Have we got PCOS all wrong? It’s now called PMOS – Polyendocrine Metabolic Ovarian Syndrome
Here’s what the landmark name change to Polyendocrine Metabolic Ovarian Syndrome means for you – and how to treat the condition
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Turns out we got PCOS – Polycystic Ovary Syndrome – all wrong. And now the condition affecting one in 10 UK women, with symptoms including irregular periods, acne, excess facial, weight gain, fertility issues and hair thinning, has officially been renamed PMOS, Polyendoctrine Metabolic Ovarian Syndrome. Experts argued that previous name did not reflect the true complexity of the condition, as many women had the condition without having ovarian cysts.
PMOS – of which the most common symptoms are irregular periods (and difficulty conceiving as a result), weight gain and excess face or body hair – is now understood to be a complex hormonal and metabolic disorder that can affect the entire body, not just reproductive health.
The National Institute for Health and Care Excellence (NICE) is recommending that the NHS diagnoses PMOS earlier and provides women with better ongoing care and monitoring that includes annual checks.
The name change seems to have happened overnight, but in fact it follows a 14-year international consultation process involving patients, clinicians and healthcare professionals, which was published in the medical journal, The Lancet.
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It is one of the most common hormonal disorders among women of reproductive age and there is no known cure, which makes accurate diagnosis and management key. Yet despite how widespread it is, more than half of those affected may not experience obvious symptoms such as fertility issues. Weight gain is a common symptom but may often put down to simply not being able to lose weight, when in fact the condition is linked to insulin resistance, increased risk of type 2 diabetes, cardiovascular disease, inflammation, and mental health challenges too.
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Laura Dowling, aka The Fabulous Pharmacist on Instagram, hails the change as “big news in women’s health, as the old name PCOS never really reflected what the condition actually was. The old name put far too much emphasis on the ovaries, periods and fertility. In reality this is a whole body condition, which is why the new name contains the word metabolic because we now understand much more about its links with insulin resistance, weight changes, inflammation, type 2 diabetes and cardiovascular risk.”
What is PMOS?
PMOS is caused by a mix of genetic predisposition, chronic inflammation, and insulin resistance. High insulin levels cause the ovaries to produce excess androgens (such as testosterone), which disrupts egg release and triggers symptoms. It most commonly begins around puberty, with symptoms including irregular periods, infertility, acne, thinning hair, excess facial or body hair growth, fatigue, insulin resistance, and weight gain.
Dr Rachel Hines a GP specialising in women’s hormone health, says the new name will help more women access diagnosis and treatment earlier. “It’s an endocrine, which is a hormonal disorder,” she says “it can affect your weight, it can affect mental health, it can affect your skin, it can affect your metabolic systems, the various hormones and the reproductive system as well. Before, it just felt very focused on the ovaries but it’s much wider than that.”
The term Polycystic Ovary Syndrome has long been misleading, she says, because many patients do not actually have cysts on their ovaries.
These small fluid-filled sacs sometimes seen on scans are not true cysts, but immature follicles that have failed to develop properly during ovulation because of hormonal imbalances, which means eggs are not released properly from the ovaries. In fact, the NHS says that having polycystic ovaries is not even required for a diagnosis of PMOS.
What impact will the name change have?
Holistic dietitian Clementine Vaughn says the renaming of Polycystic Ovary Syndrome should mark the beginning of a broader shift in how women’s health conditions are understood and treated not just within the NHS, but across medicine more widely.
“For women’s health as a whole, we need to start appreciating that female-specific conditions are complex,” she said. “Naming them appropriately helps, but beyond that, a name is just a name if we don’t take it further.”
Vaughn argues that conditions including PMOS, menopause and endometriosis affect multiple systems across the body, rather than existing as isolated reproductive issues. “Women’s health is not just one condition and therefore one solution,” she explained. “It’s not simply: ‘You have PCOS, take the pill, and that will solve everything.’”
Instead, she said the condition requires a more individualised and holistic approach.
If I’ve been diagnosed with PCOS, will the NHS still recognise that diagnosis?
