Doctors explain: PCOS has a new name. What this means for women battling the condition
PCOS (Polycystic Ovary Syndrome), a hormonal disorder that affects one in every eight women worldwide, will be renamed PMOS (Polyendocrine Metabolic Ovarian Syndrome). According to experts, the old name was scientifically misleading and ‘failed to capture the full-body nature of the condition’. The new name intends to change that
At 23, Mallika* finally had an explanation for years of irregular periods, stubborn acne, and a thick patch of hair around her chin that she tried hard to hide. Doctors diagnosed her with PCOS (Polycystic Ovary Syndrome).
She was put on a birth control pill even though she wasn’t sexually active and was repeatedly warned that conceiving might be difficult. The treatment regimen lasted for some years, and during the time, the condition was framed largely around her ovaries and fertility.
Thankfully, life unfolded differently. Mallika had two children; they were natural births. Follow-up ultrasound showed “clean” ovaries, and her menstrual cycles were regulated after the birth of her second child. She gradually believed she had beaten PCOS.
The truth, however, was that she hadn’t.
Twenty-five years later, Mallika struggles with weight. Despite a healthy lifestyle and disciplined diet – mostly low-fat and low-sugar-salt – she is pre diabetic, her cholesterol and triglyceride levels are elevated, and her blood pressure keeps fluctuating unpredictably.
More from HealthThe reality is the disorder never left her body; it just changed form.
For years, “Polycystic Ovary Syndrome” narrowed attention to ovarian cysts and fertility, giving many women the impression that once the cysts disappeared or they got pregnant, it was behind them. That specific focus gave women the wrong notion, and the confusion led to more serious metabolic consequences, according to medical experts.
This confusion is precisely why PCOS, one of the world’s most common hormonal disorders affecting one in eight women, is getting a new name. PMOS (Polyendocrine Metabolic Ovarian Syndrome).
After 14 years of global consultation involving doctors, researchers, and patient groups, the change was announced in The Lancet and presented at the European Congress of Endocrinology. The renaming is supposed to occur gradually and is likely to be fully adopted by 2028.
Experts opine that the old name was scientifically misleading and “failed to capture the full-body nature of the condition”. Many women’s groups have said the earlier name trivialised their experience and contributed to delayed diagnosis. Leading doctors in India agree.
Why is PCOS considered a misleading name?
The term Polycystic Ovary Syndrome focuses heavily on ovarian cysts. In reality, many women with the condition do not have cysts, and some with cyst-like ovaries do not have the syndrome. Doctors say what appears on scans are often immature or arrested follicles, not true cysts, meaning eggs that have failed to fully mature within the ovaries due to the syndrome’s hormonal effects.
“The problem… Polycystic Ovary Syndrome no longer reflects the disease we diagnose and treat. Since the 1935 Stein-Leventhal description, our understanding of the condition has evolved from an ovarian disorder to a complex, multisystem endocrine-metabolic disease. The name must evolve with the science,” said Dr Shashank Joshi, endocrinologist, at Mumbai’s Lilavati Hospital and founder vice president of PCOS Society, a group of medical professionals who deal with patients battling the disease.
According to Dr Geeta Chadha, senior gynaecologist and obstetrician at Delhi’s Indraprastha Apollo Hospital, the “old name reduced a complex hormonal and metabolic disorder to just a simple gynaecological issue”. “When you say ovarian disease, the specialist who deals with ovaries handles it, but not all manifestations are restricted to the ovaries.”
The condition affects multiple systems in the body, including the hormonal and endocrine systems, she adds. It impacts physical and reproductive health, fertility, and mental health. The new term, PMOS, aims to reflect that reality.
There are also scientific Inaccuracies in labelling the ailment PCOS. Dr Joshi breaks it down:
- “Polycystic”: Up to 30 per cent of patients meeting the Rotterdam criteria have normal ovarian morphology on high-resolution ultrasound. The “cysts” are arrested antral follicles, not true pathological cysts. Ovarian condition is neither necessary nor sufficient for diagnosis.
- “Ovarian”: This is limiting, as the disease affects multiple systems in the body, including the brain, hormones, insulin resistance, liver, fat tissues, pancreas, and metabolism. The ovary is an end organ, not the sole origin of many phenotypes.
- “Syndrome”: While technically correct, the term has clinically minimised the condition. “Syndrome” implies a vague collection of symptoms, contributing to delayed diagnosis, under-treatment of metabolic risk, thus, trivialising the condition for medical professionals as well as lay people.
