Polyendocrine metabolic ovarian syndrome (PMOS), previously known as polycystic ovary syndrome, affects 10%-13% of women of reproductive age and remains underdiagnosed despite its substantial health burden. The introduction of the new PMOS nomenclature in 2026 reflects a fundamental shift in understanding the condition as a lifelong endocrine and metabolic disorder with prominent reproductive, psychological, dermatological, and cardiometabolic consequences. Once considered primarily a reproductive disorder, PMOS is now recognized as a multisystem condition. Insulin resistance and compensatory hyperinsulinemia are central pathophysiological mechanisms linking endocrine and metabolic features to reproductive dysfunction. In PMOS, insulin resistance affects 75% of lean and 95% of overweight women. Here we focus on the metabolic features. Recent advances in epidemiology include the first systematic review and meta-analysis examining regional variations in PMOS prevalence. In parallel, contemporary population-based studies of unselected women have confirmed that increased risks of metabolic complications observed in selected clinical cohorts also apply at the population level and have demonstrated increased risk of major adverse cardiovascular events (MACE). These studies report an almost 3-fold increased risk of Type 2 diabetes (OR 2.9) and MACE (HR 1.2-2.5), with cardiovascular risk diverging from approximately 35 years of age. In this review, we summarize recent advances in epidemiology, pathophysiology, metabolic dysfunction, and cardiovascular risk of PMOS, together with their implications for diagnosis and clinical management. Recognizing PMOS as an early-life marker of cardiometabolic disease highlights opportunities for earlier diagnosis, prevention, and individualized risk stratification, supporting integrated, patient-centered care across the life course.
M. Forslund, J. Melin, A. Joham et al.· Journal of Internal Medicine· 0 citations
This population-based study aimed to characterize the distribution of inter-rectus distance (IRD) and its upper range in adult women using standardized multisite ultrasound measurements and a percentile-based interpretive framework. Data was driven from the Finnish Women’s Health Study (WENDY, 2020–2023), comprising women assigned female at birth with a mean age of 35 years (age range 33–37 years, SD 0,6). Women less than six months postpartum, exclusively breastfeeding, or with prior midline abdominal surgery or hernia repair involving a midline incision or abdominoplasty were excluded. Inter-recti distance was measured at six predefined locations along the linea alba in the supine, knee-flexed resting position using ultrasound. For the analysis, the maximal IRD of each examinee across all sites was used. A total of 1,840 women with naturally occurring anatomy were examined. At the standard site 3 cm above the umbilicus, the mean IRD was 2.37 cm (SD 1.19 cm; range 0.35–9.86 cm). Nulliparous women had a lower mean IRD (1.52 cm, SD 0.70 cm; 0.35–4.37 cm, n = 539) than parous women (2.71 cm, SD 1.18 cm; 0.46–9.86 cm, n = 1,301). The cohort’s 80th percentile for IRD was 3.24 cm. Based on maximal IRD, 38.5% had IRD ≥ 3 cm and 5.4% exceeded 5 cm; the 95th percentile was 5.09 cm. Maximal IRD most often occurred at the level of the umbilicus (41.3%) or 3 cm above (44.1%) and rarely below the umbilicus. Maximal IRD correlated weakly with adiposity measures (body mass index (BMI) ρ = 0.227; waist ρ = 0.273; weight ρ = 0.199) and no correlation was observed with height. Regression analysis showed that each childbirth was associated with a 0.42 cm increase in maximal IRD, and BMI increased IRD by 0.061 cm per kg/m². IRD is a continuous anatomical characteristic exhibiting considerable normal variation among adult women. A maximal IRD of up to 5 cm may be regarded as being within the upper tail of the population reference distribution. Fixed cutoff values should be proportionate to clinical symptoms, in order to prevent unnecessary interventions. Altogether, our findings provide population-based reference data for interpreting IRD measurements.
Annu Marttila, Katariina Kilpivaara, J. Kinnunen et al.· Hernia· 0 citations
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