Polycystic ovary syndrome, or PCOS, is shifting to a new name: polyendocrine metabolic ovarian syndrome, or PMOS. A CMAJ commentary, Polyendocrine metabolic ovarian syndrome: A new name to support better treatment, argues that the old name was framed too narrowly around fertility. The new moniker aims to place metabolic syndrome at the centre of the diagnosis.

Dr. Ginevra Mills, a reproductive endocrinologist in Victoria and author of the commentary, says PMOS is driven by systemic insulin resistance. Historically, PCOS was overly focused on ovarian dysfunction, although the condition can appear without irregular periods. About a third of patients do not have obesity. Symptoms such as hirsutism, acne and dyslipidemia were frequently downplayed. The new term widens the lens to the full suite of symptoms. Treatment is targeted at addressing the root metabolic cause.

Sarah Chambers experienced this narrow emphasis on irregular periods and fertility when she was 16. She says no physician ever discussed her metabolic health, and symptoms such as her persistent weight gain and hair on her face were largely ignored. She believes the new name would have streamlined her journey to diagnosis and would have given her a better understanding of what she was experiencing.

When a patient presents with irregular cycles, hirsutism or unexplained weight gain, physicians should screen for insulin resistance, dyslipidemia and hypertension rather than stopping at cycle control. Treatment should prioritize empathetic management of the underlying metabolic condition.

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