05/13/2026
Important update that I hope will be shared and taken to heart in the medical community. Polycystic Ovarian Syndrome (PCOS) has now been renamed more appropriately to Polyendocrine Metabolic Ovarian Syndrome (PMOS).
"PMOS encompasses multiple interacting endocrine abnormalities, rather than an isolated ovarian disorder.5,23–25 Meta-analyses of large-scale genomic analyses and recent definitive studies confirm that PMOS has polygenic origins across neuroendocrine, metabolic, and reproductive pathways.26,27 Hyperandrogenism is a defining endocrine and diagnostic feature, with elevated ovarian—and often adrenal—androgens contributing to hirsutism, acne, alopecia, and metabolic features.2,28,29 Central neuroendocrine abnormalities include increased gonadotropin-releasing hormone pulsatility, with consequent elevations in luteinising hormone that drive excessive ovarian androgen.24 Insulin resistance and compensatory hyperinsulinaemia, present in 85% of affected individuals (75% of lean women [with BMI ≤25 kg/m2] with PMOS),30,31 amplify androgen secretion and disrupt steroidogenesis, highlighting the metabolic–endocrine interplay.30,31 Altered AMH concentrations, ovarian endocrine function, adipokine signalling, and gut–hormone interactions influence clinical features, including reproductive and metabolic manifestations.5,32 Furthermore, the combination of endocrine disturbances underpin pregnancy risks, which are compounded by metabolic features.33,34 Collectively, these complex endocrine abnormalities underscore the multisystem manifestations of PMOS and support reframing it as a polyendocrine condition that extends beyond ovarian pathology.
Metabolic abnormalities underpin PMOS, from genetic origins to clinical manifestations.2,5,26,35 Insulin resistance affects the majority of people with PMOS and contributes to androgen excess, which, together with low-grade inflammation and dysfunctions in adipokine signalling and the sympathetic nervous system, drives metabolic dysfunction.5,36 Obesity—particularly central adiposity—is increased in people with PMOS, implicated as causal on mendelian randomisation studies, and exacerbates symptom severity.2,37 Lifestyle, pharmacological, and surgical weight management interventions have shown clinical benefit.37–40 Cardiometabolic complications, such as impaired glucose tolerance, gestational diabetes, metabolic dysfunction-associated steatotic liver disease, type 2 diabetes, dyslipidaemia, hypertension, and vascular dysfunction are increased in PMOS, exacerbated by obesity, and drive cardiovascular disease risk.2,5,35,41,42 Evidence from women who are predominantly premenopausal shows that the odds ratios of composite cardiovascular disease (1·68), myocardial infarction (2·50), and stroke (1·71) are increased in those with PMOS compared with those without PMOS.43 Collectively, this evidence shows that metabolic features are inherent in PMOS, which firmly endorses incorporation of the metabolic term in the revised nomenclature."
Polyendocrine metabolic ovarian syndrome (PMOS), previously named polycystic o***y syndrome (PCOS), affects one in eight women. However, the term PCOS is inaccurate, implying pathological ovarian cysts, obscuring diverse endocrine and metabolic features, and contributing to delayed diagnosis, fragme...
