By: Emily Kahoud, MD
Editor’s Note: Since September is polycystic ovary syndrome (PCOS) awareness month, we are delighted to feature this article by Dr. Emily Kahoud, which she wrote during her fourth year of medical school while participating in the FACTS elective. In this piece, Dr. Kahoud explores the landmark renaming of PCOS to polyendocrine metabolic ovarian syndrome (PMOS), reflecting an evolving understanding of the condition as a complex, multisystem endocrine and metabolic disorder. Like the evolution of evidence-based medicine itself, this change demonstrates how clinical understanding and practice must adapt as new evidence emerges. Similarly, female cycle charts offer clinicians a way to observe patterns in reproductive physiology over time, truly serving as a vital sign of health by providing information that may help identify changes in reproductive health function and assess a patient’s response to treatment.
Polycystic metabolic ovarian syndrome (PMOS), the newly adopted term for polycystic ovarian syndrome (PCOS), affects approximately 170 million women during their reproductive years. Women who are 20-year-old or older and in whom other disease has been excluded are diagnosed with PMOS if they meet at least two of the following International Guideline criteria: 1) oligoanovulation, which presents as irregular cycles in women; 2) hyperandrogenism, which may present clinically as androgenic pattern hair loss, hirsutism and acne; and 3) polycystic ovaries on ultrasound or elevated anti-Müllerian hormone (AMH). Note that diagnosis in adolescents requires the presence of the first two criteria.
“Polycystic metabolic ovarian syndrome (PMOS), the newly adopted term for polycystic ovarian syndrome or PCOS, affects approximately 170 million women during their reproductive years.”
Traditionally, the medical establishment has characterized PCOS as a purely gynecologic or ovarian disorder, hence the emphasis on “polycystic” ovaries in the previous name. However, years of research reveal that PMOS is not strictly gynecologic, and many have argued that its former name failed to capture the broad clinical features that accompany this disorder. With PMOS, the endocrine and consequent metabolic dysfunction play a tremendous role in the disease’s course as well as its presentation, which includes metabolic, reproductive, psychological, and dermatological symptoms.
PMOS is one of the most common causes of infertility. Women affected by PMOS experience signs and symptoms that range from uncomfortable to embarrassing. These symptoms include intermittent or absent periods; heavy, long and/or painful periods due to ovulatory dysfunction; acne and excessive hair on the face or body; female-pattern baldness or hair thinning due to excess DHEA-S or testosterone. In addition, women suffering from PMOS are at increased risk of developing other conditions associated with insulin resistance and metabolic dysfunction, including obesity, type 2 diabetes, gestational diabetes, hypertension, hyperlipidemia, cardiovascular disease, and metabolic steatohepatitis. They are also at increased risk of endometrial hyperplasia and endometrial cancer due to unopposed estrogen. Finally, due to the substantial impact PMOS may have upon a woman’s quality of life and the stigma associated with symptoms such as infertility, unwanted hair growth, and female pattern hair loss, these women may experience negative body image and develop eating disorders, as well as anxiety and depression [1].
“PMOS is one of the most common causes of infertility… (and) women suffering from PMOS are at increased risk of developing other conditions associated with insulin resistance and metabolic dysfunction, including obesity, type 2 diabetes, gestational diabetes, hypertension, hyperlipidemia, (and) cardiovascular disease”
The move to change the name from PCOS to PMOS was made for multiple reasons. Most importantly, Helena Teede (2026), an endocrinologist who led the name change process, and others argued that the old name failed to capture the breadth of systems affected by this disorder. As discussed above, PMOS does not just affect the ovary; its features are due to endocrine, neuroendocrine, and ovarian hormone dysfunction. PMOS can exhibit metabolic, reproductive, psychological, and dermatological symptoms. In addition, Teede has stated, “What we now know is that there is actually no increase in abnormal cysts on the ovary.” [2]
Teede and advocates of the name change argued that the former name’s focus on the ovaries has contributed to diagnostic inaccuracy. Research demonstrates that up to 70% of patients with this condition do not receive a timely diagnosis, which leads to delays in care that may have tremendous ramifications for these patients [2]. Changing the name from PCOS to PMOS with a new emphasis on the endocrine component improves accuracy for patient understanding and physician comprehension of the disorder, which will hopefully lead to better quality of care. Improving coherence among research can also improve advancements in knowledge of the pathophysiology and how best to treat the myriad features of this complex disorder.
