Polycystic Ovarian Syndrome Has a New Name: Here's Why

By James E. Estes, MD, FACOG, Lexington Women’s Care West Columbia

Few diagnoses in women’s health are as common—or as misunderstood—as Polycystic Ovary Syndrome (PCOS). About 8 to 13% of women of childbearing age have it. PCOS is usually seen as a problem with periods, trouble getting pregnant, high levels of certain hormones, and ovaries that look different on an ultrasound.

But the name PCOS is misleading. Many women with PCOS do not have cysts on their ovaries. Some women have ovarian cysts, but do not have PCOS.

Most importantly, PCOS is not just a problem with the ovaries. It affects many parts of the body like hormones, metabolism and the reproductive system.

As our understanding of this disorder continues to evolve, the name of the condition has changed to Polyendocrine Metabolic Ovarian Syndrome (PMOS) to more accurately reflect all the body systems it effects.

The Problem with “Polycystic Ovary Syndrome”

The term PCOS was developed during a time when the structure of the ovaries was the most visible feature of the disorder. Today, however, we recognize several shortcomings in the name.

1) The “cysts” are not true cysts. The ovarian structures seen on an ultrasound are not really cysts. They are small, undeveloped eggs. Calling them cysts has confused people and made some women worry for no reason.

2) Not all women with PCOS have polycystic ovaries. Some women are told they have PCOS even if their ovaries look normal. Others may have ovaries that look like PCOS but do not have the other health problems that come with it.

The Name Ignores the Endocrine Nature of the Disorder

PCOS changes how different hormones work in the body, including:

• Androgen production
• Insulin regulation
• Gonadotropin secretion
• Ovarian hormone function
• Metabolic signaling pathways

Focusing only on the ovaries ignores the hormonal issues throughout the body.

The Metabolic Component is Overlooked

The name PCOS also does not address metabolic health risks, including:

• Insulin resistance
• Prediabetes and type 2 diabetes
• Obesity
• Dyslipidemia
• Increased cardiovascular risk

These long-term health problems have a greater impact on one’s overall health than the ovarian differences that originally gave the syndrome its name.

Why PMOS?

The new name, Polyendocrine Metabolic Ovarian Syndrome (PMOS), explains the scope of the condition better.

Polyendocrine
PMOS is a disorder involving multiple endocrine systems, which release hormones throughout the body. PMOS is a disorder that affects many hormone systems in the body. It changes how the body uses insulin, makes certain hormones, how the brain coordinates the hormones systems and how the ovaries function.

"Polyendocrine" means PMOS is not just about the ovaries. It also involves many hormones throughout the body.

Metabolic
Problems with metabolism are now known to be a major part of PMOS, not just a side effect.

Many women with PMOS do not process their natural insulin normally, even if they are not overweight. This can lead to higher male hormone levels, problems with periods, and a higher risk for diabetes and heart disease.

Adding "metabolic" to the name shows that it is important to treat these health risks early.

Ovarian
Even though PMOS affects more than the ovaries, problems with periods, trouble getting pregnant, and the structure of the ovaries are still important signs.

Keeping the word "ovarian" in the name is important because these problems are often what bring women to see a doctor.

Syndrome
There is not just one sign of PMOS. Different women can have a range of symptoms and health problems from PMOS.

Calling it a "syndrome" shows that it can look different in each person.

Benefits of a Name Change

• Improved patient understanding. Many women think PCOS only means having cysts in the ovaries. The new name, which includes the issues with hormones and metabolism, explains the real problem better.
• Greater focus on long-term health. By focusing on metabolism, PMOS helps patients and doctors pay attention to heart health, blood sugar, and diabetes risk, as well as periods and getting pregnant.
• Better alignment with current science. Medical names should change as we learn more. PMOS is a better name because it matches what scientists now know about PMOS.
• More comprehensive care. 

Care for PMOS should include:

• Nutritional counseling
• Weight management
• Exercise interventions
• Diabetes prevention
• Cardiovascular risk reduction
• Reproductive and fertility care

What Changes for Patients?

Changing the name does not change how doctors find or treat PMOS. Women with PMOS would still get the same care and advice.

The new name helps people understand that PMOS is about hormones and metabolism, not just the ovaries. This helps women better understand their health now and in the future.


James E. Estes, MD, FACOG, Lexington Women’s Care West Columbia