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An international panel has renamed polycystic ovary syndrome (PCOS) as polyendocrine metabolic ovarian syndrome (PMOS).
It has argued that the old term misrepresented the condition and focused too narrowly on ovaries.
The new name highlights multiple hormonal pathways, central metabolic dysfunction and broader systemic risks.
It is expected to improve diagnosis, communication and patient care, especially in countries like India with high metabolic disease burdens.
For decades, polycystic ovary syndrome (PCOS) has been recognised as one of the most common hormonal disorders affecting one in eight women worldwide. But scientists, researchers and patients have pointed out that the name fails to describe the true nature of the condition. In a major shift, an international panel of experts have formally renamed it polyendocrine metabolic ovarian syndrome (PMOS) in a policy consensus paper published in The Lancet, citing the growing evidence that the disorder extends far beyond just one organ that is the ovaries.
The name change was important, they wrote, to avoid the confusion arising from the current name, which delayed diagnosis and hindered effective communication between patients and health professionals, contributing to patient dissatisfaction with care. And also the reproductive focus of the name may reinforce stigma, particularly in sociocultural contexts where fertility carries high value as many individuals have reported distress associated with the name itself.
The earlier term “PCOS” was considered misleading because many women diagnosed with the condition do not actually have polycystic ovaries. The so-called “cysts” are immature follicles that fail to ovulate rather than true pathological cysts, the term itself is a misnomer, the experts wrote in the report.
At the same time, some women with the syndrome may not display the ovarian cysts at all. By focusing primarily on the ovaries, the older terminology unintentionally narrowed both diagnosis and treatment. Women with mainly metabolic, dermatological or psychological symptoms often felt overlooked, while care remained restricted largely to gynaecology clinics.
The new name represents a major conceptual shift in understanding the condition, Kolkata-based endocrinologist Dr Torsha Chatterjee told Down To Earth. It acknowledges that several endocrine pathways are involved, including insulin, androgens, luteinising hormone, follicle-stimulating hormone and stress-related hormonal mechanisms, she said.
Importantly, Chatterjee highlighted, the metabolic component is now being placed at the centre rather than being treated as a secondary issue. The word “polyendocrine” highlights the involvement of multiple hormone-producing systems; “metabolic” recognises the connection with metabolic dysfunction and that insulin resistance and cardio-metabolic dysfunctions are central features, not secondary associations; “ovarian” retains the reproductive aspect of irregular menstruation, infertility and ovulation problems but it is not the sole defining features; and the word "syndrome" reflects a complex multisystem disorder rather than a single-organ complication.
Dr Chatterjee further explained that this evolving understanding is especially relevant in India because Indian women appear to develop metabolic complications at younger ages and often at lower BMI thresholds compared to Western populations. India already carries a high burden of insulin resistance, prediabetes, type 2 diabetes, central obesity, dyslipidaemia, fatty liver disease and cardiovascular disorders. Even women with “lean PCOS” (PMOS in people with normal or low body weight) may have significant insulin resistance despite appearing non-obese, leading to missed opportunities for early diagnosis and intervention under the older ovarian-centric framework.
She emphasised that insulin resistance is now considered one of the most important pathophysiological drivers of PMOS. Current evidence suggests it may be present in nearly 70-80 per cent of women with the syndrome, including many who are not overweight.
Hyperinsulinemia directly contributes to increased ovarian androgen production, reduced SHBG levels, worsening hyperandrogenism, menstrual irregularities, acne, hirsutism, infertility and ovulation, she added. Simultaneously, it raises the long-term risk of impaired glucose tolerance, hypertension, dyslipidaemia, fatty liver disease and cardiovascular complications.
“The inclusion of the word ‘metabolic’ in PMOS is highly intentional because it acknowledges that insulin resistance and metabolic dysfunction are central to the syndrome’s biology and clinical consequences, not merely associated findings,” said Dr Chatterjee.
The renaming process was extensive, involving 56 academic, clinical and patient organisations worldwide and survey responses from over 14,000 individuals and healthcare professionals.
Experts believe the change will improve awareness, diagnosis, patient satisfaction and overall quality of care. The transition to the new terminology is expected to occur gradually over the next three years.
