New guidance from the Endocrine Society and an article in The Lancet this week say the hormonal condition long known as polycystic ovary syndrome, or PCOS, should now be called polyendocrine metabolic ovarian syndrome—PMOS—after years of work aimed at better reflecting what clinicians say is a complex endocrine disorder.
Researchers and supporters of the change said the older name, commonly shortened to PCOS, has been inaccurate. They said it can narrow attention to a misunderstanding about cysts and the ovaries, which in turn can contribute to missed diagnoses and inadequate treatment, according to the Endocrine Society.
Dr. Melanie Cree, a pediatric endocrinology expert at the University of Colorado Anschutz and one of the authors of the Lancet article, said the current label creates confusion about what the condition actually involves. “The thought behind that is that one, there’s no cysts in the ovary, so it’s very confusing,” Cree said. She added that the hope was that a more comprehensive and accurate name would help “enable and push better care.”
The name change was published in The Lancet on Tuesday, following what the Endocrine Society described as 14 years of collaboration between experts and patients. Clinicians and researchers said spreading the new term through medical societies and meetings is part of the effort to raise awareness of PMOS and how to help patients.
The condition is characterized by hormone fluctuations that can affect weight, metabolic health, mental health, the reproductive system and the skin. The group said PMOS is also associated with metabolic syndrome, a cluster of conditions that raises the risk of type 2 diabetes, heart disease and stroke.
Because symptoms can vary, diagnosis can be difficult. PMOS is associated with irregular menstrual cycles and higher production of androgens, hormones that can contribute to acne and changes in hair growth or thinning, and it may be linked to follicles on the ovaries. The guidance also said that not all findings are required for diagnosis.
For teens, Cree said diagnosis requires both irregular periods and signs of high androgens. She described potential indicators that include high blood levels of the hormones or symptoms such as severe acne or chest hair.
Clinicians also said PMOS is associated with infertility problems. The Cleveland Clinic experts cited in the reporting said it is the most common cause of female infertility because not ovulating frequently can make it harder to conceive, though they added that many people with the condition can still carry a pregnancy.
The guidance also tied PMOS to potential pregnancy complications, including gestational diabetes and preterm birth. For care, Cree said the No. 1 treatment involves lifestyle changes, including eating less processed food, exercising and getting a good night’s sleep.
Cree said that approach is supported by science and connected it to the condition’s hormone mechanisms. “We’re not trying to be judgmental. There is science to back this up,” she said. She explained that in PMOS, too much of the hormone insulin in many women can “confuses the ovary to make too much testosterone,” and that high testosterone can drive symptoms.
Other treatments include insulin-sensitizing medicines such as metformin, medications that block androgens and hormonal birth control. Dr. Sarah Hutto, of the University of Minnesota Medical School, said management should be individualized to address specific symptoms and concerns, including fertility-focused options for those who plan to get pregnant and other options—such as hormonal birth control—for people with different priorities.
Researchers and doctors said they are working to ensure peers learn the new terminology as it takes hold. Cree said she is “very excited about the name change,” adding that she expects “the majority of my colleagues” feel similarly.