For ages, women have learnt to live with inexplicable changes in their bodies in a state of resigned acceptance. They often repress the anxiety that arises from signs of unfamiliarity. Consulting a doctor is an afterthought that comes too late. This is reinforced by social conditions that pay scant attention to women’s health, creating a cascading effect of flawed assumptions about symptoms, late diagnoses and erroneous treatment.
One of the most pronounced examples of this lived medical reality is the Polycystic Ovary Syndrome (PCOS), a hormonal and metabolic disorder that has affected, by global estimates, 170 million women. The all-too-common disorder occurs when the ovaries produce excess hormones called androgens, which manifest in symptoms like irregular menstrual cycles, excessive acne or hair growth, or enlarged ovaries. Worryingly, a patient with no pronounced symptoms can also be diagnosed with the condition.
For a disorder so vastly prevalent, its constellation of physical and psychological symptoms has, for long, hindered a thorough comprehension of its underlying nature. Over nine decades after the term was first coined, a global congregation arrived at the consensus that “PCOS” does little to reflect the range of complications found in persons living with this condition. In May 2026, Polycystic Ovary Syndrome was officially renamed Polyendocrine Metabolic Ovarian Syndrome (PMOS). This new terminology was the result of a 14-year-long process organised by 56 academic, patient and clinical organisations.
What’s in a name?
The engagement involved two global surveys that recorded 14,360 responses from patients and health professionals, group workshops and market analysis to arrive at an agreement as to whether PCOS needed a new name and if it did, to pick a most suitable replacement. Part of the process relied on the Delphi method—questionnaire-based surveys to gather consensus from participants with domain expertise in a given subject—to arrive at a conclusive redefinition. The health professionals who participated in the surveys represented a wide range of disciplines including gynaecology, reproductive endocrinology, nutrition and nursing.
The terms “polyendocrine” and “ovarian” stood out as potential alternatives in the survey results. A workshop held in February 2026 settled on the new term. Only two participants did not support a name change. In a paper detailing the process to rename the condition, The Lancet stated that the transition to the usage of PMOS across the board is estimated to take three years of time.
“The current name reflects only one organ and fails to capture the disorder’s multisystem nature,” reads the paper authored by the researchers who led the process. A patient with PMOS can show symptoms that concern endocrine, metabolic, reproductive, psychological and dermatological features. The old term gave the misleading idea that the condition should necessarily entail the presence of cysts in ovaries, when in reality, irrespective of the presence of cysts, a patient can be diagnosed with the condition due to the evidence of other symptoms. Besides, the old term resulted in disproportionate emphasis on pregnancy-related concerns. “The reproductive focus of the name can reinforce stigma, particularly in sociocultural contexts where fertility carries high value,” the authors said.
An evolving perception of PCOS
PMOS patients, and doctors across specialties who have been treating this disorder, have widely welcomed the new terminology. “It helps to specify what exactly is the clinical diagnosis. The ovaries are only one part and not the whole disease on its own,” says Dr. Aakanksha Padma Naik, a Mumbai-based gynaecologist. The term PCOS, she says, suggested that cysts in the ovaries “was the only point that mattered”.
While references to symptoms in the ovaries can be traced back to medical texts of the 19th century, the first significant breakthrough in characterising PCOS is attributed to Irving Freiler Stein and Michael Leo Leventhal, two American gynaecologists. In 1935, at a meeting of the Central Association of Obstetricians and Gynaecologists, Stein and Leventhal described the clinical histories of seven women with symptoms including irregular periods, hirsutism (excessive hair growth in a male pattern) and infertility. They also reported that the seven women had enlarged ovaries. The paper presented by the two doctors was titled “Amenorrhea associated with bilateral polycystic ovaries”, elaborating on the formation of multiple cysts–fluid-filled sacs–in the ovaries, causing them to become enlarged and painful. Amenorrhea denotes the absence of menstruation.
Besides, the old term resulted in disproportionate emphasis on pregnancy-related concerns.
PCOS has since been a subject of extensive research in modern medicine, evolving to acknowledge that its diagnosis cannot be confined to symptoms in the ovaries. A milestone in the study of this disorder arrived in 2003 when 27 medical experts gathered in Rotterdam, Netherlands for a conference to come up with a revised criteria to diagnose it. The guidelines that are now known as the Rotterdam criteria stipulate that a patient can be diagnosed with PCOS if two of these three features are found: oligo-anovulation, that is infrequent or absent ovulation; hyperandrogenism characterised by an excess production of androgens which are hormones typically associated with male physiological characteristics; polycystic ovaries, that is, the presence of 12 or more follicles–small sacs containing immature eggs–in each ovary measuring 2-9 mm in diameter and/or an ovarian volume exceeding 10 ml. This consensus at Rotterdam expanded the definition of PCOS and became the widely accepted standard to confirm the diagnosis of this condition.
