PCOS is Now PMOS: What Women Need to Know About the New Terminology

For many years, women have known the condition as PCOS – polycystic ovary syndrome. You may have been diagnosed with PCOS yourself, or perhaps you have experienced irregular periods, excess facial or body hair, acne, hair loss or fertility difficulties without ever being told you have the condition.

The terminology is now changing.

PCOS is increasingly being referred to as PMOS – Poly Endocrine Metabolic Ovarian Syndrome.

But why has the name changed, and what does it actually mean for women living with the condition?

Why has PCOS become PMOS?

The traditional name, polycystic ovary syndrome, has often led women to believe that the condition is primarily about having cysts on the ovaries.

However, that isn’t an accurate picture of the whole condition.

The ovaries do not necessarily need to have a polycystic appearance for a woman to have the syndrome. What were traditionally described as “cysts” are actually follicles that have not released an egg and contain some fluid.

The condition is much wider than what can be seen on an ultrasound scan.

PMOS reflects our understanding that the condition can involve hormonal, metabolic and cardiovascular health, as well as reproductive health. It is therefore considered a multi-system disorder, with effects that can continue throughout a woman’s life.

This change in terminology is important because it encourages a broader approach to care, rather than focusing solely on periods, fertility or the appearance of the ovaries.

What are the signs of PMOS?

PMOS can present differently from one woman to another.

Some of the more familiar symptoms include irregular, scanty or missed periods, particularly when cycles are consistently very long or very short.

Signs of increased androgen, including testosterone, can also be important. These may include increased facial or body hair, acne, oily skin and female-pattern hair loss.

Some women may also experience difficulty conceiving or significant weight changes.

Importantly, however, you don’t have to be overweight to have PMOS.

There can be what is sometimes described as “lean PMOS”, where a woman has a normal body weight but still experiences problems with periods, ovulation and fertility.

This is one reason why recognising the wider pattern of symptoms is so important.

PMOS isn’t just about fertility

One of the biggest changes in thinking around PMOS is recognising that its effects can extend well beyond reproductive health.

Insulin resistance can occur, meaning the body’s cells become less responsive to insulin. The pancreas may then produce more insulin to compensate. Over time, this can contribute to raised blood sugar and an increased risk of developing type 2 diabetes.

There can also be effects on weight and cardiovascular health, including blood pressure, cholesterol and the risk of heart and blood-vessel problems.

PMOS can also affect skin, hair, mood and sleep.

Women may experience persistent acne, increased facial or body hair, hair loss or darker, velvety areas of skin associated with insulin resistance. Anxiety, low mood and depression can also occur, while sleep disruption and sleep apnoea may contribute to tiredness and difficulty concentrating.

What happens as you approach perimenopause?

This is particularly important for women who have lived with PMOS for many years.

It can be tempting to assume that if periods become more regular in your 40s, your PMOS has improved.

That isn’t necessarily the case.

As women approach perimenopause, oestrogen levels naturally begin to decline. At the same time, the hormonal and metabolic effects associated with PMOS can continue.

This means some women may experience an overlap between PMOS and perimenopause symptoms, including changes in mood and other hormonal symptoms.

The androgen and metabolic effects of PMOS can continue beyond the reproductive years, even when periods appear to have become more regular.

This is why ongoing health monitoring remains important.

Can PMOS be treated?

Although PMOS is a long-term condition, it can be managed with appropriate treatment and lifestyle changes.

The right approach will depend on the individual woman and her symptoms.

Lifestyle measures can include regular physical activity, particularly weight-bearing exercise, and a healthy diet such as a Mediterranean-style diet.

Depending on individual circumstances, treatments may include medicines such as metformin, which can improve insulin sensitivity and may help with blood sugar, weight management and androgen levels.

Other treatments may be considered for period regulation, heavy bleeding, fertility difficulties or symptoms such as unwanted facial and body hair.

For women approaching menopause, HRT is not automatically ruled out because of PMOS. Whether HRT is appropriate is an individual decision that should be discussed with a qualified healthcare professional.

What health checks are important?

Because PMOS can have metabolic and cardiovascular implications, women may benefit from ongoing monitoring.

The source material recommends consideration of checks including blood glucose, blood pressure and cholesterol/lipid levels, alongside appropriate assessment based on symptoms and individual circumstances.

This highlights one of the most important reasons behind the change from PCOS to PMOS.

The condition deserves to be looked at as a whole, rather than simply as an ovarian or fertility problem.

The important message for women with PCOS

If you have previously been diagnosed with PCOS, don’t be alarmed by the new terminology.

PMOS is a change in how we describe and understand the condition.

The important thing is recognising that your hormonal and metabolic health can remain relevant throughout your life – including as you move through perimenopause and menopause.

If you have irregular periods, symptoms of androgen excess, fertility concerns, insulin resistance, unexplained weight changes or other symptoms associated with PMOS, speaking to a healthcare professional can help you understand what is happening and what support may be appropriate.

You don’t need to wait until your symptoms become overwhelming before asking for help.