PCOS is Now PMOS: What's in a Name? A Lot Actually

A condition that affects one in eight women worldwide recently got a new name—PCOS or Polycystic Ovarian Syndrome is now PMOS or Polyendocrine Metabolic Ovarian Syndrome.The announcement, published in The Lancet on 12 May, followed 14 years of global collaboration involving over 22,000 patients, clinicians, researchers, and advocates across 56 organisations. For a rename, that’s an extraordinary amount of work. But why does a name matter so much? The answer, it turns out, is everything.‘It Happens a Lot’: The Flaws in India’s Sex Ratio Data and 'Gender Test' LawFor decades, the name Polycystic Ovarian Syndrome told a misleading story. It implied that the condition was defined by ovarian cysts, an incorrect description contributing to delayed and missed diagnoses, fragmented care, and profound stigma. Many women with PCOS never develop cysts at all. Meanwhile, the name said nothing about what the condition actually is: A complex, multisystem disorder of hormonal, endocrine, and metabolic dysregulation, primarily driven by insulin resistance and androgen excess, with consequences rippling across cardiometabolic function, mental health, cognition, and skin.The name PCOS kept the conversation anchored in gynaecology, i.e. in fertility, reproduction, and ovarian dysfunction. The woman who wasn't trying to conceive, or who was lean, or whose ultrasound looked unremarkable, was dismissed or sent home with more questions than answers.According to the World Health Organization (WHO), almost 70 percent of women with this condition worldwide remain undiagnosed throughout their lifetime. A name that obscures the condition's true nature is not a minor inconvenience but a public health oversight with far-reaching ramifications.The new name does three things simultaneously. ‘Polyendocrine’ acknowledges a disorder of multiple interacting hormonal systems—not an isolated ovarian dysfunction. ‘Metabolic’ foregrounds insulin resistance, dyslipidemia, obesity and the elevated risks for Type 2 diabetes and cardiovascular disease—not accidental but intrinsic to the condition. ‘Ovarian’ retains the connection to ovulatory dysfunction and fertility. Together, the name reflects its true multi-organ nature, opening the door to comprehensive, evidence-informed care that most women have never received.By centring metabolic and endocrine identity over reproductive function, PMOS begins to widen who gets to be seen. Women who have undergone bilateral oophorectomy for ovarian cancer, endometriosis, or other reasons can still carry the syndrome’s underlying endocrine and metabolic dysregulation without having ovaries. The old name rendered them entirely invisible. The new name is more inclusive, even if the word "ovarian" in PMOS remains imperfect, a conversation the medical community should continue.PCOS Affects More Than Just Your Period: Hear These Women OutIndia has one of the highest burdens of this condition worldwide. A large cross-sectional study of nearly 10,000 Indian women found a 20 percent prevalence—nearly 1 in 5 women of reproductive age. Among those diagnosed, 92 percent had dyslipidaemia, 43 percent had obesity, and 25 percent had metabolic syndrome. These are not gynaecological statistics but cardiometabolic risk factors accumulating silently in millions of Indian women, largely unaddressed.NFHS-6: Women Empowerment Is Rising—But Their Health Data Tell a Different StoryIndian women with PMOS often endure years of diagnostic uncertainty, cycling through multiple specialists and investigations. Since most people in India access outpatient care in the private sector, the financial burden is mostly borne by these women. Nonetheless, these direct costs are likely just the tip of the iceberg. Indirect costs associated with productivity loss owing to absenteeism (missing workdays) and presenteeism (sub-optimal productivity while at work) at school and work among those living with this condition would be substantial. Add to this the social costs associated with psychological distress among those dealing with this difficult condition, whether accessing or foregoing care altogether, and the overall economic and social toll would be stark.A report by the Indian Council of Medical Research (ICMR) on infertility treatment costs found that nearly nine in 10 patients undergoing IVF crossed the WHO threshold for catastrophic health expenditure (spending more than 10 percent of annual household income on health-related costs), with PCOS as the most common underlying diagnosis.With assisted reproductive technologies largely excluded from insurance coverage, the financial toll falls entirely on families. This burden exacerbates the psychological weight of living with a misunderstood condition, with serious implications for quality of life, mental health, and overall well-being.A 2024 multi-centric study in the Indian Journal of Public Health found that awareness programmes were negligible, diagnostic knowledge was lacking, and case documentation in public health facilities was sub-optimal. PMOS does not appear in the National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD) nor in primary health centre screening protocols. It is, in the language of public health, a missing disease—present in vast numbers, but absent from policy. If PMOS is understood as a metabolic and endocrine condition rather than just a reproductive one, it belongs in India's NCD framework, in the conversations at menopause clinics and general medicine OPDs, not just in fertility centres.Did You Know PCOS and Diabetes Have a Connection?There is one dimension of PMOS that almost no one is talking about yet: what happens to women as they move through perimenopause and into menopause? The hormonal transition of midlife, i.e. declining oestrogen, shifting metabolic parameters, heightened cardiovascular vulnerability, does not erase the underlying burden of PMOS. It compounds it. Women who spent their reproductive years with unrecognised insulin resistance, dyslipidemia, and androgen excess enter middle age, carrying an accumulated physiological burden that elevates their collective risk of cardiovascular, cognitive and mental health conditions. Yet, midlife women with PMOS are almost absent from both clinical guidelines and research literature.PMOS, understood as a lifelong metabolic condition, demands a life course approach to care that doesn’t begin and end with the reproductive phase. Women must be followed through adolescence into menopause, and older age, with their cardiometabolic risk actively monitored.A landmark name change in a medical journal does not automatically translate into better care for women in our country. For that, several things must happen.PMOS needs to be formally incorporated into India’s NCD frameworks, including NP-NCD and the National Programme for the Health Care of the Elderly (NPHCE), with screening protocols reflecting its multisystem nature. Primary care providers must be trained to look beyond reproductive manifestations, recognising insulin resistance and cardiometabolic indicators in women who may never have presented with fertility concerns. The health system must be strengthened to absorb this additional load, in terms of workforce, diagnostic capacity, and referral pathways. And awareness must reach women themselves, in languages they speak, through platforms they trust, without reducing this condition to weight, ovarian cysts, or infertility. And research must follow through prospective, longitudinal studies tracking cardiometabolic trajectories of women with PMOS through midlife and beyond.The name has changed. Now the work begins.(Dr Rubina Mulchandani is an early-career researcher at the Indian Institute of Public Health, Delhi. Dr Aashna Mehta is a health economist and Associate Professor, and Professor Jyoti Sharma is the institute’s Director. This is an opinion piece. The views expressed above are the author’s own. The Quint neither endorses nor is responsible for them.)Indian Women Are Talking About Menopause: It's Time Workplaces Listened

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PCOS is Now PMOS: What's in a Name? A Lot Actually

The new name reflects its true multi-organ nature, opening the door to care that most women have never received.

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