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Polycystic Ovary Syndrome Formally Renamed to Polyendocrine Metabolic Ovarian Syndrome

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"A more accurate name may lead to earlier diagnosis and treatment."

Polycystic Ovary Syndrome Renamed to PMOS in Landmark Global Decision

A global consortium of clinicians, researchers, and patient advocates has formally renamed the condition previously known as polycystic ovary syndrome (PCOS) to polyendocrine metabolic ovarian syndrome (PMOS). The name change, which was announced at the European Congress of Endocrinology and published in The Lancet, is intended to more accurately reflect the condition's multisystem nature.

The condition affects an estimated 170 million people worldwide, or approximately one in eight women, with the World Health Organization estimating that up to 70% of those affected are undiagnosed.

Rationale for the Name Change

The previous name, polycystic ovary syndrome, was criticized as misleading for several critical reasons:

  • Cyst misrepresentation: The condition does not involve an increased rate of abnormal ovarian cysts. A study published concurrently in JAMA Internal Medicine found that women with PCOS/PMOS were 12 times more likely to have multiple antral follicles, but the rate of dominant follicles or pathological cysts was similar between groups.
  • Gynecological focus: The name implied the condition was primarily a gynecological disorder, whereas it is a multisystem condition involving endocrine, metabolic, dermatological, and psychological components.
  • Delayed diagnosis: The misleading name was cited by experts as a contributing factor to delayed diagnoses and fragmented care.

"The new name more accurately reflects the complexity of the condition, which will lead to advancements in clinical practice and research." — Professor Helena Teede, Monash University

The new name, polyendocrine metabolic ovarian syndrome, was chosen to emphasize the condition's hormonal and metabolic impacts.

Diagnosis and Symptoms

Diagnostic criteria for the condition remain unchanged. Diagnosis typically requires two of three criteria based on the Rotterdam Consensus: elevated androgen levels, irregular menstrual periods, or the presence of polycystic ovaries on ultrasound.

Symptoms can include:

  • Irregular or absent periods
  • Irregular ovulation
  • Excess facial or body hair (hirsutism)
  • Acne
  • Weight gain
  • Scalp hair loss
  • Infertility

The condition is associated with an overproduction of androgens by the ovaries, often linked to an imbalance between follicle-stimulating hormone and luteinising hormone. Insulin resistance and high insulin levels can further increase androgen production.

Associated Health Risks

PMOS is a lifelong condition associated with increased risks for several health conditions, including:

  • Type 2 diabetes
  • High blood pressure
  • Cardiovascular disease
  • High cholesterol
  • Endometrial cancer
  • Obesity
  • Sleep apnoea
  • Eating disorders
  • Depression and anxiety
  • Fatty liver disease

"The renaming recognizes the full reality of patient experiences and shifts the conversation toward overall health." — Melanie Cree, MD, PhD, University of Colorado Anschutz

Prevalence and Demographics

  • PMOS affects an estimated 10% to 13% of reproductive-age women globally.
  • The condition affects approximately 5–6 million women in the United States.
  • Black and Hispanic women are reported to have a higher likelihood of severe metabolic complications and are less likely to receive an early diagnosis.

Process of Renaming

The name change resulted from a 14-year collaboration led by Professor Helena Teede, director of the Monash Centre for Health Research Implementation. The process involved:

  • Surveys collecting approximately 22,000 responses from stakeholders worldwide
  • Multiple international workshops with patients and health professionals
  • Support from 56 academic, clinical, and patient organizations, including the Endocrine Society

The new name was selected from three candidates, with 87 of 90 voters supporting PMOS.

Implementation

The new name will be interchangeable with PCOS over a three-year transition period. Full implementation is expected in the 2028 update of the International Guideline. The consortium plans to:

  • Launch an international education and awareness campaign
  • Seek updates to the World Health Organization's International Classification of Diseases
  • Update clinical guidelines and medical education materials

"Including 'endocrine' and 'metabolic' in the name tells clinicians it is a whole-body condition." — Steven Vasilev, MD, Lotus Endometriosis Institute

Management

There is no cure for PMOS. Management focuses on treating symptoms and may include:

  • Hormonal contraceptives for cycle regulation and hair growth management
  • Drugs to stimulate ovulation for fertility
  • Weight management strategies
  • Personalized dietary approaches (research indicates DASH and Mediterranean-style diets may offer symptom improvement)
  • New weight-loss medications are under trial

Study Limitations

The research on ovarian cysts analyzed ultrasound data from 223 women with PCOS/PMOS and 1,012 women without the condition, all participants in the Finnish Women's Health Study (WENDY). The study population was 97% white European, and ultrasounds were performed by five different clinicians on random cycle days.

Concerns and Considerations

Some experts noted potential concerns regarding the name change, including:

  • The possibility of a male variant of the syndrome, which some researchers are studying
  • The cost and confusion of rebranding for organizations and businesses built around the old acronym
  • Ensuring cultural appropriateness to avoid stigmatizing terms in different countries

"The previous name implied 'it's all about the ovary, which it's not.'" — Professor Colin Duncan, University of Edinburgh