The Endocrine Society on Tuesday published a new name for polycystic ovary syndrome (PCOS) in The Lancet, renaming the condition polyendocrine metabolic ovarian syndrome (PMOS) after 14 years of collaboration between experts and patients. The change aims to correct a long-standing mischaracterization that reduced a complex hormonal disorder to a label about cysts and ovaries, contributing to missed diagnoses and inadequate care for the estimated 1 in 8 women worldwide who have it.
“The thought behind that is that one, there’s no cysts in the ovary, so it’s very confusing,” said Dr. Melanie Cree, one of the authors of the Lancet article and a pediatric endocrinology expert at the University of Colorado Anschutz. “The hope was that with a more comprehensive and accurate name change, that it would start to enable and push better care.”
The condition, now called PMOS, is characterized by fluctuations in hormones that can affect weight, metabolic and mental health, the reproductive system, and the skin. It is associated with metabolic syndrome—a group of health conditions that increases the risk of Type 2 diabetes, heart disease, and stroke—according to Dr. Sarah Hutto of the University of Minnesota Medical School. No single cause is known, but evidence points to roles for genetics and obesity, the Cleveland Clinic notes.
Symptoms vary, making diagnosis difficult. The condition is linked to irregular menstrual cycles and excess production of a group of hormones called androgens, which can cause acne, hair growth or thinning. Follicles may appear on the ovaries, but the name “polycystic” was misleading because abnormal cysts are not typical. For adolescents, the diagnosis requires both irregular periods and signs of high androgens, such as severe acne or chest hair, Cree said.
PMOS is the most common cause of female infertility, because infrequent ovulation can prevent conception, according to Cleveland Clinic experts. The condition may also increase the risk of certain pregnancy complications, such as gestational diabetes or preterm birth, although most people with the condition can successfully carry a pregnancy.
Cree said the No. 1 treatment is lifestyle changes: eating less processed food, exercising, and sleeping well. “We’re not trying to be judgmental. There is science to back this up,” she said. “In PMOS, there is too much of the hormone insulin in many women, and that insulin confuses the ovary to make too much testosterone. And it’s the high testosterone that is causing all the symptoms.” Other treatments include insulin-sensitizing medicines such as metformin, medications that block androgens, and hormonal birth control. Hutto stressed that management must be individualized to address specific symptoms and concerns—patients planning pregnancy may focus on fertility treatments, while others may prioritize options like hormonal birth control.
Researchers and doctors are spreading word of the name change through medical societies and conferences. Cree said she and the majority of her colleagues are “very excited about the name change,” which they hope will raise awareness of the condition and improve how providers help patients.