PMOS and the pitfalls of personal health

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A few days ago, my esthetician was slathering hot wax on my face. The caterpillars I call the Eyebrows were in desperate need of taming – as my lady was hiding. I hate this monthly ritual, but facial hair is a sore point. Hirsutism is perhaps one of the few visual indicators of the condition that has plagued us for the past decade. Until this week, I had always known it as polycystic ovary syndrome (PCOS).

Typically, I spend my waxing sessions talking about the weather (it’s hard to have deep conversations when someone is ripping hair out of your face). But that day, we spent the entire session talking about how the global medical establishment decided this week To rename polycystic ovary syndrome to polyendocrine metabolic ovary syndromeOr PMOS.

There are several reasons for this. Despite its original name, PMOS — which affects approximately 170 million women, or one in eight women worldwide — does not often lead to ovarian cysts. The updated name more accurately reflects how it is a hormonal and metabolic condition, rather than a purely reproductive condition. The truth is that this condition can affect multiple organs and is associated with other health conditions, such as insulin resistance, type 2 diabetes, obesity, cardiovascular disease, and obstructive sleep apnea. according to New York Timeswith emphasis on the noun one The symptoms of the condition — ovarian cysts — have led to inadequate clinical training, poor research funding, delays in diagnosis, and fragmented care for people with PMOS. In my experience, doctors often tell me that PMS is benign and refuse to offer treatment unless I want to actively pursue the pregnancy.

As it turns out, my esthetician also has PMOS. Except when you have ovarian cysts, I don’t do that. I have insulin resistance. She doesn’t do that. I suffer from a bit of hirsutism, while she suffers from cystic acne. We both gained nearly 60 pounds out of nowhere, but she got it under control through intermittent fasting, a specialized diet, and supplementing with milk thistle and myo-inositol, a type of carbohydrate that helps improve insulin sensitivity. Metformin — a diabetes drug used off-label to treat PMOS — did absolutely nothing for her, while it is an effective part of my treatment alongside GLP-1.

I’ve had this conversation with many of my fellow PMOS sufferers over the years. We always marvel at how the same condition can manifest itself in completely different ways. While we often exchange advice, I’ve never heard of one treatment that works for everyone I meet with PMOS. Personally, I spent almost 12 years at this point trying to get my condition under control. That’s why I first turned to wearables and health technology.

This is the first thing I think of when a health tech company or health influencer comes up with the idea of ​​personalizing health.

May is usually the time when my schedule starts filling up with meetings with companies I follow. It’s the start of many conversations about what new products and features are on the menu, where they see the category evolving, and how they think about current wellness trends. Of the six I’ve covered so far this year, there’s one concept that keeps coming up again and again: personal wellness.

All the companies I spoke with agree that extracting useful insights from a mountain of health data is overwhelming. But I’ve been told that over and over again through existence tasty In terms of data, the holy grail is personalized health, i.e. recommendations based on your individual health metrics versus generic advice. A simple example might be if your heart rate variability meter shows good recovery, but you had a poor night’s sleep, the wearable might recommend a 20-minute moderate vinyasa yoga practice instead of a high-intensity training workout. If you carefully log your meals, a health AI might determine that the roasted broccoli in your lunch interacts with medication and is the likely culprit behind your daily battle with sulfur burps. Based on CGM and blood test data, a fitness tracker may one day tell you which supplements you should take. and thenI’m often told that you will have more control over your health.

It’s a tempting hypothesis. health He is Very individual. Genetics plays a big role in what medications are right for you, what conditions you tend to have, and even what sports your body may be best suited for. I can understand why health tech companies, large and small, are excited about the concept. But again, I have to mention my journey with PMOS.

For better or worse, most doctors will tell someone with PMOS to try to lose weight. The logic is that weight loss generally improves or potentially reverses symptoms. The only problem is that it’s a 22. Weight gain with PMOS is often associated with insulin resistance, which in turn makes the simple “calories in, calories out” logic more difficult to enact because it leads to a vicious cycle. High insulin levels lead to increased androgen production, which in turn causes more abdominal fat to be stored in PMOS patients. Studies have also shown that those suffering from PMOS They tend to have lower basal metabolic rates. Meaning, with everything else, they burn fewer calories per day than people without PMOS. The condition may also contribute to complications building Lean muscle mass.

I have yet to find any fitness or nutrition feature that takes these factors into account. There’s no button I can press to adjust recommendations or calorie burn estimates. (This is one reason I don’t recommend people put a lot of stock into tracking calories with fitness trackers.) The same is often true of reproductive health technology features. When it comes to predicting fertile periods, I usually can’t even test these features because the algorithms aren’t equipped to handle hormonal birth control — another common treatment for PMOS (and for people with all sorts of other conditions!). Do these features explain how Oral hormonal contraceptives can alter body temperatures? Each health tech maker has its own algorithm, so you have to ask each one of them.

Perhaps this will be possible one day. Wearable technology He is Helping researchers Discover what’s new Links between biometric data points, especially in the area of ​​reproductive health. But so far, there are few modes specifically for people who deviate from the “norm” for which the algorithms were designed. If you fall into this category, “personal wellness” often ends up being a series of customized solutions that you put together yourself.

Some of this is a matter of timing. Generative AI is still relatively new, and companies are discovering limitations in real time. In addition, the human body remains largely a mystery. that it difficult To deliver truly personalized health technology even if medical experts are at a loss due to certain circumstances. Perhaps most damning is that good science takes a long time, while the drive is for technology to move quickly. PMOS was first officially recognized in 1935, and only in 2026 did the name come to accurately reflect the scope of the condition. (Even the renaming process took 14 years and more than 50 specialty medical groups.) However, custom health features are being rolled out. now. For some people, this may mean a relatively straightforward experience because they don’t have a particularly complex health condition. For many others, it is an experience built on a foundation that is constantly changing.

For me, personalized health technology currently means a lot of burnout. I have to train an AI coach. I should think deeply about the indicators of PMOS and non-alcoholic fatty liver disease. I have to decide which metrics I’ve collected over the years are relevant to my needs. I have to do independent research and subject myself to the torture of consulting several doctors. I have to do trial and error in testing available treatments. I spent an enormous amount of time asking experts a lot of questions and then validating the answers.

I’m not trying to rain on the personal medicine parade. I’m cautiously optimistic about some of the health features I’ve gotten sneak previews of. And there have been many times over the past 12 years that I’ve wanted that kind of guidance. (Who knows, maybe it saved me from listening to that quack doctor who insisted I take dried pig thyroid extract because they misdiagnosed me with hypothyroidism.) I hope that in the future, health tech companies will explore “algorithmic patterns” to account for different diagnoses, medications, and other health idiosyncrasies.

All I’m saying is that health tech companies will start promoting this concept as much as possible now. As if it were as simple as wearing a device and consulting an AI. And this is not so. At least, not in the way you probably want it to, in the background, and with minimal effort on your part.

In the meantime, I thought I would research the milk thistle supplement my esthetician recommended.