Dr Amita Jain, associate director, urogyneacology at Gurugram Medanta, The Medicity, believes that the “concern is not merely semantic”. “The name has shaped how patients and even clinicians perceive the disease. In my experience, I have seen so many patients who present no cysts but manifest all other metabolic symptoms or vice versa.”
Why is PCOS renamed to PMOS?
Dr Joshi explains that the 2023 International Evidence-Based Guideline now defines PCOS as a “metabolic + reproductive + psychological disorder”. “The name lags behind the definition. PMOS was proposed to align the name with the symptoms,” he adds.
He deconstructs PMOS:
- Polyendocrine: Recognises involvement of multiple glands and hormonal systems. PMOS is not a single-organ disease.
- Metabolic: Insulin resistance, weight changes, diabetes, and cardiovascular risk are central diseases rather than secondary complications. Over 70 per cent of patients meet criteria for metabolic syndrome by age 40. Metabolic risk is the leading cause of long-term disease.
- Ovarian: The letter O has been retained as the core reproductive component is the ovaries, as there is irregular ovulation, and androgen excess. The use of O maintains continuity and preserves clinical recognition.
- Syndrome: Appropriate, given the heterogeneous presentation; it shows that people can have PCOS in multiple ways.
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Women with PMOS often gain weight and struggle with losing it. Representational pic/Reuters
What symptoms are linked to PMOS?
Dr Chadha says the condition affects multiple systems in the body, and the symptoms manifest in different ways:
- Irregular or absent periods and difficulty in conceiving. The ovaries' function is to produce follicles, without which there will be no ovulation or anovulation. Hence, the patients can’t get pregnant.
- Insulin resistance caused by impaired function of the pancreas
- Acne, excess body, and facial hair. Hair thinning
- Weight gain or difficulty losing weight. The inflammation of adipocine signalling causes obesity.
- Anxiety and depression. Neurotransmitters, like dopamine, are affected.
“Sometimes the condition is also associated with a higher risk of Type 2 diabetes, sleep disorders, fatty liver disease, cardiovascular problems, and even certain cancers. So instead of going to multiple specialists, the patient should know this is all related. Patients are calmer and less confused,” feels Dr Chadha.
Will the diagnosis or treatment change after the renaming?
Doctors believe that the renaming is mainly intended to improve awareness, reduce stigma associated with various symptoms, and also encourage earlier diagnosis.
“Naming the metabolic component directly prompts earlier cardiovascular and diabetes screening. Many patients who are missed as they may not present typical symptoms can now receive proper diagnosis,” Dr Joshi says.
According to Dr Chadha, treatment approaches like early lifestyle management, hormonal therapy, and insulin-sensitising drugs will continue to be given. “The new terminology will help us look beyond the fertility symptoms and recognise the condition as a lifelong metabolic and endocrine disorder,” she asserts.
Doctors also believe diagnoses will be earlier and faster. Dr Jain says it will be easier to convince patients about their conditions. “Sometimes girls come with clear ultrasounds, and when you tell them they have PCOS, they refuse to accept it, saying our ovaries are fine. Now with the new definition, the real scope of the disease being a syndrome will be easier to accept.”
Dr Joshi is confident that the renaming will help researchers avoid being limited to studying ovaries and encourage broader research. It will encourage proper fund allocation once the lifelong implications are highlighted. “Polyendocrine signals to investigators that models limited to ovarian theca cells are insufficient. It encourages research to look beyond ovarian cells and study how the brain, adrenal glands, and body fat may also play a role.”
Are there any concerns with the name change?
Loss of awareness can be worrying. However, Dr Joshi says, “It’s not for the first time that names have been changed. It happened with AIDS replacing GRID, and ADD becoming ADHD. This will also happen gradually.”
Right now, both names are likely to be used side by side until the usage of PMOS becomes common. “Changing name could ultimately change the standard of care,’’ says Dr Jain.
About 22,000 stakeholders, before the name change, gave similar feedback. Some women reported being told they could not have PCOS as their scans are clear. Others said the condition was treated as only a fertility problem, while mental health and metabolic symptoms were ignored. Some others said their symptoms were dismissed because they were lean.
According to researchers and medical experts, the change is intended to help women like Malika. PMOS aids in better communicating that the condition can persist throughout life, even when reproductive symptoms improve.
Mallika only wishes she had known better.
* The name has been changed as the individual did not wish to be identified.
Toufiq Rashid is a journalist with over 25 years of experience in print and digital media. She covers health and lifestyle. She has extensively written about Kashmir as the bureau chief of ‘Hindustan Times’. She has previously worked for ‘The Indian Express’ in New Delhi and was the digital editor at ‘The Outlook’.
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