PCOS Renamed PMOS: The Long-Overdue Reframe in Women’s Reproductive Health

Jun 11 • Hormones

In a newly published article by The Lancet (2025), the women’s health condition previously known as PCOS (Polycystic Ovary Syndrome) has been formally reclassified as ‘PMOS,’ or Polyendocrine Metabolic Ovarian Syndrome. This name change was the result of a multistep global consensus process, established through the engagement of 56 leading academic, clinical, and patient organizations, and more accurately reflects the disease’s multisystem pathophysiology.

Why is the change from PCOS to PMOS so important?

It was never just about the cysts. The problem with the previous name, Polycystic Ovary Syndrome, is that it placed the pathological burden on ovarian cysts, which not every woman with ‘PCOS’ even experiences, and completely overlooked the diverse endocrine and metabolic features of the condition. This narrow focus was an incredible disservice to millions of women suffering from the disease because it frequently led to delayed diagnosis, fragmented care, and significant stigma around associated symptoms like obesity and hyperandrogenism. Approximately 10% to 13% of reproductive-age women around the world are impacted by PMOS, but an estimated 70% don’t know they have it- often because their symptoms seem unrelated to a reproductive disorder.

The physiological complexity of PMOS results in not just menstrual irregularities and fertility challenges, but also insulin resistance, Type II Diabetes, obesity, cardiovascular disease, sleep apnea, depression, body dysmorphia, and female-pattern baldness. Recognizing that this condition is not limited to the ovaries and expanding the diagnostic criteria is a huge step forward in improving diagnostic accuracy and women’s health care.

Polyendocrine

The condition involves reproductive hormones like estrogen, progesterone, and androgens (testosterone), but is not isolated to those hormones. It also involves metabolic hormones like insulin and neuroendocrine hormones like cortisol, highlighting the strong connection between PMOS and mood disorders like anxiety and depression.

Metabolic

Insulin resistance is a foundational feature of this condition, and influences not just a predisposition to overweight and obesity, but a higher risk for dyslipidemia and cardiovascular disease- emphasizing the cardiometabolic burden of the disease.

Ovarian

Disrupted ovarian function remains a core tenet of PMOS; the emphasis on the presence of ovarian cysts is no longer the feature of focus. Ovarian involvement is more strongly associated with anovulation, irregular cycles, an elevated LH:FSH ratio, and fertility challenges. The key takeaway, however, is that ovarian dysfunction is recognized as part of the story, not the entire of the story.

Diet to Support PMOS

From a dietary perspective, the Mediterranean diet (MD), particularly a low-glycemic version, has been shown to be incredibly beneficial for women with PMOS by supporting insulin sensitivity, reducing the inflammatory load, and providing healthy fats for hormone function/balance. Periodic adherence to a ketogenic diet (KD) is also an excellent strategy for improving insulin response, reducing body weight and even reducing androgen dominance6– however long-term adherence to a KD diet may not be ideal from a mental health and sustainability perspective, so alternating a few months at a time on a KD diet with longer-term adherence to an MD diet provides a sustainable framework for a nutrition foundation grounded in multisystem balance.

Supplements: Herbs and Nutrients to Support PMOS

Myo-inositol

omega-3 fatty acids

Berberine

White peony root

Gymnema

Saw palmetto

Magnesium

and progesterone cream (which is not a supplement but very beneficial)

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PCOS Renamed PMOS: The Long-Overdue Reframe in Women’s Reproductive Health