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Tara Loader Wilkinson

At age 22, Ashleigh Martin’s body went into rebellion. She watched as her periods became erratic and she gained 35kg (77lbs) in just six months.
Then came the frightening diagnosis: an ultrasound showed 20 “cysts” on each ovary.
“I remember being told that I might not be able to have kids and that the cysts might be cancerous. I was terrified,” says Martin, a now 34-year-old British-Singaporean born in Hong Kong who at the time was working in the food and beverage industry as a VIP account manager, and as a model and emcee.
But those “cysts” were likely underdeveloped, fluid-filled sacs called follicles, each containing an immature egg, and the name of her condition – polycystic ovary syndrome (PCOS) – was fundamentally misleading.
Last month, in what is being hailed as a landmark victory for women’s health, PCOS was given a more accurate name after a global survey of more than 14,360 women with the disease. It is now called polyendocrine metabolic ovarian syndrome (PMOS).
The change aims to end decades of delayed diagnoses, fragmented care, overlooking of potential hormonal and metabolic symptoms, and even stigma surrounding a condition that affects one in 10 women globally, according to a publication in the medical journal The Lancet.












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Looking back, Martin notes that she initially felt “completely helpless”. At the time, her high-profile jobs “were part of the need to stay skinny”, causing her to misattribute her increasingly erratic period cycles to undereating and over-exercising.
“There were months I would go without a period, and sometimes I’d have a period for three weeks. I was seriously concerned.”
When the weight gain began for no apparent reason, it triggered a vicious cycle of emotional eating.
“The stress of my body changing so much in such a short space of time was devastating,” she recalls, adding that it led to severe anxiety, depression and an inability to work.
Unexplained abdominal weight gain, persistent difficulty losing weight and clinical depression are all deeply common symptoms of PMOS, according to scientists.
Shaken by her initial prognosis and unable to afford further private medical screening, Martin embarked on her own mission to understand her habits, behaviours and lifestyle choices.
“Having the weight of the medical possibility of infertility and cancer was very hard at the time. I really had to change my mindset to give myself time and compassion,” she says.
She sought out a therapist to help her address her poor body image and took up MMA fighting and boxing. The sports helped her accept her larger body as strong and brilliant, “not something to be ashamed of”, she says.
Over the next five years, she slowly lost the weight through adopting better eating habits and regular exercise. While the underlying PMOS has not gone away, its day-to-day effects are entirely manageable.

For other women experiencing symptoms, she describes how she felt “departed” from her body.
“It was only when I invested in behaviours and habits to ‘reclaim’ it that I could find a sustainable balance,” she says.
Dr Michelle Tsui, a specialist in obstetrics and gynaecology at Hong Kong’s Artis Medical Centre, believes the shift from PCOS to PMOS represents a massive leap forward.
“With this new name, doctors are reminded to focus not only on women’s ovaries and ovulation but also on their endocrine and metabolic issues,” Tsui says.
She sees patients affected by PMOS “all the time, with a wide spectrum of severity”, and stresses that the gynaecological, endocrine and metabolic systems are interrelated. “Improvement in insulin resistance and metabolic rate can lead to better ovulation function.”

Crucially, women with PMOS are not always subfertile – taking longer than normal to conceive – and accidental pregnancies are common due to unpredictable ovulation. Those who do experience fertility struggles due to PMOS should not despair, Tsui says, as the condition is “highly treatable”, often simply with lifestyle changes and oral ovulation tablets.
While missing periods for years can increase the long-term risk of endometrial (uterine lining) cancer, Tsui stresses that this worst-case scenario remains “uncommon and mostly preventable”.
Managing missing periods relies on using targeted hormonal treatments to keep the uterine lining healthy, and directly tackling the underlying metabolic issues through diet, exercise and medications like metformin.
GLP-1s vs holistic management
Rebranding PMOS as a metabolic disorder opens the door to modern weight-loss treatments.
Tsui notes that about 30 per cent of PMOS patients in Hong Kong have a high BMI. For those struggling to respond with traditional diet and exercise, she believes GLP-1 receptor agonists like semaglutide could be a powerful aid.
“GLP-1s could help achieve more pronounced weight loss,” she says.

She cautions that these treatments should be avoided by patients with a history of depression, though, as they can exacerbate anxiety.
“It can help counter rapid weight gain and insulin resistance, but it is best to be avoided in those who are depressed.”
Tsui adds that because stopping GLP-1 therapy often results in rebound weight gain, patients must have a long-term diet and exercise strategy in place.
Martin sees this differently after she shed 25kg – from 86kg to 61kg – through martial arts, boxing and a lifestyle overhaul. She has moved back to Hong Kong and thrives as a personal trainer and lifestyle nutrition coach at Limitless Health. Her periods are regular, and she is not infertile as she once feared she might be.
“Don’t be tempted to take a GLP-1 to address PMOS weight gain,” Martin warns. “If I were given an option to take an injection, my relationship with food would continue to be disjointed. I see this today in women who haven’t addressed their basic foundations of sleep, stress and nutrition. What I learned, and relearned, will carry me through a lifetime.”

Do you have PMOS?
According to Dr Michelle Tsui, a PMOS diagnosis generally requires meeting two out of the three following criteria:

Irregular cycles: Infrequent ovulation or periods – that is, cycles that last longer than 35 days, or having fewer than eight periods a year.


Hormonal imbalance: Signs of excessive male hormones (androgens), such as severe acne, excessive body hair or male-pattern hair loss.


Polycystic ovaries: An ultrasound scan showing an accumulation of tiny, undeveloped follicles – historically misnamed “cysts” – on the ovaries.

Tsui emphasises that irregular cycles and a “polycystic” appearance on an ultrasound are completely normal during early puberty and do not necessarily mean a teenager has PMOS.
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Dr Michelle Tsui believes the shift from PCOS to PMOS represents a massive leap forward. Photo: Dr Michelle Tsui

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MMA helped Martin (top) accept her larger body as strong and brilliant. Photo: Ashleigh Martin

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Lifestyle

Health & Wellness

Health

Personal trainer Ashleigh Martin reveals her journey with PMOS – until recently called PCOS – and why her lifestyle overhaul avoids GLP-1s


Personal trainer Ashleigh Martin reveals her journey with PMOS – until recently called PCOS – and why her lifestyle overhaul avoids GLP-1s.


How a former model with PMOS who put on 35kg in 6 months handled it without GLP-1s

.css-1c6uqr6{color:inherit;font-weight:inherit;font-size:inherit;font-family:inherit;line-height:inherit;overflow-wrap:break-word;}Personal trainer Ashleigh Martin reveals her journey with PMOS – until recently called PCOS – and why her lifestyle overhaul avoids GLP-1s

Personal trainer Ashleigh Martin reveals her journey with PMOS – until recently called PCOS – and why her lifestyle overhaul avoids GLP-1s