The proposal for a name change traces back to the U.S. National Institutes of Health Office of Disease Prevention Evidence-Based Methodology Workshop in 2012 when the inaccuracy of the name “PCOS” was highlighted. Patient groups and leaders in the field of reproductive medicine long advocated for a change in name with expert commentaries, guidelines and surveys emphasizing repeatedly the inaccuracies and consequences for affected individuals. Still, efforts to change the name failed time after time. According to Teede, the repeated failures to change the name were due to a “lack of inclusive global leadership and the need for a coordinated international consensus process, alignment between patient advocacy groups, agreement on an alternative name, and a comprehensive implementation strategy.”
Advocates for the name change focused on the following evidence-based reasons for the change:
- The term PCOS implies pathological ovarian cysts, which are not a feature of the condition
- The name focused on only one organ instead of the actual multi-system nature of the disease
- The name’s failure to capture the scope of disease led to delayed diagnoses and inadequate care
- The reproductive focus of the name reinforced social stigma, especially in sociocultural contexts where an individual’s worth is affected by fecundity
- The inaccuracy of the name led to complications in research comparability, epidemiologic classification, and even health system coding
- A more accurate name was discussed to improve scientific coherence, research funding, and health-related policies
International guideline expert groups, including patient advocacy and physician organizations, have repeatedly called “PCOS” a misnomer and advocated for a change in name. From 2015 to 2023, Teede and her team conducted international longitudinal anonymous online surveys and face-to-face workshops with PCOS (now PMOS) patients and health professionals across six continents. The intention of these surveys was to assess patient and clinician perspectives on the clinical features of the disease, its current name, advantages and disadvantages of a name change, and possible alternative names [3]. Workshops included a broad range of health professional disciplines including obstetrics and gynecology, reproductive endocrinology, pediatrics and primary care, nutrition or exercise, nursing or midwifery, dermatology, psychology, and those researchers from academia or who conduct laboratory work.
According to Teede et al. (2025), prior to the name change, more than 20% of patients and health professionals failed to recognize associations between “PCOS” and non-alcoholic fatty liver disease, pregnancy complications, cardiovascular risk factors, and endometrial cancer. In an Endocrine Society press release, Teede remarked that “it was heart-breaking to see the delayed diagnosis, limited awareness, and inadequate care afforded those affected by this neglected condition.” [4] Finally, in a 2023 workshop, 84% of patients and health professionals committed to a consensus-driven name change process. An impact assessment that accompanied the global study demonstrated that the “perceived benefits of a name change outweighed the risks.” Following this workshop, Monash University’s Center for Research Excellence in Women’s Health in Reproductive Life and the Androgen Excess and PCOS Society, alongside Verity, a UK-based charity and advocacy organization, launched a global initiative to mandate the change in name. Teede said this was the largest initiative to change the name of a medical condition and commented: “Make no mistake, this is a landmark moment that will lead to desperately needed worldwide advancements in clinical practice and research.”
“Prior to the name change, more than 20% of patients and/or health professionals failed to recognize associations between “PCOS” and non-alcoholic fatty liver disease, pregnancy complications, cardiovascular risk factors, and endometrial cancer. “
The new name
The development of a new name for PCOS was based on global Delphi surveys and workshops including major stakeholders. The multi-step process included the following key stages:
- Funds for the name change process and translation
- Establishment of an international governance framework and recruitment of major stakeholders, including patient organizations, professional societies, and lived experience and multidisciplinary health professional experts
- Delphi surveys that built on 7,708 previous survey responses
- Online workshops from all world regions for systematic testing of endocrine, metabolic, and reproductive terms and acronyms with consideration of accuracy, acceptability, and cultural appropriateness
- Marketing and communication analysis to assess transition strategies for candidate names
- Implementation strategy including a roadmap to support new name adoption across clinical practice, research, education, and public communication
The leading priorities during the development of the new name were to correct the inaccurate polycystic term—which implied pathological ovarian cysts—and to recognize the multisystem features of the condition. Although one of the top-ranked new name suggestions on a survey was polyendocrine metabolic ovulatory syndrome, the follow-up workshop revised it to polyendocrine metabolic ovarian syndrome, which all participants supported except for two who did not support a name change from the start. The authors gave careful consideration to language translation and sociocultural implications.
