The PMOS/PCOS Inflammation Review Changes the Question, Not the Treatment

A 2025 review in Endocrinology argues that inflammation in PCOS is better studied inside particular tissues, like your ovaries, your fat tissue and the parts of your brain that run your hormones, than through one blood marker for the whole body (De Robles et al. 2025).

The review uses the name PCOS, which is now also called PMOS. For Inflammatory PCOS, it changes the question researchers ask, not the treatment. All women with PCOS have some degree of chronic inflammation, but in Inflammatory PCOS it is the primary cause of your symptoms, and it can come from many different places.

What did the review actually find?

The authors start with a mismatch in the research so far. A raised CRP, a blood marker of inflammation, in women with PCOS is what led to the idea of body-wide chronic inflammation, but studies of other inflammatory messengers in the blood, such as IL-6 and TNF-alpha, have given inconsistent results.

So the review looks at how immune cells and hormone-producing cells interact inside specific tissues: the hypothalamus and pituitary in your brain, your ovaries, the lining of your uterus and your fat tissue. It concludes that PCOS is marked by immune activity in those particular tissues rather than by one body-wide, low-grade state, and that the inflammation in these tissues contributes to PCOS (De Robles et al. 2025).

In your ovaries, that matters. Chronic inflammation stimulates your ovaries to produce more testosterone, just as high insulin does, and that testosterone drives acne, scalp hair loss and facial hair and disrupts ovulation.

How early is the evidence?

Early. Human tissue is hard to obtain, so much of the tissue research comes from animal models, which reproduce the hormonal side of PCOS but not all of its genetics. The authors call for studies that pin down cause and effect between local immune activity and hormone problems, and they see treatments aimed at specific immune pathways as the direction ahead.

What changes for someone with PCOS today?

How you treat Inflammatory PCOS stays the same, because the treatment already starts by finding where your inflammation comes from. It can come from an autoimmune condition like Hashimoto's, gut problems like IBS or SIBO, food sensitivities, excess iron or nutritional deficiencies, so there is no one treatment: it is a process of elimination to work out what will help you most.

A blood test is only part of the picture, and my Inflammatory PCOS checklist starts with your signs: chronic digestive issues, food sensitivities or a chronic skin condition, an autoimmune condition, headaches, joint aches or low moods. Testing is optional. hsCRP and ESR measure your inflammation, and a full thyroid panel with antibodies, gluten antibodies, vitamin D and iron studies look for its causes.

From there, the core treatment works on the source: check your thyroid, heal your gut lining, eat an anti-inflammatory diet, consider an anti-inflammatory omega-3 supplement for PCOS, correct nutritional deficiencies, reduce your exposure to environmental toxins and find the right movement for your body. If you take warfarin or another blood thinner, check the omega-3 with your prescriber first.

My Inflammatory PCOS guide goes through each step, my free root cause quiz tells you whether inflammation is your root cause, and The PCOS Repair Protocol sets out the full plan.