After decades of being treated primarily as an ovarian condition rather than a hormonal disorder, with inadequate means of treatment or diagnosis, polycystic ovary syndrome (PCOS) has finally been given a new name: polyendocrine metabolic ovarian syndrome (PMOS). This change comes after two years of research by a group of endocrinologists led by Professor Helena Teede from Monash University in Australia, with their findings published in The Lancet Journal.
Why the Name Change?
Professor Helena Teede, professor of women's health, equity, and impact at Monash University, explains that PCOS is not always a primary ovarian disease. There is no increase in pathological or abnormal cysts in this condition. In some cases, patients do not present with cysts in their ovaries but exhibit other symptoms. The name PCOS focused solely on the ovaries, ignoring the endocrine system, even though there is involvement of insulin, androgens, and reproductive and metabolic hormones. Teede emphasizes that PMOS can be recategorized as an endocrine or hormonal disorder, meaning hormone regulation should be the first and foremost approach to treating the condition.
Prevalence of PCOS/PMOS
According to a 2024 Chennai-based study published in the Obstetrics and Gynaecology Forum, 21% of school and college girls were found to have PCOS, with some studies indicating that one in five young Indian women suffers from the condition. Prevalence is higher in urban areas and among adolescents, with reported rates ranging from 4.17% to 22.5% across various regions.
Expert Insights on the Shift
Dr. V. Mohan, chief diabetologist at Dr. Mohan's Diabetes Specialties Centre, notes that the shift to focus on the metabolism of diseases began with type 2 diabetes. Globally, it is slowly being viewed as a metabolic disease. Another example is the renaming of non-alcoholic fatty liver disease (NAFLD) to metabolic associated steatotic liver disease (MASLD) a few years ago, which has influenced thinking about PMOS. Dr. Mohan explains that PMOS exhibits insulin resistance, seen in 85% of those with the condition, which increases androgen secretion and disrupts steroidogenesis—the process of synthesizing steroid hormones from cholesterol. The condition also includes type 2 diabetes, gestational diabetes, obesity, and MASLD. These manifestations cause irregular periods and facial hair growth, but all signs indicate it is truly an endocrine disease.
Implications for Diagnosis and Treatment
Dr. Priya Selvaraj, gynaecologist and fertility specialist, says greater awareness around the renaming to PMOS could help gynaecologists, especially those who do not routinely deal with infertility or obesity, recognize symptoms much earlier—from young women in their reproductive years to those who have struggled with infertility for years. Many doctors currently manage it with oral contraceptives and advise only diet and exercise. Recognizing PMOS as a metabolic condition will encourage doctors to learn more about it and create better referral channels to endocrinologists and physicians, particularly when patients have developed hypertension or diabetes.
Dr. Priya notes a noticeable rise in PMOS over the past decade, driven by increasing awareness and lifestyle changes. Parents and young women are now more aware of irregular menstrual cycles and are approaching gynaecologists to understand whether it is temporary or linked to PMOS. In infertility cases, nearly 40% of women present with anovulation and irregular cycles associated with the condition. While some patients respond to lifestyle changes and ovulation-inducing medication, others may require advanced fertility treatments such as IUI or IVF while trying to conceive.
A Multidisciplinary Approach
Clinically, this change in nomenclature may encourage metabolic screening and a more multidisciplinary approach to management, rather than focusing only on reproductive symptoms, says Garima Dev Verman, dietitian and health educator at The Healthy Indian Project (THIP), a health information and fact-checking organization.
Future Treatment Possibilities
While the condition has no cure, it is managed by lifestyle changes and hormone therapy. Several semaglutide drugs, such as Ozempic and Wegovy, are being used to treat diabetes, obesity, fatty liver disease, appetite regulation, cardiovascular protection, and kidney protection. Dr. Mohan says that now that PMOS is recognized as a metabolic condition, these drugs may soon be used to treat PMOS as well. Trials have already begun in the United States.
Garima adds that PCOS diets mostly focused on weight loss because obesity was commonly linked to PCOS. However, with the redefinition, nutrition therapy will be considered more important to manage insulin and enhance body composition rather than focusing only on weight loss. An anti-inflammatory diet, managing sleep and stress, preserving muscle mass, and improving fertility outcomes will be key. Nutrition will play a central role rather than being just supportive care.
