Lancet
PCOS out, PMOS in: reframing a hormonal, metabolic disease
Clinical Takeaway: The rename is a signal to widen workup and follow-up beyond reproductive concerns. Insulin resistance, dyslipidemia, hypertension, fatty liver, and cardiovascular risk belong in routine care for these patients, not as afterthoughts.
The old PCOS label had been a clinical liability for years. It steered attention toward cysts that aren't actually more common with the disease, while the insulin resistance and cardiometabolic disease behind most of the long-term harm went underappreciated.
Up to 70% of affected individuals remain undiagnosed, and patient surveys have consistently documented frustration with both delay and incomplete care. This initiative aimed to fix the name and, with it, the framing that shapes how the condition is identified, worked up, and managed.
The new name was selected to make the biology unmistakable. "Polyendocrine" captures the hyperandrogenism, neuroendocrine dysregulation, and disturbed gonadotropin signaling at the core of the disorder. "Metabolic" makes explicit what evidence has long supported: insulin resistance is present in roughly 85% of patients overall and 75% of lean patients. "Ovarian" was retained to preserve continuity and acknowledge follicular and ovulatory dysfunction without implying that cysts are central.
Compared with unaffected women, the condition is associated with about 2.5 times the odds of heart attack and roughly 70% higher odds of stroke and overall cardiovascular disease. The reframe also lands at a useful moment for therapy. GLP-1 receptor agonists are reshaping how clinicians treat the obesity, insulin resistance, and cardiovascular risk that sit at the center of the condition. A name that foregrounds metabolism may help align prescribing and follow-up with the biology that drives long-term risk.
Patient and clinician preferences aligned: a new, symptom-based name was favored by 86% of patients and 71% of health professionals over keeping the PCOS acronym or adopting a generic label. Stigma concerns led the group to choose "ovarian" over "reproductive," which workshop participants flagged as potentially harmful in cultures where fertility is tied to a woman's perceived worth.
The process spanned four years and engaged 56 patient and professional organizations across all world regions. Investigators used iterative Delphi surveys with 14,360 responses, nominal group workshops, and marketing analysis to settle on principles, terms, and an implementation path. The work was led by Monash University's Centre for Research Excellence in Women's Health in Reproductive Life, the Androgen Excess and PCOS Society, and the UK patient charity Verity. Participation skewed toward higher-income countries and away from Asia, Africa, and South America.
A managed three-year transition is now underway, with co-designed multilingual resources, integration into electronic health records and SNOMED CT, formal engagement with the WHO for ICD coding, and incorporation into the 2028 update of the International Guideline, already used in 195 countries.
"What we now know is that there is actually no increase in abnormal cysts on the ovary, and the diverse features of the condition were often unappreciated," said lead author Helena Teede, MD, PhD, director of the Monash Centre for Health Research and Implementation. "It was heart breaking to see the delayed diagnosis, limited awareness and inadequate care afforded those affected by this neglected condition. While Monash-led international guidelines have advanced awareness and care, a name change was the next critical step towards recognition and improvement in the long-term impacts of this condition."
Source: Teede HJ. Lancet. 2026 May 12. Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: a multistep global consensus process