Polycystic Ovarian Syndrome (PCOS) has a new name that better reflects the multi-system, multi-causal nature of this condition. It’s now: Polyendocrine Metabolic Ovarian Syndrome (PMOS). Read on to discover the hallmark features, causes and a bit of history on what is the most common hormonal condition affecting women.
Historically the name ‘Polycystic Ovarian Syndrome [PCOS]’ tended to suggest it was a condition of the ovary or a reproductive disease. However, this condition produces a significant disease burden that spans multiple body systems. It’s a multi-system, multi-causal condition. If you’re reading this now and you have a PCOS diagnosis (or a suspicion that you might have it), it’s possible that the conventional treatments you’ve been offered seem a little simplistic and symptom driven. Perhaps they only mask the symptoms by suppressing the menstrual cycle (the oral contraceptive) or lowering androgens (anti-androgenic drugs). Truth is, PCOS is a complex condition to treat no matter what paradigm you’re coming from (medical or not).
The pathogenesis of PCOS has been somewhat mysterious to the health profession and symptoms vary between individuals. Initially, evidence of ovarian sclerotic changes was reported as early as 1844 by Chereau, and a seminal paper was published in 1935 by Stein and Leventhal. This was followed by associations with hormonal markers such as elevated Luteinising hormone (LH) around 1958, insulin resistance in 1976 and ultrasound identification of ovarian cysts in 1981 (Homburg, 1996).
For many years now researchers and health practitioners have been calling for a more integrated model of treatment for PCOS to help make diagnosis and treatment more speedy and efficacious. They’ve also been calling for rename. The rename will benefit future PCOS patients. The essence of PCOS is metabolic, even though there’s been a strong focus on its anti-fertility and anovulatory effects. This is one result of the former name, PCOS.
I’ve been working with women with PCOS for two decades now and had many a conversation with fellow practitioners around the inaccuracy of the name ‘polycystic ovarian syndrome’. Yes it may be a women’s condition, but that doesn’t mean it’s simply a reproductive pathology. A dysregulated neuroendocrine system featuring altered insulin function, hormone changes (androgens in particular) and abnormalities in levels and regulation of neuropeptides like kisspeptin underlie PCOS (Szeliga et al., 2022). This is why it is important to choose a name that reflects the diverse factors that drive this multi-system condition.
Neuroendocrine = the interaction between the nervous system, it’s signalling and hormone secretion.
Prof. Helena Teede of our own Monash University (VIC) and team explained the name change and provided the context for why this was important in a paper published in The Lancet on May12th 2026 (Teede et al., 2026). The new name is Polyendocrine Metabolic Ovarian Syndrome (PMOS). It better represents the metabolic essence and complexity of this condition. Hopefully this will lead to more investment and research into PMOS and make it more of a research priority than it currently is. At the moment, international guidelines for PMOS are constrained by low quality evidence (Channon et al., 2026). We’re now set on a path for a three year transition phase to implement this new name.
How common is PMOS (formerly PCOS)?
PMOS affects around 1 in 5 women globally (20% prevalence) and is the most common hormonal condition affecting women during their fertile years. This equates to over 170 million women worldwide (Teede et al., 2026). It would seem from statistics that PMOS affects more women than endometriosis and fibroids combined. Endometriosis affects up to 9.2% of Australian women (Australian Institute of Health and Welfare [AIHW], 2023) and 10% of women globally (World Health Organisation [WHO], 2025). Fibroids affect 7.3% of Australian women (Wilson et al., 2024) and there is a lack of similar studies to provide statistics on a global scale for fibroids (Wu et al., 2025). However, there is some variability in the numbers from different publications.
How is PMOS (formerly ‘PCOS’) diagnosed?
According to international guidelines, adults over the age of 20 years must have two of the following three symptoms to be diagnosed with PMOS:
- Oligo-anovulation (ovulation and/or periods are irregular, or there is a lack of ovulation)
- Hyperandrogenism (androgen levels are high in lab studies, or there are clinical features of high androgens such as acne)
- Polycystic ovaries detected by ultrasound or high anti-Müllerian hormone (AMH) levels
Adolescents between the ages of 10 and 19 years must have the presence of both of these symptoms to be diagnosed with PMOS:
- Oligo-anovulation
- Hyperandrogenism (clinical or biochemical)
(Teede et al., 2026)
The diagnosis needs to be made by a health professional.
Why was PCOS renamed as PMOS?
