PCOS Has a Proposed New Name: Polyendocrine Metabolic Ovarian Syndrome (PMOS) — Why It Matters

July 23, 2026

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Infertility

Medically reviewed by Dr. Laurence Jacobs, Reproductive Endocrinologist, CCRM Fertility & Gynecologic Surgeons of Illinois

For decades, millions have been diagnosed with polycystic ovary syndrome (PCOS), one of the most common endocrine disorders affecting women of reproductive age. Yet despite its prevalence, the name itself has long been a source of confusion.

After more than 14 years of international discussion involving patients, healthcare professionals, researchers, and more than 50 medical societies across six continents, a global consensus initiative has proposed a new name: Polyendocrine Metabolic Ovarian Syndrome (PMOS).

The proposed change reflects a growing recognition that PCOS is not simply an ovarian disorder, nor is it primarily a condition defined by ovarian cysts. Rather, it’s a complex, lifelong disorder involving endocrine dysfunction, metabolic abnormalities, reproductive health concerns, and significant impacts on mental and emotional well-being.

PCOS affects nearly every aspect of health, often years before a woman ever considers trying to become pregnant. PMOS more accurately reflects all the complex metabolic, ovarian, and endocrine dysfunction and abnormalities seen in this syndrome.

Here’s what to know about PMOS, the importance of this name change, and treatment options at CCRM Fertility.

Why the name change from PCOS to PMOS?

The traditional term “polycystic ovary syndrome” has long been recognized as scientifically inaccurate and clinically misleading.

Many women diagnosed with PCOS don’t actually have ovarian cysts. Conversely, some women with ovarian cysts don’t have PCOS. In fact, the small structures commonly seen in excess on vaginal ultrasound are immature ovarian follicles rather than true cysts.

More importantly, the name PCOS focuses attention on the ovaries while overlooking the contributions of the endocrine and metabolic abnormalities that drive much of the problem.

The proposed new term, Polyendocrine Metabolic Ovarian Syndrome (PMOS), addresses the three major components of the condition:

Polyendocrine: involving multiple hormone systems
Metabolic: reflecting the central role of insulin resistance and metabolic dysfunction
Ovarian: acknowledging the important reproductive and ovulatory manifestations

The new terminology removes the misleading reference to ovarian “cysts” while better reflecting current scientific understanding.

Status of the PMOS name change

The proposed renaming of PCOS to PMOS stems from this international collaboration. Most major reproductive and endocrine organizations, including the American Society for Reproductive Medicine (ASRM), have supported efforts to adopt new terminology that better reflects the condition’s underlying biology.

However, PCOS still remains the diagnostic term used in most clinical guidelines and medical records. Importantly, the established diagnostic criteria remain unchanged. PMOS should therefore be viewed as an emerging consensus term that more accurately describes the disorder while broader implementation continues, but it will take time.

The importance of early diagnosis

Many women have been told they “don’t have PCOS” because they lacked ovarian cysts. Others have been diagnosed primarily because ovarian cysts were present on ultrasound.

In some cases, women were told the diagnosis was only important if they wished to become pregnant. Consequently, many women never received proper evaluation or treatment for the metabolic and hormonal consequences of the condition. This often contributed to delayed or missed diagnoses and inadequate care, leading to untreated insulin resistance, chronically elevated androgen levels, and unmanaged metabolic dysfunction, in addition to the ongoing ovulatory dysfunction. (see below)

The reality is that delayed diagnosis can result in many years of unmanaged/untreated:

Insulin resistance

Hyperinsulinemia

Hyperandrogenism

Ovulatory dysfunction

Metabolic abnormalities

Weight gain

Over time, these untreated abnormalities may often increase the serious risk of:

Type 2 diabetes

Cardiovascular disease

Endometrial hyperplasia

Endometrial cancer

Persistent infertility

Modern research demonstrates that PCOS encompasses endocrine, metabolic, reproductive, psychological, and dermatologic manifestations. It is far more than just an ovarian or infertility disorder.

Infertility and PMOS

Ovarian dysfunction remains a characteristic feature of PMOS and is responsible for many of the reproductive symptoms associated with the condition.

Elevated anti-Müllerian hormone (AMH) levels reflect disordered follicular development and accumulation. High AMH levels are now included in the adult diagnostic criteria for PCOS/PMOS.

The clinical consequences of these ovarian abnormalities include:

Irregular or absent menstrual cycles

Infrequent or absent ovulation

Infertility

Increased risk of pregnancy complications, most often gestational diabetes

Chronic anovulation associated with PCOS/PMOS over many years, if untreated, increases the risk of endometrial hyperplasia and endometrial cancer due to prolonged estrogen exposure without adequate progesterone. Ovulation and/or progesterone are protective.

Non-gynecologic symptoms of PMOS

Hyperandrogenic dermatologic features

Hirsutism (excess facial, chest, or abdominal hair growth)

Acne

Androgen-related hair loss

Acanthosis nigricans of the skin (darkened, velvety patches on skin)

Metabolic features

Weight gain

Obesity

Insulin resistance

Psychological features

Anxiety

Depression

Self esteem issues

Reduced quality of life

Eating disorders

A woman who isn’t currently trying to conceive still deserves and requires evaluation and treatment for hormonal, metabolic, weight problems and mental health concerns. These issues should be addressed by clinicians long before infertility ever develops.

Diagnostic criteria for PCOS/PMOS

Diagnosis requires exclusion of other endocrine disorders that can mimic PCOS/PMOS, including thyroid disease, hyperprolactinemia, adrenal disorders, and androgen-secreting tumors (adrenal or ovarian).

