PCOS is now PMOS: what the new name means, and what helps

Why the name changed

The old name suggested the ovaries were full of cysts. In reality:

• the "cysts" are small, immature follicles (egg sacs), not true cysts;
• some people with the condition don't have them at all;
• the condition affects hormones (endocrine), metabolism and the ovaries.

The new name was agreed after a multistep global process with more than 14,000 survey responses from patients and health professionals. Most patients (86%) and health professionals (71%) supported a new name. A three-year transition is under way, and the international guideline is expected to formally adopt the term in 2028. You will see both names used for a while.

What are the symptoms?

PMOS looks different in different people. Common features include:

• irregular, infrequent or absent periods;
• excess hair growth on the face, chest or abdomen, acne, or scalp hair thinning (signs of higher androgen, or "male-type" hormone, effects);
• difficulty getting pregnant, because ovulation happens less often;
• weight gain, particularly around the abdomen, and difficulty losing weight;
• low mood or anxiety, which are more common with PMOS.

How is it diagnosed?

Using the current international guideline (2023), adults are usually diagnosed when two of these three are present, after other causes are ruled out:

1. irregular or absent ovulation (usually shown by irregular periods);
2. signs of high androgens, on examination or in a blood test;
3. polycystic ovarian appearance on ultrasound, or a raised AMH blood test in adults.

In adolescents, both irregular cycles and high androgens are needed, and ultrasound is not recommended, because these features overlap with normal puberty.

Your doctor will also usually check for related metabolic issues, such as blood sugar, cholesterol and blood pressure.

Why the "metabolic" part matters

People with PMOS have higher risks of:

• prediabetes and type 2 diabetes;
• diabetes during pregnancy;
• abnormal cholesterol and high blood pressure;
• fatty liver;
• sleep apnoea, depression and anxiety.

This is why regular metabolic checks are part of good care, even in people who are slim.

What helps?

Lifestyle foundations

• Regular physical activity, including strength training, improves insulin sensitivity whatever your weight.
• A balanced eating pattern you can sustain, with plenty of fibre, vegetables, legumes and protein, and fewer sugary drinks and refined carbohydrates. No single "PCOS diet" has been shown to be best.
• Modest weight loss if you carry excess weight. Losing about 5% to 10% of body weight can improve cycles, ovulation and metabolic markers.
• Sleep and stress management.

Medical treatment

Depending on your symptoms and goals, your doctor may discuss options to:

• regulate periods and protect the womb lining;
• reduce excess hair growth and acne;
• improve insulin resistance and metabolic risk;
• support fertility when you are trying to conceive.

Treatment is tailored to what matters most to you.