Introduction
Polycystic ovary syndrome (PCOS) was so named in 1935 as doctors initially thought of the condition as a disease of ovaries. Since then, research has contradicted this initial finding, instead showing that women who have "PCOS" have an imbalance of mainly two hormones, insulin and the androgen group of hormones. This imbalance causes systemic issues around the body, including metabolic, mental, skin, endocrine, and reproductive health, and increases risk of diabetes and heart disease.
Patients with PCOS instigated the campaign to have the name changed. It was important to acknowledge that they had suffered due to the misnamed syndrome, causing misconceptions, misdiagnosis, stigma, and more. It took more than a decade to finally make it happen, involving 56 medical and patient societies around the world.
Why the name change
The name PCOS is misleading as it defines the syndrome as one that involves cysts on the ovaries, which isn't the case. Professor Colin Duncan of the MRC Centre for Reproductive Health at the University of Edinburgh told The Guardian that this likely "came from when researchers first examined the ovaries of people with the condition and identified the small fluid-filled sacs that are actually follicles, not cysts".
After a transition period, the new name will be fully implemented in the next update to international guidelines for managing the condition, to be published in 2028. The hope is to correct classification, research and policy implications, and health system coding.
What this means for diagnosis
The diagnosis of PCOS/PMOS requires women to have two of three criteria, which are irregular periods, excess androgen (any steroid hormone that regulates male characteristics), and polycystic ovaries. However, many women who do have PCOS don't actually have polycystic ovaries, making this name change essential. The current name reflects dysfunction in only one organ, the ovaries, and fails to capture the full multisystem nature.
The name change helps to decrease confusion from the current name, which has delayed diagnosis and hindered effective communication and treatment plans between patients and healthcare workers.
What this means for management
Women have also been frustrated by how often doctors relied solely on prescription medications instead of consulting on lifestyle interventions, such as diet and exercise. Furthermore, there was stigma and misunderstanding around weight gain for women with PCOS/PMOS. Now by explicitly having the words "endocrine" and "metabolic" in its name, more management and treatment modalities can be highlighted to support multisystemic and holistic healing.
By accurately naming the condition, it also reduces stigma. Reproductive disorders often carry with them significant stigma. In many parts of the world, women's value and worth in society continues to be (wrongly) tied to their reproductive condition. This reduces cultural implications and stigma, and helps women be diagnosed more timely and seek emotional and psychological support.
What this means for fertility treatments
In the past, women with PCOS/PMOS have been told they would not be able to have children. Although true for some, this is not absolute. Healthy ovaries typically develop multiple follicles each month, eventually leading to one reaching maturity and releasing an egg. In women with PCOS/PMOS, these sacs often can’t release an egg due to follicles not fully maturing, meaning ovulation doesn’t occur, making becoming pregnant difficult for some women.
Because of this, many medical professionals may assume that fertility is their main priority, making it difficult to receive other help to manage the condition outside the context of fertility and maternity. Hopefully, the name change will lead to better care and bring greater awareness of PMOS' nuances.
Furthermore, clinicians may be more likely to recognise the condition in patients who present with irregular cycles, hyperandrogenic symptoms, insulin resistance, or weight changes—even before they try to conceive.
Ultimately, by emphasising endocrine–metabolic dysfunction, future guidelines may give more weight to: pre-conception metabolic optimisation (weight, insulin resistance, lipids) before ovulation‑induction or IVF and ongoing cardiometabolic surveillance during and after fertility treatment, not just achieving pregnancy.
