PCOS (now PMOS): polyendocrine metabolic ovarian syndrome

Author: Jessica Lloyd
Senior Naturopath | BHSc(N) | ISSVD, ISSWSH, BSSM, ATMS

Last reviewed: June 8, 2026

In February 2026, polycystic ovarian syndrome (PCOS) had a name change and is now known as polyendocrine metabolic ovarian syndrome (PMOS). The new name better reflects what’s really happening in the body.

PMOS is a set of hormonal and metabolic symptoms occurring due to an underlying metabolic condition: insulin resistance. Insulin resistance, in turn, can result in irregular ovulation due to high androgens or high androgen sensitivity. Androgens are hormones responsible for male-type characteristics.

It is normal for women to have some androgens, which are necessary for oestrogen production, libido, and keeping bones strong. However, in PMOS/PCOS, excess androgens result in symptoms such as acne, male-pattern hair growth (hirsutism), stubborn weight gain, and scalp hair loss.

Excess androgens also interfere with ovulation, making the menstrual cycle irregular, contributing to infertility.¹

If you’ve been diagnosed with PMOS/PCOS, you may have an image in your head that your ovaries are covered in cysts. They are not. The cystic appearance of the ovaries seen in some people with PMOS is caused by many tiny eggs trying to develop at the same time, instead of just one. These follicles cause the ‘cystic’ appearance on ultrasound. They are not true cysts. This is partly why PCOS has a new name.

In PMOS, the hormonal feedback loop needed for ovulation is interrupted, and the developing eggs can’t reach the maturity needed to be released. As a result, people diagnosed with PMOS may not get a menstrual period for long stretches or have irregular cycles.²

Symptoms of PMOS

Other than irregular or infrequent periods, the major signs and symptoms of PMOS include:

Hirsutism: male-pattern hair growth, particularly on the belly, chin, upper lip, chest, back upper arms and inner thighs³
Hair loss: thinning hair or male-pattern scalp hair loss
Acne
Anxiety and stress
Depression
Sugar cravings
Difficulty losing weight
Skin pigmentation (acanthosis nigricans): areas of thicker, darker skin with a velvety texture that tend to occur in body folds such as the neck and groin.⁴
Trouble conceiving
Severe premenstrual syndrome (PMS)

Symptoms and severity vary from person to person, and one person may not have all of the symptoms mentioned above.

The elephant in the room is actually insulin resistance. Poor blood sugar control can have consequences if left untreated. Those with PCOS have a greater risk of developing type 2 diabetes and cardiovascular disease.⁵

Diagnosis of PMOS/PCOS

The Rotterdam criteria is the most commonly used diagnostic tool for PMOS, with two of these three required for a diagnosis:⁶

Lack of ovulation
Excess androgens (seen via hirsutism, male-pattern hair growth, or raised blood androgen levels)
Ovaries have multiple ‘cysts’ (immature follicles)

Other conditions must be excluded for these presentations, including thyroid disorders, congenital adrenal hyperplasia, hyperprolactinaemia, and androgen-secreting tumours.

Long-term risks of PMOS/PCOS

Those with PMOS who experience infrequent periods (<6-8 per year) have an increased risk of endometrial cancer.⁷

People with PCOS have an increased risk of high blood pressure, preeclampsia, and gestational diabetes during pregnancy and should be screened frequently during pregnancy.⁸

References

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