A condition that affects 1 in 8 women has a new name: polycystic ovarian syndrome (PCOS) is now called polyendocrine metabolic ovarian syndrome (PMOS). This change isn’t just a simple swapping of letters; it is the culmination of 14 years of extensive work from researchers and patients with health and patient organizations to accurately describe the condition.

We spoke with Dr. Rosalyn Miller, an obstetrician-gynecologist with Houston Methodist, about what the name change means for women living with PMOS and those who may have yet to be diagnosed.

PCOS vs. PMOS: What’s the difference?

Polycystic ovarian syndrome (PCOS) had long been defined by a single characteristic in its name, “polycystic,” meaning “many cysts.” The name suggested that it was solely a reproductive disorder with ovarian cysts present in the body, causing pain and ruptures. These cysts were egg follicles that failed to mature and accumulated in the ovaries, all due to unusually high levels of the hormone androgen, a hallmark of the condition.

The hormonal imbalance and other symptoms, including coexisting conditions such as obesity, insulin resistance, type 2 diabetes, heart disease, depression, anxiety and eating disorders, were downplayed in the name PCOS. However, they are front and center in the new name, polyendocrine metabolic ovarian syndrome (PMOS).

“The term ‘PCOS’ does not accurately reflect the complexity of the condition, as research has shown that this is more than an ovarian disorder,” Dr. Miller says. “It’s a systemic condition involving hormonal regulation, insulin resistance, metabolism and reproductive function.”

Dr. Miller also emphasizes that many women diagnosed with PCOS, now PMOS, do not actually have the polycystic-appearing ovaries on ultrasound. The name change emphasizes that the condition is a complex, long-term hormonal or endocrine disorder.

“The term PMOS (polyendocrine metabolic ovarian syndrome) better reflects the significant metabolic implications that women face,” Dr. Miller says.

Symptoms remain unchanged despite the name change

Despite the name change, Dr. Miller says that the diagnostic criteria remain largely the same.

Women with PCOS can experience the following symptoms:

• Acne: Difficult-to-treat acne on the face, back and chest may start during puberty and can last throughout a person’s lifetime.

• Cysts: Egg sac cysts or extra follicles may be present on the ovaries, or the ovaries may look larger than normal.

• Excess hair growth: Someone with PMOS may grow facial hair or have more hair growth on the arms, chest or abdomen.

• Irregular periods: Some may miss periods, have heavy bleeding during their periods or may not have a period at all despite not being pregnant.

• Obesity: People with PMOS often have difficulty maintaining a healthy weight for their height; up to 80% of people with PMOS experience obesity.

• Patches of dark skin: Certain areas of the body may appear darker, including the armpits, groin, neck and under the breasts.

• Problems conceiving: PMOS is one of the biggest drivers of infertility in women.

• Skin tags: Excess skin may develop in places like the armpits or on the neck.

• Thinning hair: People may lose hair in patches, or experience balding.
  
  

PMOS exists on a spectrum, with some women having only mild symptoms to others experiencing severe symptoms that interfere with their everyday life. The condition can also evolve as one ages, with severe acne and irregular periods early in life transitioning to issues such as high cholesterol, hypertension and insulin resistance in the 40s and 50s.

“What has evolved is our understanding of the condition and the emphasis on the full spectrum of metabolic risks to the patient,” Dr. Miller says. “We know that many women with PMOS also face increased risk for insulin resistance, hypertension, dyslipidemia and cardiovascular disease. The new terminology highlights the interconnectedness of these systems and the importance of preventive and long-term care.”

Why the name change matters

PMOS affects approximately 8-13% of reproductive-aged women, according to the World Health Organization, and, of these women, up to 70% remain undiagnosed. Dr. Miller says that women can go two years or more and see multiple healthcare clinicians before receiving a diagnosis.

“The transition from PCOS to PMOS is part of an ongoing effort to improve how we understand and communicate about this condition. It encourages both clinicians and individuals to think beyond menstrual cycles and address long-term metabolic health.”

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Dr. Rosalyn Miller, obstetrician-gynecologist

For women who have experienced a constellation of symptoms but never connected the dots may now see a name for the issues they experience. And for women who worked hard for their PCOS-now-PMOS diagnosis, it may feel like a victory.

“For many patients, the name change may be validating,” Dr. Miller says. “The terminology may increase awareness of symptoms and lead to earlier recognition and better long-term health outcomes.”

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What you should do if you’re concerned about PMOS

For those who may now be having an aha moment reading this, Dr. Miller says it’s important to reach out to your primary care doctor or OB-GYN.

“Women should consider talking to their physician if they are experiencing irregular or absent menstrual cycles, unwanted facial or body hair, persistent acne, difficulty conceiving or signs of insulin resistance,” Dr. Miller says.

Dr. Miller says that when we recognize the reproductive, hormonal and metabolic signs of this condition together, women can receive more effective care and decrease the risk of long-term health challenges.

“The earlier these issues are identified, the greater the opportunity to improve their reproductive health and metabolic health,” Dr. Miller says. “The more comprehensive name may help reinforce the importance of treating the whole patient rather than focusing solely on reproductive symptoms.”