07/27/2026
PCOS is now PMOS: Polymetabolic Ovarian Syndrome.
I actually think this name makes a lot more sense.
For years, we’ve known this condition is about much more than “cysts on the ovaries.” It’s a metabolic condition that can affect insulin resistance, weight, fertility, cardiovascular health, liver health, and so much more.
What’s important to know is that the name has changed, but the way we diagnose it hasn’t.
We still make the diagnosis when 2 of these 3 criteria are present (after ruling out other conditions):
✔️ Irregular or absent ovulation (irregular menstrual cycles)
✔️ Signs of excess androgens—like acne, excess facial/body hair, scalp hair thinning—or elevated testosterone on blood work
✔️ Polycystic ovaries on ultrasound
One point that’s often misunderstood: adolescents do not need an ovarian ultrasound to make the diagnosis. In teenagers, it’s common to see multifollicular ovaries, so we rely on menstrual irregularities and evidence of hyperandrogenism instead.
The lab work may include total and free testosterone (or free androgen index), and sometimes DHEAS or androstenedione. We also check tests like TSH, prolactin, and 17-hydroxyprogesterone to rule out other conditions that can look similar.
For me, the biggest message is this: don’t miss the diagnosis. It’s not just about irregular periods or fertility. Identifying PMOS early gives us the opportunity to address insulin resistance, prediabetes, type 2 diabetes, fatty liver disease, sleep apnea, and future cardiovascular risk—before they become bigger problems.
A new name won’t change the criteria. But hopefully, it will change how seriously we take this condition.
ObesityMedicine InsulinResistance HormoneHealth PreventiveMedicine