In adults, current international guidelines require at least two of the following three criteria:

Ovulatory dysfunction

Irregular or absent menstrual cycles

Infrequent ovulation

Absent ovulation

Clinical or biochemical hyperandrogenism

Hirsutism

Acne

Androgenic alopecia (baldness)

Biochemical evidence includes elevated androgen levels, such as testosterone.

Polycystic Ovarian Morphology (PCOM) and/or elevated AMH

This may be demonstrated by:

Vaginal ultrasound evidence of polycystic ovarian morphology (20 or more follicles)
Elevated anti-Müllerian hormone (AMH) levels

Note that for adolescents, ultrasound findings are no longer considered reliable diagnostic criteria because multi-follicular ovaries are common during normal puberty and teenage years. It’s also important to recognize that not all women with PCOS/PMOS are overweight. Some women have so-called “lean PCOS” but may still demonstrate significant insulin resistance and metabolic dysfunction.

PCOM health problems and infertility

One of the most important concepts behind the new name is, as we’ve discussed, it’s not simply an ovarian or infertility condition, as previously emphasized. It’s a chronic endocrine and metabolic disorder that affects multiple organ systems throughout a woman’s lifetime.

Insulin resistance is present in the majority of affected women and appears to play a central role in the disease, especially if undiagnosed and untreated.

Hyperinsulinemia contributes to:

Increased androgen (male hormone) production

Abnormal ovulation

Weight gain
Metabolic dysfunction

Additional factors include:

Chronic low-grade inflammation

Abnormal ‘adipokine signaling’ (how adipose tissue communicates with other organs); body fat is actually an active endocrine organ producing dozens of hormone-like signaling molecules— adipokines, which affect metabolism, fertility, inflammation and insulin sensitivity. (Leptin; TNF-a; IL-6 and several others).

Sympathetic nervous system dysregulation

Lifestyle medicine and early identification of PMOS

Lifestyle medicine is a branch of healthcare focused on preventing, treating, and sometimes reversing chronic disease through evidence-based lifestyle interventions involving nutrition, exercise, sleep, stress management, and weight optimization.

For women with PCOS/PMOS, lifestyle medicine is often a foundational component of treatment, but unfortunately remains overlooked by many clinicians.

Research has consistently demonstrated that even modest improvements in metabolic health can significantly improve hormonal function, ovulation, fertility outcomes, and long-term health risks. For women carrying excess weight, a weight reduction of just 5 to 10% may improve spontaneous ovulation and increase pregnancy rates, both naturally and during fertility treatments, even IVF.

Why preconception health matters

Historically, many women with PCOS don’t receive meaningful intervention until they experience infertility. Today, that approach is changing.

The concept of preconception health recognizes that improving a patient’s metabolic and overall health before pregnancy can improve fertility, reduce pregnancy complications, and enhance long-term maternal health.

As emphasized earlier, a woman with PCOS/PMOS who is not yet trying to conceive still benefits from:

Hormonal evaluation and management

Assessment of insulin resistance and metabolic risk

Weight management support

Nutritional counseling

Exercise guidance

Sleep optimization

Mental health services

Screening for PMOS at CCRM

CCRM Fertility & Gynecologic Surgeons of Illinois offers the PCOS/PMOS Awareness Program, a structured screening and evaluation program designed to identify women who may have undiagnosed PCOS/PMOS or may need confirmation and specialized care.

Many women struggle for years with irregular cycles, acne, unwanted hair growth, weight gain, or insulin resistance before receiving a formal diagnosis or treatment.

The PCOS/PMOS screening program consists of a single visit:

An in-person appointment (done on day 2,3 or 4 of the menstrual cycle)

Brief questionnaire regarding signs & symptoms typical of PCOS/PMOS

Exam for height, weight and blood pressure to determine BMI

Vaginal ultrasound (US) for evaluating antral follicle count (AFC)

Fasting comprehensive laboratory evaluation: Estradiol, Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), Prolactin, Thyroid Stimulating Hormone (TSH), Insulin, Comprehensive Metabolic Panel, Lipid Panel, Free and Total Testosterone, DHEAS, 17- alpha- hydroxyprogesterone, and anti-Mullerian Hormone (AMH).

Within approximately one week, each patient (and their referring physician, if applicable) receives the results of their testing.

If the CCRM physician identifies any abnormalities, we advise the patient to schedule a follow-up telehealth appointment for a consultation and to discuss any possible additional testing needed, such as a 2-hour Glucose/ Insulin Tolerance Test and/or a Dexamethasone Suppression test.

If a diagnosis is confirmed, we discuss all treatment and lifestyle options for PCOS/PMOS and manage the patient and/or advise their doctor.

Our goal at CCRM is not simply to determine whether or not a patient meets the PCOS/PMOS diagnostic criteria, but to identify the full spectrum of reproductive, endocrine, and metabolic issues that may require intervention and treatment.

Early accurate diagnosis of PCOS/PMOS allows women to receive appropriate counseling regarding fertility, metabolic health, cardiovascular risk reduction, weight management, and long-term disease prevention.

The bottom line

Whether the name ultimately remains PCOS or transitions to PMOS as expected, the underlying message is clear: This is not merely an ovarian disorder. It’s a lifelong endocrine and metabolic condition that affects reproductive health, metabolism, cardiovascular risk, psychological well-being, and overall quality of life.

The proposed PMOS terminology reflects our evolving understanding of this complex condition and encourages a more comprehensive approach to diagnosis and treatment.

Most importantly, it reminds both patients and healthcare professionals that proper comprehensive care should begin long before a woman wants to conceive or before infertility develops.

Early recognition of PMOS, comprehensive evaluation, lifestyle optimization, and individualized medical treatments offer the best opportunity to improve not only fertility outcomes, but lifelong health.

To schedule an appointment with a CCRM fertility specialist (at which you can discuss any concerns or questions you may have about PMOS), click here.

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