The Evolution of PCOS to PMOS: Aligning the Name with Scientific Understanding

Polycystic ovary syndrome (PCOS) is a common health condition impacting over 170 million female adolescents and adults worldwide. Recently, a global initiative officially recommended a new name: polyendocrine metabolic ovarian syndrome (PMOS). This change isn’t cosmetic — it’s scientific, patient‑driven, and overdue.

The term “polycystic ovary syndrome” has long been thought misleading, as pathological ovarian cysts are not actually a feature of the condition. Furthermore, the term “PCOS” has had more damaging effects, such as misdiagnosis or delayed diagnosis (up to 70% of cases remain undiagnosed), stigma, fragmented care, confusion among patients, policymakers, and clinicians, and barriers to research funding. The disorder was also known by several other names such as polycystic ovarian disease, Stein-Leventhal syndrome, and hyperandrogenic anovulation, reflecting the clinical heterogeneity and diagnostic uncertainty that many patients face. 

PMOS, on the other hand, accurately conveys a disorder involving multiple hormones, metabolic dysfunction that can manifest as obesity, diabetes, among other conditions, and ovarian involvement without implying that cysts are the only feature. The term also indirectly accounts for psychological manifestations, such as anxiety, depression, eating disorders, and reduced quality of life, as well as dermatological features, such as acne, alopecia, and hirsutism. 

The renaming was a culmination of a rigorous global consensus involving 56 international organizations, 14,360 survey responses from patients and health care professionals, and input from patient advocacy groups. The new name is now in the process of being integrated into clinical guidelines and the ICD disease classification.

Management of PMOS hasn’t changed and is focused on regulating menses for endometrial protection, treatment of hyperandrogenic symptoms, fertility management, and prevention/treatment of metabolic and psychological complications. Therapy is individualized based on the clinical presentation, risks and benefits of available therapies, and patient goals, such as the desire for pregnancy. Lifestyle modifications including changes to diet and/or physical activity, is the first-line treatment. It may be accompanied by pharmacological treatment.

PMOS is associated with a variety of complications, including metabolic complications (such as insulin resistance, glucose intolerance, and type 2 diabetes), pregnancy complications (such as gestational diabetes, hypertensive disorders of pregnancy, and preterm labor), mental health complications (such as anxiety, depression, and eating disorders), and endometrial cancer. Complications may be more common with delayed diagnosis, untreated disease progression, and inappropriate monitoring for many patients. Prevention and management strategies for these complications should be included as a part of comprehensive health care for patients with PMOS.

A shift toward scientific accuracy and global health equity, this is a long-awaited moment for the PMOS community. 

The full article on the name change can be found in The Lancet. 

DynaMed provides several articles on PMOS: the overall condition, its evaluation, management, management of associated infertility, and complications.