Polycystic ovary syndrome, known as PCOS, has a new name: PMOS!
The endocrine disorder is now officially called polyendocrine metabolic ovarian syndrome, or PMOS, and many doctors, patients, and advocates believe this will lead to a higher standard of care for what can be a complex, confusing, and often underdiagnosed condition. But what led to the name change, and what does it actually mean? Let's break it down.
What is PMOS, anyway?
You may have heard the acronym PCOS—now PMOS—but aren't sure what it really means. PMOS (going forward, we'll use the new name) is a hormonal and metabolic condition that occurs in people of childbearing age with a vagina. Symptoms may include irregular menstrual cycles, acne (especially on the jawline, chin, and lower cheeks), weight gain, excess hair growth on the face and body, hair thinning, anxiety and depression, and infertility, among others.
“Because the condition impacts so many systems, a woman may experience some or combinations of these [symptoms] at different points in her life,” says Prati Sharma, MD, a board-certified OB/GYN and reproductive endocrinologist based in Toronto. (She is also a medical advisor for the fertility company Bird & Be.) “As for prevalence, research shows that PMOS affects more than 170 million women globally; and among younger people specifically, global cases among adolescents and young adults increased by nearly 60% in both incidence and prevalence between 1990 and 2021.”
Why was the name changed from PCOS to PMOS?
Originally the condition was named for follicles on the ovaries that many referred to as “cysts,” which is what providers often looked for to diagnose the condition, says Dr. Sharma; “but the reality is that not everyone with [the condition] has that symptom.” Instead, she explains further, PMOS is diagnosed when an individual exhibits at least two out of three criteria: irregular cycles, clinical or laboratory signs of high levels of hormones called androgens, and a characteristic appearance of the ovaries on ultrasound.
“This name change has been a long time in the making,” says Sameena Rahman, MD, a board-certified gynecologist in Chicago. “The previous name, PCOS, was both misleading and incomplete because it focused narrowly on ovarian cysts, which are not present in every patient and are not the root cause of the condition.”
According to Lora Shahine, MD, a board-certified OB/GYN and reproductive endocrinologist at Pacific Northwest Fertility, the name change—a process led by Professor Helena Teede at Monash University that involved a consortium of 56 patient and professional organizations and input from more than 22,000 patients and clinicians worldwide—was a major feat. The new name was revealed in a May 12 paper in The Lancet. Says Dr. Shahine, “It took over a decade of rigorous work to get here, and the result is a near-unanimous global consensus that the old name was holding patients back.”
The problem with PCOS as a name, Dr. Shahine notes, is that “it centered the condition on ‘cysts on the ovaries,’ but those are not actually cysts.” Instead, she explains, what patients have are “small, immature follicles, essentially [sacs of immature] eggs, that did not get the hormonal signal to mature and release, and many people with this condition do not have them at all on ultrasound.” However, if you didn't have “cysts,” you were often told you didn't have PMOS, even if you had other symptoms of the condition. “That misunderstanding," she adds, "has caused real harm, including delayed diagnosis, missed diagnosis, and confusion.”
The use of “polyendocrine” versus “polycystic” shifts the conversation from cysts to “hormonal complexity,” says Dr. Shahine. The new name also adds “metabolic,” which “acknowledges the metabolic dimension that drives so much of the long-term health impact. The word ‘ovarian’ stays because the ovaries are still part of the picture, but they are no longer the whole story.”
But wait—what does the word “metabolic” even mean in this context? It refers to “how the body regulates energy, hormones, and insulin,” explains Dr. Sharma. “In PMOS, insulin resistance is present for the majority of affected individuals, sometimes even in women who are not overweight, and it drives a cascade of effects, including androgen excess, disrupted ovulation, weight changes, and elevated risk of type 2 diabetes and cardiovascular disease.”
In short, she says, “the name change reflects a shift in what clinicians look for and who gets involved in a patient's care.”
How is the name change expected to help improve care going forward?
Changing the name is intended to help broaden education and awareness about how the condition actually impacts people and how to treat it, hopefully leading to increased diagnosis and treatment. “When PCOS was framed as a gynecological disorder, research funding and medical education followed that framing," says Dr. Sharma, "which left a gap in how providers recognized and engaged with the condition.”
The new name, PMOS, helps “de-stigmatize the diagnosis and shifts the conversation beyond reproductive health alone, recognizing that this is a complex metabolic and endocrine condition that affects multiple systems throughout the body,” says Dr. Rahman. She hopes the new change decreases the “dismissal many patients experience when seeking care,” not to mention shortening the delay in diagnosis, which she notes can currently take years for some patients. Hopefully, with increased education and new terminology, doctors and patients alike will start to see PMOS in a new light.
Says Dr. Shahine, there is a “three-year global rollout” for use of the new name, so it may take a while to see fully updated terminology. “[The change] opens the door to better research funding, updated clinical guidelines, earlier diagnosis and care that finally reflects the full reality of what patients live with every day,” she explains.
“For young women, specifically," she continues, "my hope is that this name change leads to earlier diagnosis, better support, and a stronger sense that you are not alone or ‘broken.’ This is a common, manageable, lifelong condition, and with the right care, you can absolutely thrive."