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Not just a gynaecologist’s concern
The new term—Polyendocrine Metabolic Ovarian Syndrome—decentres the ovaries and represents the disorder’s character as one that affects diverse aspects of the body. The endocrine system is responsible for creating and releasing hormones that regulate various bodily functions. The new name draws focus towards hormonal imbalance and metabolic dysfunction that characterise the condition.
For instance, resistance to insulin, a hormone that regulates blood sugar, is commonly observed in patients diagnosed with PMOS. This may result in hyperinsulinemia—the body’s response of overproducing insulin to keep blood sugar levels stable. The high-insulin state can stimulate the ovaries to produce excess androgens, which in turn triggers insulin resistance, furthering a vicious cycle that disrupts multiple bodily functions. The new term is meant to reflect such interactions between endocrine and metabolic abnormalities.
PMOS is not just a gynaecological concern, but a syndrome that needs to be treated by a cross-section of specialists
Dr. Naik says that irrespective of the name change, gynaecologists were already following the practice of referring patients with symptoms such as insulin resistance to doctors specialised in endocrinology. “With the change of name, patients are more likely to see and understand the diagnosis versus just us understanding it,” she says. Earlier, she says, when gynaecologists referred patients to an endocrinologist or recommended that they undergo a series of tests to check hormone levels, patients were often sceptical of its necessity. If they approached a gynaecologist to address their irregular menstrual cycle, they were puzzled as to why they were being asked to test their insulin levels. With the new term, Dr. Naik hopes that patients will comprehend that PMOS is not just a gynaecological concern, but a syndrome that needs to be treated by a cross-section of specialists.
“When you look at ‘polycystic ovaries’, people think that it is all about cysts in the ovaries,” says Dr. Anurag Lila, an endocrinologist, adding that patients were mainly concerned with the status of the cysts, requesting an ultrasound to see whether they have grown or reduced. “The disease is much beyond that,” Dr. Lila says.
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The disruption of the Hypothalamic-Pituitary-Gonadal axis, the endocrine system that functions through a complex feedback loop between hormone-producing glands, is a key factor underlying PMOS. To diagnose or rule out PMOS, an endocrinologist examines the hormonal levels which in turn reflect the extent of risk of diabetes, gestational diabetes, and dyslipidemia (abnormal levels of lipids or fats in the bloodstream).
Dr. Lila opines that there is no reason for a delay in diagnosing PMOS regardless of the specialist consulted by a patient. A gynaecologist, endocrinologist or dermatologist, he says, can identify symptoms associated with the condition. “There are difficulties in managing it because like in any disorder such as obesity or weight gain, it is not easy to make lifestyle changes,” he says.
PMOS, as Dr. Lila put it, is not owned by any one branch of medicine. “If we try to make a strict compartmentalisation, it will be wrong. It is a team of doctors who manage it.” If the symptoms manifest in hirsutism, for example, a dermatologist steps in to treat it. Likewise, only a mental health professional can address the depression or anxiety that a PMOS patient may be coping with. “It is a multisystem disorder that affects you at multiple levels. The treatment and the modality changes at every stage of its management,” Dr. Lila says.
The role of nutrition
Women live with the symptoms of PMOS for much of their lives, and a balanced diet is critical to keeping them in check. But there is no one-size-fits-all approach, says nutritionist Aditi Prabhu. “Each case has to be handled with care and personalised based on individual goals, current symptoms, health complaints, root cause analysis, medical history, blood reports, lifestyle patterns, sleep habits, stress levels, mental health and their overall relationship with food, especially if they have had any previous experience with dieting,” she says. Broadly, whole grains and pulses, protein sources, a variety of fruits and vegetables, fibre and omega-3-rich foods are part of the diet plan that Prabhu charts for her patients.
Patients grappling with PMOS can grow conscious of their body image. “A lot of women are constantly under the pressure of losing weight, as they are repeatedly made to believe that losing weight is the only solution,” says Prabhu. Enforcing this as the one-stop solution is a trivialisation of a complex condition that manifests differently in each patient. Even a woman with a regular menstrual cycle and optimal weight, Prabhu points out, can struggle with other PMOS symptoms such as mood swings, insulin resistance or metabolic dysfunction.
This name change will not make a major impact unless it is also accompanied by changes in the way this condition is diagnosed, treated and communicated to patients
Insulin resistance heightens the risk of diabetes in PMOS patients. Irregular diet, poor sleep patterns, inflammation, increased fat percentage, chronic stress accelerates sensitivity to insulin. “Early screening and managing it before it worsens can help reduce the risk of diabetes in the long term,” the nutritionist says. Insulin resistance and other symptoms of this condition can be significantly improved if the patient consistently follows recommended dietary and lifestyle changes.
Like many healthcare professionals, Prabhu agrees that the new terminology is a “more holistic representation of the condition”. But it can only go so far in translating into positive practical implications. “This name change will not make a major impact unless it is also accompanied by changes in the way this condition is diagnosed, treated and communicated to patients,” she says.
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