Polyendocrine metabolic ovarian syndrome (PMOS), formerly known as polycystic ovary syndrome, affects millions of women worldwide and is one of the most common endocrine disorders among young women. Its roots, however, may begin far earlier than most people realize.
Growing research suggests that childhood adversity – especially unstable caregiving and chronic stress – may shape how the body regulates stress in ways that influence long-term health. PMOS may be one example of a much broader pattern: the body remembers early adversity.
In early childhood, the brain and body develop rapidly and the systems that regulate stress are especially sensitive to the environment. During this period, children rely heavily on caregivers to help them manage physiological responses to stress. When caregiving is consistent and supportive, the body learns how to return to a baseline state after stress. But when environments are marked by neglect, instability or chronic conflict, the body may adapt differently. One major component of the body’s stress response system, often referred to as the hypothalamic–pituitary–adrenal (HPA) axis, can develop altered patterns of reactivity following early adversity, including heightened or blunted responses.
These early adaptations may be useful in the short term, helping children cope with difficult environments. Over time, however, they may increase vulnerability to a range of health issues, including metabolic and reproductive conditions. Still, linking early stress directly to specific outcomes like PMOS remains complex; not all individuals exposed to adversity will experience negative health consequences. What matters is not just early experience, but how developmental processes unfold over time.
Developmental scientists increasingly suggest that adolescence may offer a second window of opportunity. During the transition through puberty, the stress system undergoes significant reorganization, making it a period of both vulnerability and plasticity. Researchers have proposed that this stage may allow earlier stress-response patterns to be recalibrated, particularly when adolescents are in supportive social environments. In other words, the effects of early adversity may not be permanent.
If adolescence is a window of possibility, then the environments young people encounter during these years become particularly important. For many girls, school is one of the most consistent and influential social environments in their daily lives. Supportive school relationships, such as trusted teachers, mentoring programs, school-family partnerships and a strong sense of belonging, have been linked to healthier stress responses.
This perspective challenges us to rethink how we understand girls’ health and the role schools are meant to play. Conditions like PMOS are often treated as isolated medical issues, but they may reflect processes that begin much earlier and unfold over years.
Rather than focusing only on treatment after symptoms appear, there is value in asking where earlier interventions might matter most. Recognizing this developmental trajectory highlights an important opportunity: investing in supportive school environments may help protect not only students’ academic outcomes and mental well-being, but also their long-term physical health.
For Canadian provinces, the implication is not that teachers should diagnose or treat PMOS but rather that health and education ministries should work together to provide stable mentoring, accessible school-based relational support, and reliable pathways to primary care, and then evaluate their long-term effects.
Especially for girls shaped by early adversity, what happens in classrooms and hallways may help determine not only how they learn, but also how their bodies carry the past into the future.
A special thanks to Dr. Suna Eryigit-Madzwamuse for her guidance and support in writing this article.
