PCOS has a new name: PMOS

The condition, polycystic ovarian syndrome (PCOS), has a new name:  polyendocrine metabolic ovarian syndrome or PMOS.  I can’t stress how much sense this makes and much more accurately represents the actual endocrine condition.

This name change was a result of a global consensus process led by the Monash Centre for Health Research and Implementation, in collaboration with Verity (a UK patient charity), the Androgen Excess, and PCOS Society, and almost 60 additional academic, clinical, and patient organizations worldwide. Well over 14,000 survey responses were also collected from patients and clinicians throughout the world, with additional input from working groups and marketing analysis.

This name, PCOS, has long been a conundrum, because you did not even have to have multiple cysts on the ovaries to have the condition.  The condition is a complex polyendocrine, cardiometabolic, neuroendocrine, and reproductive disorder and the inaccurate and imprecise thinking and evaluation has led to up to 70% of women actually affected, remaining undiagnosed and therefore vulnerable to future significant problems when untreated.

The description, “polyendocrine’ is important.  PMOS physiology does in fact involve several endocrine systems interacting and having influence on the dysfunction.  The  hypothalamic-pituitary-ovarian axis (HPO),  adrenal androgen production, the pancreatic insulin-signaling pathway, adipokine signaling from adipose tissue, and gut-hormone interactions are all involved.   Insulin resistance and hyperandrogenism continue to be the focus of treatments… whether that be the use of natural and/or pharmaceutical strategies and medicines.   Hyperandrogenism contributes to not only hirsutism, acne, and alopecia, but also affects metabolic dysfunction through its effects on fat distribution and insulin signaling.

The metabolic statement in the name change is significant.  In my mind, it acknowledges that the focus on reproductive status and just ovarian function is misguided.  The metabolic disorder of PMOS and the insulin resistance present in almost 100% of those with PMOS, whether obese, overweight or lean, leaves women at higher risk for dyslipidemia, type 2 diabetes and cardiovascular disease including increased incidence of heart attacks and strokes.  Insulin resistance is the central metabolic driver with hyperinsulinemia driving ovarian androgen secretion, suppressing sex hormone-binding globulin (SHBG), shifting fat redistribution toward central adiposity, and influences every pathogenic process of PMOS.

Women with PMOS  also have more metabolic function that affect the liver, affecting 43% of women with PMOS, called metabolic dysfunction associated steatotic liver disease, (MASLD), formerly called NAFLD. Women with PMOS have three times the risk of MASLD.  Another condition, obstructive sleep apnea is present in an estimated 30–40% of women with PMOS, driven by a combination of androgen excess, obesity, and insulin resistance.

The clinical imperative is direct: every patient with PMOS should receive a complete cardiometabolic workup as standard of care, and earlier in life than many women are currently receiving screening.

Ovarian dysfunction is still central to PMOS, it is a downstream result of the metabolic endocrine dysfunction, not a primary ovarian defect.  Remember that PMOS also results in an increased risk of endometrial cancer due to anovulatory cycles and the endometrium (lining of the uterus), getting the normal estrogen stimulation, but not the cyclic progesterone effect and thus what is called an unopposed estrogen effect.

Elevated anti-Müllerian hormone (AMH), now included in adult diagnostic criteria as an alternative to ultrasound, reflects disordered folliculogenesis and granulosa-cell dysregulation driven by the broader endocrine environment.

If you are a patient who has been diagnosed with PCOS…you will hopefully hear your doctor use the new term.  However, more importantly, your clinician should have a broader approach to whatever your primary PMOS issues are…whether that is fertility, irregular cycles, facial hair, acne, or hair loss.  Proper management requires addressing the “now”, but also the future and monitoring and reducing risks of dyslipidemia, cardiovascular disease, type 2 diabetes and endometrial cancer with proper testing, prevention strategies, and treatment strategies.

PMOS lends itself, perhaps more than any other women’s health condition, to an integrative approach, using the best of conventional diagnostic testing and monitoring, the best of evidence based herbal and nutritional therapies for not only the management of PMOS but the fallout of PMOS and the best use of hormonal management, anti-androgen medications, blood sugar medications and cardiac medications for blood pressure and/or lipids when needed.

A well trained licensed naturopathic physician with expertise in women’s health is an optimal clinician for women with PMOS. 

Reference: Teede HJ, Bahri Khomami M, Morman R, et al. Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: a multistep global consensus process. Lancet. Published online May 12, 2026.