PCOS has been renamed to PMOS

In May 2026 Polycystic Ovary Syndrome (PCOS) was formally renamed to Polyendocrine Metabolic Ovarian Syndrome (PMOS) in a journal article published by the Lancet. This came after a large international consensus process involving clinicians, researchers, and patients worldwide. The key purpose of the change was to reflect the reality that the condition is not simply an ovarian or fertility disorder, but a complex multisystem endocrine and metabolic condition.

Why the name change?

The name “PCOS” was scientifically misleading for several reasons:

• Many people with the condition do not actually have ovarian cysts
• The “cysts” seen on ultrasound are typically immature follicles, not true cysts
• Some patients meet diagnostic criteria without polycystic ovaries on imaging
• The old terminology overemphasised fertility and ovarian features while under-recognising the broader systemic disease burden

The new term breaks down as:

• Polyendocrine → reflects dysfunction across multiple hormonal systems
• Metabolic → highlights insulin resistance and cardiometabolic disease risk
• Ovarian → acknowledges reproductive involvement without making it the sole defining feature
• Syndrome → recognises the broad variability in presentation

Key hormonal implications highlighted

The name reframes the condition primarily as a disorder of endocrine dysregulation, rather than a purely reproductive condition. The hormonal features emphasised include:

• Hyperandrogenism (elevated androgens/testosterone)
• Dysregulation of the hypothalamic-pituitary-ovarian axis
• Altered LH:FSH signalling
• Ovulatory dysfunction
• Insulin acting as a hormonal driver of androgen excess
• Interactions between metabolic hormones and reproductive hormones

It also reinforces that symptoms such as:

• acne
• hirsutism
• scalp hair thinning
• irregular cycles
• infertility

are manifestations of broader endocrine dysfunction rather than isolated ovarian pathology.

Major metabolic shift in understanding

One of the biggest conceptual changes in the paper is the explicit positioning of PMOS as a metabolic disease.

Key metabolic implications include:

• Insulin resistance
• Hyperinsulinaemia
• Increased risk of:
  • type 2 diabetes
  • impaired glucose tolerance
  • metabolic syndrome
  • dyslipidaemia
  • hypertension
  • fatty liver disease
  • cardiovascular disease

A major implication of the PMOS terminology is that patients may increasingly receive:

• metabolic screening
• cardiovascular risk assessment
• earlier insulin resistance evaluation
• multidisciplinary management

Multi-organ and whole-body implications

The reclassification strongly emphasises that PMOS affects multiple body systems simultaneously, with involvement across:

• endocrine
• reproductive
• metabolic
• dermatological
• cardiovascular
• psychological systems

Examples of multi-system effects include:

Reproductive

• anovulation
• subfertility/infertility
• menstrual irregularity
• pregnancy complications

Dermatological

• acne
• hirsutism
• androgenic alopecia

Metabolic/cardiovascular

• insulin resistance
• obesity
• dyslipidaemia
• cardiovascular disease risk

Mental health

• anxiety
• depression
• body image distress
• reduced quality of life

Clinical implications of the PMOS model

Importantly:

• diagnostic criteria have not yet fundamentally changed
• current Rotterdam-based diagnostic approaches still apply for now
• fertility treatments remain similar in the short term

However, the renaming is intended to shift:

• clinical education
• guideline development
• disease classification systems
• research priorities
• public understanding

 

Overall takeaway

PCOS is no longer being framed primarily as an ovarian disorder causing infertility, but rather as a lifelong systemic endocrine-metabolic syndrome with reproductive manifestations.

The move to PMOS reflects recognition that:

• hormonal dysfunction,
• insulin resistance,
• metabolic disease risk,
• cardiovascular health,
• skin manifestations,
• and mental health impacts

are all core components of the condition — not secondary complications.

From a Naturopathic perspective

This reclassification mirrors the way we approach treating people with PMOS, that it is a multi-system condition that needs to be treated holistically. If you are looking for further support please reach out to any of the Naturopaths in our team. 

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