Importantly, the new name PMOS encompasses the reality that multiple interacting endocrine and metabolic abnormalities—rather than an isolated ovarian abnormality—are responsible for the array of signs and symptoms present in this disorder. This reflects biological reality as large-scale genomic studies have confirmed that PMOS has polygenic origins across neuroendocrine, metabolic and reproductive systems [2].
“The new name, PMOS, encompasses the reality that multiple interacting endocrine and metabolic abnormalities—rather than an isolated ovarian abnormality—are responsible for the array of signs and symptoms present in this disorder.”
How the name change relates to users of fertility awareness-based methods (FABMs)
FABM users have long tracked their cycles and noted observations that demonstrate how their bodies may not function as optimally as possible. Their meticulous cycle tracking and altered ovulatory function may have served as a basis for diagnosis and treatment. They have seen how their disorder and its most effective treatments are those that impact not just one system but many. Therefore, the name change may be particularly meaningful to this population that already has a deeper understanding of the breadth and scope of this disorder and the myriad of impacts upon other systems in the body. The new name may also inspire clinicians to reconsider this disorder in all of its complexity and come to recognize the crucial role that FABMs may play in enabling patients and physicians alike to perceive incremental improvements in ovulatory function that may occur over time and in response to a particular treatment. Ultimately, consideration and successful treatment of the multi-system facets of this disorder, especially the metabolic and endocrine systems, may be reflected in a woman’s charting. The updated name, therefore, aligns well with the potential systemic impact FABMs may have upon the body.
REFERENCES
[1] World Health Organization Fact Sheet. 22 Jan 2026. https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome
[2] Teede HJ, Khomami MB, Morman R, Laven JSE, Joham AE, Costello MF, Patil M, Rees DA, Berry L, Cree MG, Zhao H, Norman RJ, Dokras A, Piltonen T; Global Name Change Consortium. Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: a multistep global consensus process. Lancet. 2026 May 12:S0140-6736(26)00717-8. doi: 10.1016/S0140-6736(26)00717-8. Epub ahead of print. PMID: 42119588.
[3] Teede HJ, Moran LJ, Morman R, Gibson M, Dokras A, Berry L, Laven JSE, Joham A, Piltonen TT, Costello MF, Norman RJ, Bahri Khomami M. Polycystic ovary syndrome perspectives from patients and health professionals on clinical features, current name, and renaming: a longitudinal international online survey. EClinicalMedicine. 2025 May 28;84:103287. doi: 10.1016/j.eclinm.2025.103287. PMID: 40687737; PMCID: PMC12273733.
[4] “Polyendocrine Metabolic Ovarian Syndrome: New name to improve diagnosis and care of condition affecting 170 million women worldwide.” May 12, 2026. Endocrine.org; https://www.endocrine.org/news-and-advocacy/news-room/2026/pcos-name-change
ABOUT THE AUTHOR
Emily Kahoud is a recent graduate of Rutgers New Jersey Medical school who is honored to be working as a clinical assistant at MD for Life and a professional USMLE and MCAT tutor during a gap she is taking between medical school and residency to nurture her newest family member and four-year-old. Prior to medical school, Emily worked in biomedical research and as the associate producer of a film highlighting lifestyle medicine’s role in addressing our chronic disease epidemic. Emily is passionate about sharing her love of medicine with the public through writing and teaching. Her personal struggle with infertility and loss shifted her career interests and she hopes to incorporate what she’s learned from her health journey into her future career, treating patients with the empathy she desired in her own care experiences.
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