The Endocrine Society, a global organisation of scientists and physicians devoted to hormone-related conditions, has decided to rename Polycystic Ovary Syndrome (PCOS) as Polyendocrine Metabolic Ovarian Syndrome (PMOS).

What’s in a name, you might ask. But there is good reason why this name change is important. In an article published in The Lancet, the authors Helena J. Teede et al, argue that the term PCOS is inaccurate as it refers to cysts in the ovaries, and if diagnosis is based on this, contributes to delays in diagnosis, treatment, and stigma. Instead, they explain that “accuracy is improved by omitting cysts and by capturing endocrine, metabolic, and ovarian dysfunction.” A “global implementation strategy, including a transition period, education, and alignment with health systems and disease classification” is reportedly underway.

Burden and diagnosis

PCOS is estimated to affect 170 million women during their reproductive years alone. It is diagnosed, based on women over 20 meeting at least two of the following International Guideline criteria: irregular or absent ovulation (oligo-anovulation), meaning that periods that are infrequent, too long between cycles, or absent; high male hormone levels (hyperandrogenism), with either visible signs such as excess hair growth, acne, or hair loss; or blood tests; and polycystic ovaries detected as small follicles, on ultra sound scans or high Anti Müllerian Hormone levels in the blood. 

However, as the paper says: “the broad clinical features of the condition are not captured in its current name, as although arrested follicular development is common, ovarian cysts are not increased. These factors delay diagnosis—with up to 70% of affected individuals remaining undiagnosed—and also contribute to widespread knowledge gaps and patient dissatisfaction.”

The authors write that PCOS has long been “primarily perceived as a gynaecological or ovarian disorder.” The reproductive focus of the name can reinforce stigma, particularly in sociocultural contexts where fertility carries high value. Many individuals report distress associated with the name itself, they argue.

However, mounting research, evidence synthesis, and International Guidelines have shown that PCOS is underpinned by endocrine disturbances in insulin, androgens, and neuroendocrine and ovarian hormones.” 

Further, they emphasise that the multi-pronged features that underline the condition must be folded in for a diagnosis. They can be metabolic, including obesity, type 2 diabetes, hypertension, and abnormal levels of fats in the blood, they could also be reproductive - causing irregular menstrual cycles, infertility, pregnancy complications, and endometrial cancer. They can also manifest as psychological features, including depression, anxiety, poor quality of life, and eating disorders, and dermatological features including acne. The new classification will embrace the entire gamut of features.

Behind the name change

Prof. Helena Teede, author of the paper, director of Monash University’s Monash Centre for Health Research & Implementation led the name change process after spending decades researching the condition and seeing the patient impacts firsthand, according to an Endocrine Society release. 

“What we now know is that there is actually no increase in abnormal cysts on the ovary, and the diverse features of the condition were often unappreciated,” Prof. Teede says. “It was heart-breaking to see the delayed diagnosis, limited awareness and inadequate care afforded those affected by this neglected condition,” she further adds. 

More than 50 patient and professional organisations, including the Endocrine Society, took part in the process to develop the new name.