The story of Polycystic Ovary Syndrome (PCOS) is no longer confined to the ovaries. What was once classified as a reproductive disorder has emerged as a far more complex condition involving widespread metabolic and hormonal dysregulation. The new term is Polyendocrine Metabolic Ovarian Syndrome, and this transition marks a significant shift in medical science and follows a 14-year collaboration between researchers, healthcare professionals and patients. Professor Helena Teede, Director of Monash University’s Monash Centre for Health Research & Implementation and an endocrinologist at Monash Health, led the name change process after spending decades researching the condition.
No longer just a ‘reproductive’ disorder
PCOS affects 1 in 8 women or more than 170 million worldwide, but now international guidelines and a holistic approach to healthcare can improve the long-term impact of this condition. Dr Renuka David, Gynaecologist, Preventive Health Exponent, Founder of Chennai’s Radiant Wellness Centre and Founder-Curator of Radiant Wellness Conclave sheds light on the topic.
“The term Polycystic Ovarian Disease (PCOD) was coined as early as 1935,” she explains. “This name was based entirely on the appearance of the ovaries, but later evolved to Polycystic Ovarian Syndrome (PCOS) to reflect that it was a wider disorder with side effects. In a welcome move now, it is called Polyendocrine Metabolic Ovarian Syndrome (PMOS). The understanding of this condition has evolved from a physical description to recognising its hormonal and endocrine impact, and now, finally, we have entered the metabolic and molecular era. Irregular periods and hyperandrogenism are often the earliest clinical signs in adolescent girls and young women, but the underlying endocrine-metabolic dysfunction can have lifelong implications.”
She adds, “Using the term PCOS has significant psychological consequences. Women and girls who experience the condition are often distressed because the social stigma associated with it is considerable. It is largely linked to reproductive problems such as amenorrhoea or the absence of menstrual periods; hypomenorrhoea or periods with scanty flow; oligomenorrhoea or irregular periods; mood swings, obesity, acne and more. After marriage, it is often perceived as indicative of infertility and pregnancy complications. The PMOS framework also includes lifelong risks such as cardiovascular disease, metabolic syndrome, non-alcoholic fatty liver disease, sleep apnoea, and psychological disorders including anxiety and depression.”
Dr Renuka reiterates the importance of the “polyendocrine” aspect of PMOS, which reflects the fact that several hormonal systems are often involved simultaneously. The metabolic component emphasises obesity, dyslipidaemia, impaired glucose tolerance, chronic low-grade inflammation, and an increased risk of Type 2 diabetes. These metabolic abnormalities are not secondary complications but integral components of the syndrome itself.
“With this shift to PMOS, there is awareness that the focus is not just on the reproductive organs of women’s bodies,” she says. “It covers a range of issues beyond gynaecological, including metabolic, hormonal, and even mental. This offers a holistic perspective on the issue, and there is no need for women to feel isolated or segregated. Women with PMOS generally display an increase in androgens, while oestrogen levels are lower. This can show up as hirsutism (excess hair growth on the body) and alopecia (hair loss on the scalp). Metabolic changes include insulin resistance and Type 2 diabetes, where there is a spike in blood sugar and oral hypoglycaemic agents may be needed to correct it. Metabolic issues also cover obesity and skin disorders such as acne.”
Recognising the metabolic and hormonal complexity
Dr Renuka believes that screening, diagnosis and treatment are fundamental to raising awareness about PMOS. “This is done based on physical examinations alongside blood markers and tests. Knowing what we do now, it would be a misnomer to continue labelling it as PCOS, since it is not only restricted to the increase of cysts on both sides of the ovaries. In gynaecological menstrual cycles, the follicles are stimulated by follicle-stimulating hormone produced by the pituitary gland, which stimulates the follicle to grow. The egg is released and when cysts are formed, the follicles are not allowed to mature. The gamut of PMOS is difficult to pinpoint to any one cause and sometimes occurs without reason. However, typical causes include genetic predisposition or lifestyle factors. Even in lower-income groups, women may not be able to afford proper nutrition. Deficiencies and lack of access to food and hygiene can contribute to such disorders. Lifestyle modification is considered foundational to addressing PMOS. Nutritional strategies should be aimed at improving insulin sensitivity, with regular physical activity, stress management and weight optimisation forming part of treatment.”
According to reports, the new name is expected to be adopted across medical and scientific communities over the next three years, and PCOS will be replaced by PMOS in the International Classification of Diseases by 2028.
For many women who have experienced confusion, misdiagnosis or incomplete treatment under PCOS, this shift brings long-awaited clarity and relief. Recognising PMOS as a broader polyendocrine and metabolic condition validates symptoms that are complex and interconnected, extending beyond reproductive health. It offers not just a new name, but a fuller understanding, enabling earlier risk detection, more holistic care, and the reassurance that their experiences are finally being seen and taken seriously within a more compassionate medical framework.