Polycystic ovarian syndrome, PCOS, is now polyendocrine metabolic ovarian syndrome, PMOS.

Polycystic ovarian syndrome, PCOS, is one of the most common infertility diagnoses, affecting 1 in 8 women globally. We diagnose women with PCOS daily in our office. The syndrome originally got its name because one of its most common symptoms is multiple (poly) cysts that appear on the ovaries during an ultrasound. Polycystic ovaries, however, are just one of many disparate symptoms that patients with PCOS have.

A better name to fully describe the disorder

Despite PCOS being very common, its name is very inaccurate. This is because the syndrome is actually a very complex disease that goes far beyond multiple ovarian cysts. In the past, PCOS had long been primarily perceived as a gynecological or ovarian disorder. However, symptoms and the body systems involved go far beyond the ovaries and reproductive health. These can include obesity, type 2 diabetes, cardiovascular disease, inflammation, unwanted hair growth, acne, and male-pattern baldness.

The name change from PCOS to PMOS was the result of a global, decade-long effort. Medical experts wanted to more accurately describe the syndrome and diagnose patients. The resulting name change to Polyendocrine Metabolic Ovarian Syndrome, or PMOS, reflects a broader understanding of the condition and its complexity.

What’s the meaning behind the new PMOS acronym?

PMOS is now understood as an endocrine, metabolic and reproductive disorder that affects multiple systems in the body—not just the ovaries. Many people with PMOS don’t even get ovarian cysts more frequently or more severely than people who don’t have the condition. Some never develop ovarian cysts at all.

Instead, PMOS is linked to hormones and metabolism, primarily insulin resistance, that then affects multiple systems in the body, including the ovaries. The effects of insulin resistance are associated with irregular periods, anovulation, weight gain, acne, excess hair growth or thinning hair, type 2 diabetes, and an increased risk of cardiovascular disease.

This shift in the understanding of underlying metabolic and endocrine issues and the complexity of how it extends to other systems in the body was a key reason for the name change. Its focus is now on three interlinking systems: endocrine, metabolic and reproductive. The change helps shift the conversation toward overall health rather than a single aspect of the condition. 

What does the name change mean for patients?

For now, the name PMOS doesn’t change how the condition is diagnosed. PMOS diagnosis will still rely on the same criteria that doctors used to diagnose PCOS. Under this system, it requires a woman to have at least two of the three main criteria for diagnosis:

• Irregular menstruation (infrequent or absent)
• Elevated androgen (testosterone) levels or related symptoms such as acne, excess hair growth, male-pattern baldness
• Multiple follicles seen on both ovaries during an ultrasound or extremely high anti-Mullerian hormone (AMH) test levels

What could the future hold for PMOS sufferers?

Experts in the medical field, including reproductive endocrinologists, hope the name change to PMOS will spur more research into the condition. There is still so much that we don’t know about the cause of PMOS and treatment options remain limited. Focusing not just on the reproductive aspect of PMOS will hopefully create new conversations and promote further research.

Looking at PMOS as a multi-dimensional disease can help expand treatment options as well. Already, drugs used for diabetes, such as metformin, have been prescribed off label by the reproductive medicine community to help PMOS patients conceive. And new horizons that include GLP-1 drugs could help address many of the underlying metabolic issues with PMOS. These drugs have been shown to help restore ovulation and reduce long-term health risks at the same time.