The name shift from polycystic ovary syndrome to polyendocrine metabolic ovarian syndrome aims to improve understanding of the condition and support earlier diagnosis and better care.
It's a name change more than a decade in the making.
Polycystic ovary syndrome (PCOS) has been renamed polyendocrine metabolic ovarian syndrome (PMOS) to better reflect the condition's complexity and improve diagnosis and care for the estimated one in eight women who live with it.
The syndrome is characterised by fluctuations in hormones, with symptoms including, but not limited to, irregular or absent periods, acne, excessive facial or body hair, hair loss, weight problems, anxiety and depression. It can also cause infertility, and increase the risk of type 2 diabetes, heart disease and endometrial cancer.
Despite this, it's historically been incorrectly framed as a problem related to 'cysts' in the ovaries, rather than a hormonal disorder, leading to misdiagnosis and gaps in care, said Dr Michael Costello , a gynaecologist and senior lecturer with UNSW's School of Clinical Medicine.
He was a member of the international steering committee for the name change - formally announced this month and outlined in The Lancet , following a global effort involving patients, clinicians and researchers.
"We've all recognised that PCOS has been a bad name, an inaccurate and misleading name, but it took a major effort to change it," Dr Costello said.
A patient-led push for change
The name change took 14 years of global collaboration between experts and people with lived experience, including workshops and a survey which received 22,000 responses. It was led by Professor Helena Teede , Director of the Monash Centre for Research & Implementation .
"We heard from so many people who said it took them years to get diagnosed, who were dismissed by doctors because they didn't have 'cysts' on their ovaries," Dr Costello said.
The 'cysts' are actually antral follicles - small fluid-filled sacs in the ovaries containing the oocytes or eggs - which all women have.
While a higher level of follicles, 20 or more in at least one ovary, is associated with PMOS, it is not the only consideration in this syndrome.
"The main misconception is that cysts in the ovaries cause the syndrome. Firstly, they are not abnormal cysts, they are follicles which all women have. Secondly, those with PMOS typically have more, but this is not what causes the syndrome," Dr Costello said. "We still don't know what the underlying cause is."
Another concern was the focus on the ovaries, which narrowed how the condition was understood and treated.
"PCOS focused on the ovarian gynaecological symptoms and ignored all the broader endocrine, metabolic and mental health aspects," Dr Costello said. "This change highlights the multidisciplinary care that is required to better support women with PMOS."
Impact on diagnosis and care
Associate Professor Rebecca Deans , Acting Head of Discipline for Women's Health, in UNSW's School of Clinical Medicine, said the name change was a huge feat, which should improve how PMOS was recognised and managed.
As a gynaecologist, A/Prof. Deans has seen how a fixation on 'cysts' has fuelled confusion for patients.
"I do have a lot of people who come to see me for fertility issues saying, 'I've got cysts on my ovaries, that's why I'm not getting pregnant', which isn't always the case. So, then we must start by unwinding that thinking," she said.
That misunderstanding can send patients down the wrong clinical path, delaying appropriate investigation and treatment. Then there are the risks that come with undiagnosed or poorly managed PMOS, such as increased risk of type 2 diabetes, high blood pressure, high cholesterol and cardiovascular disease - all modifiable conditions if managed earlier in life.
"Framing it as a metabolic endocrine disorder could help drive more screening by GPs and put the long-term health risks at the forefront of their minds, rather than just focusing on the ovaries," she said.
"It starts with understanding, and once you know what's really going on you can start asking better questions, and providing better care to improve quality of life for patients."
What comes next
With the transition to the new name underway, attention is turning to the challenges, and opportunities, ahead.
PMOS can present in many ways, with no single known cause or linear pathway. This, and limited research funding, has made it harder to study, diagnose and manage consistently.
"When it was viewed largely as a reproductive or gynaecological issue, it struggled to attract funding compared with conditions like diabetes or heart disease. We hope that will change now," Dr Costello said.
A key focus for future research and guidelines will be improving understanding of the different subtypes of PMOS, and how they respond to treatment.
"There will be some subtypes where drug X works, and other ones where it doesn't, or one subtype will be at risk of diabetes, and the other type won't be. Understanding those differences is key to delivering better care," Dr Costello said.
A/Prof. Deans added additional research funding could support efforts to better understand the role played by genetics and environment factors, and whether early interventions could reduce long‑term health impacts.
"Women's health research has been historically underfunded. That's certainly changing, but there is more to be done," A/Prof. Deans added.
The name change will be implemented in the next update of the international guidelines for managing the condition, to be published in 2028, and supported by an international education and awareness campaign targeting health professionals, governments and researchers.