In short, Prof. Teede suggests the name change will benefit PCOS/PMOS patients, improve commitment to scientific research into the condition, encourage a better understanding of it culturally and dampen down some of the stigma associated with ‘PCOS’ (Endocrine Society, 2026)
The former name ‘PCOS’ has generated several limitations for health practitioners as well as patients. It did not align well with diagnostic criteria which has been evolving over decades. This made diagnosis challenging. A 2024 study found more than half of the female participants found it difficult to confirm their PCOS diagnosis (Al Wattar et al., 2024). Due to the name, there was an assumption that there must be ovarian cysts (or some ovarian abnormality) present for a diagnosis of PCOS to be made. Now, with the new name, the diagnostic criteria will match the diagnostic markers more accurately. This will speed up diagnosis and provide women with the treatment they deserve more efficiently.
The former name also restricted the conversation around the condition to the reproductive system, rather than seeing it as a blend of endocrine and metabolic factors. The endocrine system is incredibly complex and vast in its effects in the body. Hormones carry messages throughout your body, influencing your ovaries, pancreas, thyroid, liver, gut and your fat tissues too. The term ‘polyendocrine’ reveals the many faces of PMOS when it comes to what this disease ‘looks like’. It will produce a range of symptoms depending on which organs and hormones are affected. There are also cognitive features such as changes to attention and executive function (Dokras, 2025).
The science on PMOS is growing. We’re now aware of several causal factors including genetics (higher risk if your female relatives have PMOS) and variations in mitochondrial DNA (mtDNA) with impaired biogenesis and function of mitochondria in ovarian tissues (Finsterer, 2023). Overweight and obesity contribute to PMOS, and losing weight can be challenging if insulin resistance is present. Insulin resistance is present in 75% of PMOS patients (Szkodziak et al., 2025).
What are the symptoms of PMOS (formerly PCOS)?
The symptom picture of PMOS is a multi-system one. Many organs are affected by changes in endocrine function? Lots of people think of acne as a PMOS symptom, which is a good indicator of how changes in hormones like androgens affect our skin (an organ). Here’s a list of some of the more common symptoms in PMOS.
Metabolic symptoms and associated conditions
What’s affected: Hormones regulate metabolism, and there are several of them. Many women are unaware that thyroid hormones are important for weight management, and that levels of hunger/satiety hormones (ghrelin/leptin) start to rise in midlife. Thyroid function may be affected which could change metabolic rate, growth and development, memory and energy.
Insulin is a critical hormone in energy, appetite, blood glucose control and maintaining healthy body composition. Management of adipose (fat) tissue is altered which can cause changes in energy storage, inflammation, appetite and metabolic rate change. One recent study revealed there was a relationship between BMI, irritability, insulin and depression in women with PMOS (Asik et al., 2015). It’s possible that if you have PMOS, you will have clusters of symptoms like these.
Since 2023, PMOS is a recognised “CVD risk-enhancing condition” that may increase the risk of stroke and myocardial infarction (Dokras, 2025). There are also studies looking at the role of PMOS in microbiome health. The gut-PMOS axis model proposes that gut dysbiosis mainly caused by intestinal permeability (leaky gut) causes a flow on effect of inflammation and toxicity, compromising insulin and ovarian function.
Symptoms you might see:
- Type 2 diabetes (NIDDM)
- High blood pressure (Hypertension)
- High cholesterol, high/imbalanced lipid levels (Dyslipidaemia)
- Obesity
- Higher BMI (Body-Mass-Index) than women without PMOS
- Altered glucose levels (Dysglycaemia), impaired glucose tolerance
- Liver disease (Metabolic associated fatty liver disease [MAFLD])
- Sleep apnoea
(Teede et al., 2026)
Reproductive symptoms and associated conditions
What’s affected: The menstrual cycle and ovulatory function are the primary areas affected and this can lead to issues with fertility or cause impaired fertility. Infertility due to lack of ovulation (anovulatory infertility) is a common health issue associated with PMOS. Beyond this, simply having any change to the menstrual cycle can generate persisting problems like chronic bloating, long term mood change, emotional sensitivity, irritability, chronic acne.
Anti-Müllerian Hormone (AMH) levels may be increased in PMOS, reflecting a larger number of early and intermediate egg follicles (antral follicles) in the ovaries (Dokras, 2025). In contrast, AMH levels will be low around menopause with the marked decrease in ovarian activity at that stage of life. Higher AMH was one of the three diagnostic criteria, and it’s thought that it participates in the development of PMOS as a neuroactive hormone (Dokras, 2025).
