PMOS Awareness Month: the new name for PCOS and a more accurate one

It's PMOS Awareness Month, and this year it comes with a new name attached.

After a 14-year global consensus process published in The Lancet, PCOS is now officially PMOS, Polyendocrine Metabolic Ovarian Syndrome. More than 22,000 people fed into it, including women living with the condition. It isn't a rebrand, it's a correction. 

Here's what it means for the roughly 1 in 8 women and girls in the UK who have it, which is somewhere around 3.1 million people.

Cysts were never the whole story

For decades the name pointed at ovarian cysts and plenty of women with the condition don't have any.

Diagnosis has never actually required them, under the international guideline, it rests on meeting two out of three: irregular or absent ovulation, higher androgen activity either on a blood test or visible in symptoms and polycystic ovaries on a scan or a raised AMH level. Two of those three is enough, in any combination.

So a woman with irregular cycles and raised androgens has always met the criteria with entirely normal-looking ovaries. The old name sent both patients and clinicians looking for the wrong thing, and it's a large part of why diagnosis so often takes years.

None of that changed in May. The criteria are the same ones and the treatment pathway is the same too. What changed is the name and the framing, and the transition runs to 2028, so both names will be in use for a while yet.

Why metabolic is in the new name

The clue to what the consensus was trying to fix is the word in the middle.

Insulin resistance is a common feature. When cells respond poorly to insulin the body produces more of it, and higher circulating insulin encourages the ovaries to produce more androgens while lowering SHBG, the protein that binds testosterone and keeps it out of circulation. Less binding protein and more production means more active testosterone, which is what shows up as irregular cycles, acne, excess hair growth and disrupted ovulation.

Worth being precise here, because it often gets flattened in the retelling. Insulin resistance is a major feature for many women with PMOS, not the cause in all of them. Plenty of women with the condition are lean and insulin-sensitive, and the research is still working out how the pieces fit together. What the new name is saying is that the metabolic side belongs in the diagnosis rather than being treated as a separate problem that happens to turn up alongside it.

The numbers behind that: around 45% of women with the condition have some degree of glucose intolerance, and lifetime risk of type 2 diabetes runs somewhere between two and four times the general population.

It affects more than the ovaries

Which is the other reason the old name fell short.

Energy: Fatigue and afternoon crashes that track with blood sugar rather than with how much sleep you got.

Appetite: Cravings that follow insulin, not willpower.

Mood: Fluctuation tied to both the hormonal and the metabolic side.

Skin and hair: Acne and excess hair growth linked to more active testosterone.

Cycles and fertility: Irregular or absent ovulation and difficulty conceiving.

Long term: Raised cardiometabolic risk, which is why the consensus pushes for metabolic screening at diagnosis rather than years later.

What the change actually does

Not much, immediately. A new name doesn't shorten an NHS waiting list or change what your GP can offer you next week.

What it should do over time is get the metabolic side taken seriously from the start, and get endocrinology and gynaecology looking at the same patient rather than half of her each. For anyone who spent years being told their scan was clear and there was nothing much wrong, that's the point of it.

Verity is the UK charity for PMOS and their site is the right place to start if you want to go further. And if you've been diagnosed and nobody has mentioned metabolic screening, it's worth raising with your GP.

If you're looking for what we stock in this area, our women's health range is here.

Sources

• Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: a multistep global consensus process, The Lancet
• Polyendocrine metabolic ovarian syndrome (PMOS), NHS
• PMOS Guideline and Resources, Monash Centre for Health Research and Implementation
• Verity, the UK PMOS charity

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