A common hormonal condition that affects over 170 million people globally, with around 44 million in India alone, polycystic ovary syndrome (PCOS) – which was officially renamed polyendocrine metabolic ovary syndrome (PMOS) last week – remains a poorly diagnosed and often ignored health concern among women. From irregular periods to acne, weight gain to facial hair and difficulty getting pregnant, the condition has often been seen through a narrow lens.
But all that could change now. PMOS, say experts, better reflects the condition’s complex, multisystem nature. The shift in medical terminology, which was misunderstood to be “all about ovarian cysts”, also marks an end to a 14-year mission undertaken by a team at Monash University in Melbourne, Australia, to improve diagnosis and care.
Broader understanding
Dr Neelam Suri, senior consultant, obstetrics and gynaecology at Indraprastha Apollo Hospital explains the fallacy in the earlier terminology. “The term ‘polycystic ovary syndrome’ can sometimes create a narrow understanding of the condition by placing emphasis on ovarian cysts, even though many affected women may not have cysts at all. The condition is now increasingly recognised as a broader polyendocrine and metabolic disorder, with features that overlap strongly with metabolic syndrome, including insulin resistance, inflammation, weight regulation, fertility, and long-term cardiovascular health,” she says.
Dr Rakhee Ritesh Sahu, associate director, obstetrics and gynaecology, Dr L H Hiranandani Hospital in Mumbai, further breaks down the new terminology: “PMOS is more accurate because it acknowledges the multisystem involvement in the body. The term polyendocrine includes complex hormonal imbalance like excess androgen levels, hyper-insulinemia and elevated leutenising hormone. ‘Metabolic’ highlights the significant risks of insulin resistance, Type 2 diabetes, and cardiovascular disease, and ‘ovarian’ maintains the link to reproductive health without the misleading ‘cyst’ terminology. This helps both doctors and patients understand that it is not just a gynaecological disorder but an inter-systemic condition,” she says.
The endocrine factor
With the older name, symptoms were sometimes treated in isolation, says Dr Preeti Rastogi, director, obstetrics and gynaecology, Medanta Gurugram. “That can mean the metabolic side of the condition, including insulin resistance, diabetes risk, sleep apnea and lipid abnormalities, is missed. PMOS encourages a more integrated evaluation, so the patient is not treated symptom by symptom alone,” she adds.
Dr Rastogi says, “Diagnosis is often delayed by years. WHO notes that up to 70% of women with PCOS worldwide may not know they have it, and it is often detected only when women struggle to conceive. If untreated, the long-term impact can include infertility, insulin resistance, type 2 diabetes, obesity, endometrial hyperplasia or cancer risk, sleep apnea, and mental-health burden,” she adds. According to Dr David Chandy, director of endocrinology and diabetology at Sir HN Reliance Foundation Hospital, Mumbai, the commonest gap is treating only irregular periods with tablets, without looking at the broader metabolic picture.
“Some patients are told to worry about it only when they want pregnancy. Others are labelled based only on ultrasound,” he says.Dr Chandy explains, “The new name PMOS is more of a holistic and preventive model of care,” says Dr Chandy. Predicting how this will change the way the condition is viewed, he says “Instead of treating only periods or fertility, doctors should assess metabolic risk, screen for diabetes, address lifestyle, manage weight, treat androgen-related symptoms, and plan long-term follow-up.”
Bringing to light others lesser-known risks associated with PMOS, Dr Rupinder Sekhon, principal lead, gynae-oncology and robotic surgery, Apollo Athenaa Women’s Cancer Centres, Delhi, shares, “A recent study published in a prominent gynecologic oncology journal in July 2025 established a correlation between PCOS and the incidence of serous borderline and non-epithelial ovarian tumors. The study reported an incidence rate of 5.4 per 100,000 person-years within the PCOS population.”
She adds that research indicates a heightened propensity for endometriosis among women with PCOS, with studies suggesting a potential association in 5-15% of cases.
Treatment & management
Speaking on how treatments will now shift with this change in terminology, Dr Suri says, “The terminology shift is expected to encourage a more holistic and preventive treatment approach, moving clinicians from symptom-led to systems-led management.” “This allows doctors to personalise treatment plans earlier and address the patient’s full hormonal and metabolic profile before long-term complications develop.” Dr Suri points out “Most patients do not initially seek consultation specifically for PCOS. They usually present with isolated concerns such as acne, difficulty losing weight, irregular periods, thinning hair, fatigue, or fertility-related challenges.
Because these symptoms are frequently addressed in isolation, the underlying hormonal and metabolic connection may not become apparent immediately,” she says. Dr Suri adds that she expects the discourse to further grow, saying. “The terminology change creates an important opportunity to position PMOS as a lifelong hormonal and metabolic condition with long-term cardiometabolic implications, often beginning well before fertility becomes a concern.” According to Dr Rastogi, “We still need better awareness among patients, families, school-age girls, and frontline doctors; we also need more culturally sensitive counselling and less stigma around menstruation, infertility, weight, and appearance. The international guideline specifically emphasises education, awareness, partnership in care, and empowerment, and that same approach should now be extended to PMOS,” she says.
Dr Sekhon adds, “The broader clinical framing also improves early identification of patients at risk of persistent abnormal uterine bleeding, prolonged anovulation, or endometrial pathology. Additionally, patients tend to demonstrate better adherence to lifestyle modifications when they understand that the condition extends beyond fertility or cosmetic symptoms and has significant long-term systemic implications.”
Scene in India
Dr Sahu says, “In India, we face the ‘thin-PCOS’ (now thin-PMOS) phenotype. Many Indian women have high insulin resistance despite having a ‘normal’ BMI. There is a significant divide; urban populations show higher prevalence due to sedentary lifestyles and high-carb diets, but rural women often go undiagnosed due to a lack of screening and the social stigma surrounding menstrual health.” The tests needed for diagnosis are a financial burden for the low socioeconomic strata. Dr Rastogi says, “Within India, the clearest high-risk features are still family history of diabetes or PCOS, central obesity, and early symptom onset, while broader region- or community-specific data remain uneven.”
Disclaimer: The information in this article is for educational and informational purposes only and is not intended as medical advice. While the author has incorporated expert medical guidance while producing the story and ensured full authentic information is provided to the reader, you should always seek the advice of a qualified healthcare provider regarding a medical condition or treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here.