Following a decade of advocacy and an unprecedented global consensus process, the condition PCOS has been renamed. Published in The Lancet on 12 May 2026, it is now Polyendocrine Metabolic Ovarian Syndrome (PMOS). The new name reflects the condition's true pathophysiology. Implementation is underway across health systems, clinical guidelines, and disease classification systems, with integration into the International Guidelines, used in 195 countries, planned for 2028.
What’s in a name? PCOS - the Pathophysiological Anomaly
The term "polycystic ovary" implies the presence of pathological ovarian cysts, which are not a feature of the condition. It pointed to a single organ and obscured what PMOS actually is, a complex, multisystem disorder affecting endocrine, metabolic, reproductive, psychological, and dermatological health. That inaccuracy has contributed to delayed diagnosis, fragmented care, stigma, and a persistent gap between the condition's true burden and the clinical attention it receives.
Why does the word metabolic matter for diagnosis?
The primary metabolic aspect is dysglycaemia, encompassing prediabetes, type 2 diabetes, and gestational diabetes mellitus, driven by insulin resistance, which is present in 85% of affected individuals, including 75% of lean women. Associated metabolic conditions include obesity, hypertension, dyslipidaemia, metabolic dysfunction-associated steatotic liver disease, cardiovascular disease, and sleep apnoea. Women with PMOS face a significantly higher risk of developing gestational diabetes and experiencing adverse pregnancy outcomes compared to women without PMOS.
Implications for Diagnostic Testing
Determining the degree of dysglycaemia is a critical part of evaluating any woman with PMOS. The oral glucose tolerance test (OGTT) is the most effective and reliable tool, and most international clinical guidelines specify it for this reason. OGTT is significantly more sensitive and reliable than HbA1c in the evaluation of PMOS and the International Diabetes Federation advises against the use of HbA1c due to its low sensitivity.