Polyendocrine metabolic ovarian syndrome and venous thromboembolism: Hemostatic considerations in diagnosis and management.

Polyendocrine metabolic ovarian syndrome (PMOS), previously known as polycystic ovary syndrome (PCOS), is a complex disorder affecting females of reproductive age. Patients with PMOS can develop several comorbidities, including obesity, hyperlipidemia, arterial hypertension, insulin resistance, infertility, and increased risk for endometrial carcinoma. Venous thromboembolism (VTE) is another complication associated with PMOS, thought in part to be related to chronic inflammation leading to prothrombotic hemostatic changes. Hormonal therapy is the mainstay of management, but the presence of other comorbidities and risk factors such as thrombophilia and/or family history of VTE influences the choice of hormonal therapy. Management of this disorder requires multidisciplinary care of its gynecologic, cardiovascular, endocrine, and hemostatic components. In this review, a summary of the diagnosis and management of PMOS is provided with an emphasis on hemostatic considerations. We highlight 1) the diagnostic criteria and general management of PMOS, 2) Hormonal therapy and VTE risk considerations in PMOS management, and 3) Infertility management and the potential risk for thrombosis in patients with PMOS.