Exploring Gut-Related Symptom Patterns Across Different Mizaj Profiles of Polyendocrine Metabolic Ovarian Syndrome (PMOS): A Preliminary Unani Clinical Case Series

Abstract

Background: Polyendocrine Metabolic Ovarian Syndrome (PMOS), formerly termed polycystic ovary syndrome, is a heterogeneous endocrine-metabolic disorder frequently associated with menstrual, metabolic, and gastrointestinal manifestations. In Unani medicine, constitutional variation is characterized through Mizaj, which may influence differences in clinical presentation. This preliminary study explored gut-related symptom patterns across different Mizaj profiles in women with PMOS.

Methods: A preliminary longitudinal clinical case series included 20 women aged 18–40 years with a previously documented diagnosis of PCOS/PMOS. Participants were classified into four Mizaj categories: Damvi, Balghami, Safravi, and Saudawi, with five participants in each group. Baseline assessment included menstrual history, PMOS-related manifestations, gastrointestinal symptoms, Mizaj profile, available ultrasonographic findings, and laboratory investigations.

Results: Gastrointestinal manifestations varied across Mizaj profiles. Bloating was observed across all four groups. Damvi participants predominantly presented with abdominal bloating and fullness, whereas Balghami participants showed constipation, bloating, sluggish digestion, and flatulence. Safravi participants demonstrated bloating, dyspeptic symptoms, and altered bowel habits, while Saudawi participants predominantly showed constipation, abdominal discomfort, bloating, and flatulence.

Conclusion: Women with PMOS demonstrated distinct patterns of gastrointestinal and menstrual symptoms across different Mizaj profiles.