Why PCOS Is Now Called PMOS: What Patients Need to Know

If you've been diagnosed with polycystic ovary syndrome (PCOS), you may soon hear your condition called by a new name. The disorder, which affects about 1 in 8 women worldwide, is now known as polyendocrine metabolic ovarian syndrome (PMOS).

The change reflects a growing understanding that the condition affects much more than the ovaries. Betsy Collins, MD, MPH, and Lauryn McNally, DO, MS, both ob/gyns at Emory Healthcare, explain why the name changed, what PMOS is and what patients should know about symptoms, diagnosis and treatment.

The previous name, polycystic ovary syndrome, was misleading because it suggested the condition was primarily about ovarian cysts. In reality, many people diagnosed with PCOS never had ovarian cysts, and the condition affects multiple systems throughout the body.

The new name, polyendocrine metabolic ovarian syndrome, better reflects the hormonal and metabolic changes that drive the condition. It also acknowledges that PMOS can affect reproductive health, metabolism, cardiovascular health and long-term wellness.

The name change followed years of collaboration among international medical organizations and patients, who advocated for a term that more accurately describes the condition. 

PMOS is a hormonal and metabolic disorder that can affect menstrual cycles, fertility, weight, blood sugar regulation and overall health.

Common features include: 

• Irregular or absent periods 
• Elevated androgen (male-type hormone) levels 
• Acne 
• Excess facial or body hair growth 
• Difficulty managing weight 
• Insulin resistance 
• Increased risk of Type 2 diabetes and heart disease 

"It's not just about the ovaries," says Dr. Collins. "This is a whole-body condition with lifelong health implications."

No.

One of the main reasons for the name change is that ovarian cysts are not required for diagnosis.

Instead, a patient generally needs two of the following three findings:

• Irregular or absent periods
• Signs of elevated androgen levels, such as excess hair growth or acne
• Multiple follicles visible on the ovaries during ultrasound

A patient can meet the criteria and be diagnosed with PMOS even if an ultrasound does not show ovarian changes.

Irregular periods are one of the most common reasons patients seek evaluation.

Other symptoms can include:

• Going several months without a period
• Very heavy or unpredictable periods
• Persistent acne, particularly on the face, chest or back
• Excess facial or body hair growth
• Difficulty losing weight
• Symptoms of insulin resistance or prediabetes

It's important to remember that irregular periods can have many causes, including thyroid disorders, stress and other hormonal conditions. A healthcare provider can help determine the cause.

PMOS is linked to several long-term health risks.

Because many patients experience insulin resistance and other metabolic changes, they have a higher risk of: 

• Type 2 diabetes
• High blood pressure
• High cholesterol
• Heart disease

Another important concern is endometrial cancer.

When periods occur infrequently, the lining of the uterus can continue to build up without shedding regularly. Over time, that can increase the risk of abnormal changes and cancer.

"Many patients focus on the reproductive symptoms," says Dr. Collins. "But we also want to help prevent diabetes, heart disease and uterine cancer."

Yes, but effective treatments are available.

Many people with PMOS do not ovulate regularly, which means they have fewer opportunities to become pregnant each year. They may also have difficulty predicting when ovulation is occurring.

Fortunately, fertility challenges related to PMOS are often highly treatable.

"These patients usually have eggs," says Dr. McNally. "The challenge is getting regular ovulation to occur."

Many patients successfully conceive with medications that stimulate ovulation. Others may benefit from fertility treatments such as intrauterine insemination (IUI) or in vitro fertilization (IVF).

Genetics appear to play an important role.

Many patients have a family history of the condition, suggesting an inherited component. Researchers also believe environmental and lifestyle factors contribute to how symptoms develop and progress.

Treatment depends on a patient's symptoms, health goals and whether pregnancy is desired.

Treatment options may include:

• Healthy eating and regular physical activity
• Weight management strategies 
• Hormonal birth control to regulate periods and lower androgen levels 
• Progesterone therapy to protect the uterine lining
• Metformin to address insulin resistance 
• Anti-androgen medications to improve acne and excess hair growth
• GLP-1 medications for appropriate patients with metabolic concerns
• Fertility treatments when pregnancy is desired

Because PMOS affects multiple body systems, treatment often involves a team of specialists, including gynecologists, endocrinologists, primary care providers and fertility experts.

PMOS is one of the most common conditions gynecologists treat, and Emory providers take a comprehensive approach to care.

Patients at Emory benefit from close collaboration among specialists in gynecology, endocrinology, reproductive endocrinology and primary care. This team-based approach helps address both reproductive symptoms and long-term metabolic health.

What's the most important thing patients should remember? 

The new name says it all.

PMOS is not simply an ovarian condition. It's a complex hormonal and metabolic disorder that can affect many aspects of health throughout a person's life.

Recognizing PMOS as a whole-body condition can help patients get appropriate care earlier, reduce long-term health risks and better manage symptoms over time.