetic services.

‘It’s really important because this condition can affect [a patient in] lots of different ways. Nurses are really well equipped to do the referrals that are required, but it really needs to be an MDT approach.

‘Also, to make sure nurses in practice are symptom checking, are supporting pain management, [and] discussing symptoms.

‘It might not just be menstrual symptoms, but also other things that might go with it, hair growth, weight gain, acne, psychological, it might affect psychological conditions – so it’s a holistic assessment.’

Nurses are advised to access NHS England, National Institute for Health and Care Excellence (NICE) guidance, Royal College of Obstetricians and Gynaecologists (RCOG), Verity UK, and RCN’s women’s health forum for patient information and resources on PMOS.