Terminology Change to PCOS and What This Means for Lifestyle Medicine

By Dr Chetna Patel, MBChB, MRCGP, DipBSLM/IBLM

28th May, 2026

Recent publication in The Lancet has proposed significant terminology change:

PMOS- Polyendocrine Metabolic Ovarian Syndrome, which is currently termed Polycystic Ovary Syndrome (PCOS) [1].

PMOS is one of the most common conditions affecting around 10% of reproductive aged women, with many remaining undiagnosed[2]. PMOS presents with a range of features, as a result of the multisystem pathophysiology.

Why is the name change important?

  • The term PCOS is inaccurate and implies pathological ovarian cysts (the Ultrasound scan features are actually immature follicles (egg-bearing sacs) that stop growing before ovulation [1].
  • The term PCOS reflects only one organ and fails to capture the disorder’s multisystem nature [1].
  • The international consensus group argues that the term “PCOS” inadequately reflects the condition’s complex pathophysiology and contributes to misunderstanding amongst both patients and clinicians.
  • The term PCOS can contribute to delayed diagnosis and fragmented care [1].
  • The reproductive focus of the name can reinforce stigma, particularly in sociocultural contexts where fertility carries high value.

Why Polyendocrine Metabolic Ovarian Syndrome (PMOS)?

PMOS highlights the multisystem nature of the condition:

“Polyendocrine” recognises the involvement of multiple endocrine and hormonal axes, including ovarian, adrenal, metabolic, and hypothalamic-pituitary pathways.

“Metabolic” acknowledges the central role of insulin resistance and cardiometabolic dysfunction

“Ovarian”retains recognition of reproductive manifestations such as ovulatory dysfunction and hyperandrogenism.

“Syndrome” – recognises the multiple, connected symptoms and pathophysiology.

PMOS encompasses the diverse endocrine, metabolic, reproductive, psychological, and dermatological features of the syndrome.
The shift reflects the growing understanding that the syndrome extends far beyond ovarian morphology. Some individuals diagnosed with PCOS do not have polycystic ovaries on ultrasound, while metabolic features may precede or dominate reproductive symptoms. Current evidence supports insulin resistance as a major pathophysiological driver in many patients, contributing to compensatory hyperinsulinaemia, increased androgen production and chronic low-grade inflammation. Genetic susceptibility, adiposity, circadian disruption, gut microbiome alterations, epigenetics and lifestyle factors also interact in disease expression.

PMOS and Lifestyle Medicine

For Lifestyle Medicine clinicians, the terminology change reinforces the importance of reviewing the breadth of symptoms of PMOS and the impact of symptoms on each individual. It reinforces whole-person, person-centred, holistic assessment and management. PMOS is associated not only with infertility and menstrual irregularity, but additionally increased risks of a range of conditions, including Type 2 Diabetes, cardiovascular disease, MASLD, sleep disturbance, depression and reduced quality of life. PMOS has disease complications which are amenable to prevention. For patients with PMOS, lifestyle interventions targeting nutrition, physical activity, sleep, stress regulation, emotional wellbeing and weight management remain foundational across the lifespan.

It is hoped that the new terminology will improve patient understanding, reduce stigma associated with the term “cysts,” and encourage broader recognition of the endocrine-metabolic dimensions of the condition. Thus helping with symptom control, management and prevention of long-term complications.

References

  1. Teede, H.J., Tay, C.T., Laven, J.J.E., Dokras, A., Moran, L.J., Piltonen, T., Costello, M.F., Peña, A.S., et al. (2023) Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: a multistep global consensus process. Available at: https://pubmed.ncbi.nlm.nih.gov/ (Accessed: 28 May 2026).
  2. Monash University PCOS guideline. Available at: https://www.monash.edu/medicine/mchri/pcos/guideline (Accessed: 28 May 2026).
  3. NHS (2024) Polycystic ovary syndrome (PCOS). Available at: https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/ (Accessed: 28 May 2026).
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