From PCOS to PMOS: A shift in terminology

Following a mutual agreement or worldwide consensus, the known term “Polycystic Ovarian Syndrome” (PCOS) has officially been renamed to “Polyendocrine Metabolic Ovarian Syndrome.”

The underlying pathophysiology, diagnostic criteria, signs and symptoms, and treatment strategies remain identical—only the name has changed to better understand the disorder itself.

Reasons Why the Name Changed:
For years, the term “polycystic ovary syndrome” was thought to be misleading. The shift to “polycystic ovarian syndrome” rectifies several misunderstood concepts.

* The previous name implied that a patient must have ovarian cysts to be diagnosed. Whereas, actually, the “cysts” seen on ultrasound are arrested, immature fluid-filled follicles, and many diagnosed patients never showed the mentioned sonographic feature.
* The term “polyendocrine” shifts the focus from a single organ, i.e., the ovary, to hormonal dysregulation involving areas of the brain like the hypothalamus and pituitary gland. Also, other glands like adrenal glands and ovaries.
* Including the term “metabolic” formally appreciates the role of peripheral insulin resistance, hyperinsulinemia, and visceral adiposity. These drive the cardiometabolic risks, i.e., type 2 diabetes and cardiovascular disease, in the long run.

If we compare the two terms, then it is evident that the diagnostic focus of the new name, PMOS, remains systemic (endocrine, metabolic, ovarian). However, that of PCOS is organ-specific (ovaries/cysts).

Although the name has changed, the management strategy has not shifted.
Treatment continues to be symptomatic. Patients tend to improve by making changes to lifestyle to improve insulin sensitivity. They use combined oral contraceptives for cycle regulation and anti-androgenic effects. Some go for ovulation induction therapies, for example, letrozole for fertility preservation.

By Dr.Ayesha Mughees: Medical Doctor – Registered with PMDC & the Irish Medical Council. Journalist/International Health Reporter at ghanaeducation.org and newsghana24.com