Symptoms you might see:
- Ovulatory problems (no ovulation [anovulation], sporadic or irregular ovulation [oligo-anovulation])
- Low progesterone (as a result of not ovulating)
- Elevated anti-müllerian hormone (AMH)
- Irregular menstrual cycles (Oligomenorrhoea)
- Infertility, impaired fertility, issues during pregnancy
- Endometrial cancer where the uterus is exposed to chronically high levels of oestrogen.
(Teede et al., 2026)
- Oestrone (E1) may be elevated (Li et al., 2019)
- Luteinising hormone (LH) may be elevated (Li et al., 2019)
- The ratio of Luteinising hormone to Follicle stimulating hormone (FSH) may be imbalanced (Li et al., 2019)
- Endometrial dysfunction may be present and cause thickening of the endometrial lining of the uterus, or difficulties with embryo implantation (Li et al., 2019)
- Sex Hormone Binding Globulin may be low causing higher bioavailability of pathogenic hormones. (Szybiak-Skora et al., 2025) This is possibly due to higher fat levels in the liver (as opposed to high BMI or insulin resistance as previously thought) (Simó et al., 2015)
Psychological symptoms and associated conditions
What’s affected: The combination of multiple symptoms including changes in body weight and skin, cardiovascular disease and liver health all contribute to a significant psychological burden with PMOS. Other known causes of mental health conditions in women with this condition are obesity, anxiety around food, use of long-term oral contraceptives and finances. Over 50% of women with PMOS have at least one mental disorder (Hasan et al., 2022)
Often lifestyle changes are recommended to manage PMOS, which makes sense. Changing diet and improving exercise and quality of life tends to have a positive effect on hormonal health, mood and nutrition. Success on this front though, requires a good level of confidence in one’s ability to meet those lifestyle goals and take them on (self efficacy). This is something that is often ignored in biomedical treatment (Farajzadegan et al., 2023). Some women with PMOS will find the required diet and lifestyle requirements daunting or difficult, and should be lovingly supported through that. This is where herbal medicines and step-by-step nutritional programs really shine.
Symptoms you might see:
- Poor focus, low self-esteem (Pinto et al., 2024)
- Irritability (Asik et al., 2015)
- Loneliness (71% of PMOS women affected)
- Mood change, low/flat mood, depression (60% of PMOS women affected)
- Generalised anxiety (88% of PMOS women affected)
- Eating disorders
(Teede et al., 2026)
Dermatological (skin) symptoms and associated conditions
What’s affected: Our skin is affected by our hormones, particularly androgens. For women with high testosterone or high androgens (hyperandrogenism) in combination with insulin resistance, this can lead to oily skin, acne, facial hair and loss of hair on the head. Acne tends to affect hormonal zones of the face (chin, jawline, upper neck).
Symptoms you might see:
- Acne
- Hair loss (Alopecia)
- Hair growth around the chin, neck, shoulders (Hirsuitism)
(Teede et al., 2026)
And finally, researchers have found links between PMOS and the microbiome. PMOS is linked to lower number of gut species and their proportion at one particular sampling site (low alpha-diversity). Certain gut bacteria species are altered in women with PMOS including Bacteroidaceae, Bacteroides, Prevotella, Lactobacillus and Escherichia/Shigella (Guo et al., n.d.)
This is one benefit to PMOS…
Women with PMOS are more likely to enter menopause later with midlife symptoms beginning later than the mid-40s. If you have a PMOS diagnosis, you may have a lower frequency of hot flushes and sleep disruption in midlife. Mental fog, irritability and vaginal dryness don’t appear to differ between women with PMOS and women without PMOS (Lavi et al., 2026).
Summing up…
PMOS is a condition that requires awareness of the cross-talk that goes on beneath the surface between hormones within the endocrine system. Deviations in normal endocrine function have far reaching effects in the body and the symptoms are broader than ‘reproductive’ issues. It’s the most common endocrine condition affecting women in their reproductive years, and for too long women have been left in the dark about the causes, symptoms and options for management.
I hope this was helpful to anyone affected by PMOS. It appears that there is some strong movement in research into this condition, in large part thanks to Prof. Teede along with fellow researchers in the Netherlands and London for this name change.
If you would like to work on your PMOS, or if you have some hormone irregularity that you’d like to get more clarity on, consider booking in for a consultation with me. This could be the first step in decoding what’s happening beneath the surface in your body, and taking charge of your health.
Take care of your beautiful self,
To cite this article (APA 7th) use: Sze, S. (2026, May 16) Polyendocrine Metabolic Ovarian Syndrome (PMOS) – A multi-system, multi-cause condition. https://www.herbalwell.com.au/pmos/
Sources that informed this article have been carefully selected to provide high quality evidence and insight. All sources are a SCImago ranking of Q1. None feature in predatory journals.
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