A narrative review in Drug and Therapeutics Bulletin maps current pharmacotherapy for polyendocrine metabolic ovarian syndrome (PMOS) — the newly proposed renaming of polycystic ovary syndrome — covering metformin, GLP-1 receptor agonists, antiandrogens, combined oral contraceptives, and ovulation-induction agents. Metformin delivers modest body weight reductions alongside improved metabolic and anthropometric markers. GLP-1 receptor agonists show promise for weight management but lack robust PMOS-specific trial data. Letrozole is confirmed first-line for ovulation induction based on safety and efficacy evidence. Periconceptual GLP-1 use raises unresolved safety concerns.
The renaming from PCOS to PMOS is more than semantic: it signals a long-overdue shift toward recognizing the syndrome's polyendocrine and metabolic core rather than its ovarian morphology, which is neither necessary nor sufficient for diagnosis. This framing matters clinically because it redirects treatment logic toward systemic metabolic correction rather than symptom suppression. The metformin endorsement is well-established, but the GLP-1 discussion reflects a genuinely evolving frontier — semaglutide and tirzepatide trials in women with PMOS-associated insulin resistance and obesity are underway, yet reproductive-safety data remain sparse, a gap with real consequences given the overlap between this population and those actively trying to conceive. As a narrative review rather than a systematic meta-analysis, this piece carries inherent selection bias. It reads as confirmatory and consolidating rather than paradigm-shifting, but its practical value lies in synthesizing an increasingly complex pharmacological landscape for a common, under-diagnosed condition affecting roughly 10–15% of reproductive-age women.