The NHS is currently in a three-year implementation process and is rolling out the shift from PCOS to PMOS across clinical guidance and patient-facing information.
The National Institute for Health and Care Excellence (NICE) is expected to adopt the updated terminology in its forthcoming clinical guidelines and has released draft guidance that pushes for women to be diagnosed sooner and monitored more closely. Meanwhile, the NHS website is currently using both PCOS and PMOS interchangeably across literature and patient resources, while updates are made.
An NHS spokesperson said: “We routinely review and update content on the NHS website to ensure it reflects the latest clinical advice and will carefully consider these recommendations.”
How is PMOS diagnosed?
The condition is diagnosed by having two or more of three symptoms: elevated androgen levels (which manifest as acne or excess facial and body hair) irregular or infrequent periods, and polycystic ovaries seen on an ultrasound.
The best ways to manage PMOS
PMOS symptoms can be managed effectively with the right treatment and lifestyle support. Because the condition affects people differently, treatment plans are usually tailored to individual symptoms. Here’s what to try:
Fine-tune your diet
Focusing on nutrition that regulates your blood sugar levels like a fibre rich, whole foods diet that helps with weight loss can significantly improve symptoms such as irregular periods, insulin resistance and fatigue.
Holistic dietician Clementine Vaughn says, “It is important to look at your diet as a whole and focus on a low inflammation diet with lots of healthy fats, lots of lean protein. Women with PMOS have a higher rate of type 2 diabetes so managing your blood sugar spikes is beneficial. PMOS has an inflammatory basis, so think about an anti-inflammatory diet.”
Supplements to support overall health
“Many women with insulin sensitivity can benefit from targeted nutritional support,” says Vaughn. “One supplement I often recommend is inositol, particularly a 40:1 ratio of myo-inositol to D-chiro-inositol, which has been widely studied for supporting hormonal balance and insulin function.
“Vitamin D is also incredibly important, as low levels can contribute to inflammation, fatigue, and low mood. I’d also advise taking a high-quality omega-3 fish oil supplement to support overall health and reduce inflammation.
Women with PMOS often have irregular and/or heavy periods and so are at higher risk of iron deficiency so an iron supplement may be advisable (get your levels checked first though). If you’re a woman with PMOS who is veggie or vegan, so doesn’t get iron from meat sources, this is especially worth keeping an eye on.
Consider your contraception
Hormonal contraception is commonly used to regulate menstrual cycles. Dr Rachel Hines says, “Hormonal contraception can have a variety of benefits when managing the symptoms of PMOS. Hormonal contraception includes the combined oral contraceptive pill (COCP) which contains oestrogen and progesterone, progesterone only methods – pills, injections, implants and a coil/IUD containing progesterone.
She continues: “Menstrual cycles can be irregular in PMOS, and if you use a combined oral contraceptive pill – oestrogen and progesterone – this can regulate your cycle and give a monthly withdrawal bleed.”
“In addition, a risk of having infrequent periods with PMOS is that the lining of the womb (the endometrium) can get thicker which can potentially lead to abnormalities and pre-cancerous cells. Taking the COCP, or progesterone only methods, helps to keep the lining of the womb thin and therefore reduce the risk of developing changes.
“Other benefits from using the COCP is that androgen (male hormones) levels reduce and this can treat acne and also help to reduce extra body hair. The type of COCP can make a difference and it is important to use one that is good for reducing androgenic symptoms, such as Yasmin or Dianette.”
Prescription medicines
Metformin is a commonly prescribed medication used to help regulate and lower blood sugar levels and will help with insulin resistance. Additionally, GLP-1 medications help to mitigate some of the symptoms of PMOS. Whilst GLP-1 medications don’t directly treat PMOS itself, they help with some of its most challenging symptoms, notably helping with weight loss and improving insulin sensitivity (how effectively the body processes blood sugar).
For more a deep dive on GLP-1s and their support for PMOS sufferers, the Hertility Health webinar between Dr Helen O’Neill and consultant gynaecologist Dr Paul Hardiman, who specialises in the condition, is well worth a watch.
