You may be familiar with PCOS, but what about PMOS?

Polycystic ovary syndrome (PCOS) is being renamed polyendocrine metabolic ovarian syndrome (PMOS). The condition itself hasn’t changed, but the new name reflects a much better understanding of what it actually is: a complex condition that can affect far more than the ovaries.

It can influence periods and fertility, but also hair and skin, metabolism, cardiovascular health and emotional wellbeing. And with around one in ten women thought to be affected – potentially as many as one in eight because some remain undiagnosed – understanding it matters.

In this Henpicked Lunch & Learn, Sally Leech, Co-Founder and Director of Henpicked, led the conversation on PMOS, joined by Dr Emma Sloan of Dr Morton’s Women’s Health Service, a medical specialist with extensive experience in hormone health and weight management. Facilitated by Deborah Garlick, they explored why PCOS is becoming PMOS, what the change tells us about our growing understanding of the condition, the signs and symptoms to look out for, diagnosis and treatment and how people can advocate for the support they need. 

Why is PCOS changing its name to PMOS?

Sally Leech: Let’s start with the name change. Lots of people will be familiar with PCOS, so what does PMOS mean and why is the terminology changing?

Dr Emma Sloan: Firstly, it’s important to reassure anyone who has previously been diagnosed with PCOS that their condition hasn’t changed. It is the same condition – it has simply been renamed.

PCOS stands for polycystic ovary syndrome, but that name is actually quite misleading. It frames the condition around the ovaries and suggests there are cysts in the ovaries. They aren’t actually cysts. They are underdeveloped follicles containing eggs which have been halted during their development.

And some women with PMOS don’t have these follicles visible on an ultrasound at all.

We now understand that this condition is much broader than the ovaries. It can involve hormone production, ovulation, metabolism, skin and hair, fertility, emotional wellbeing and longer-term health.

That’s why polyendocrine metabolic ovarian syndrome – PMOS – better reflects our understanding of what is happening across the whole body. 

What are the signs and symptoms of PMOS?

Sally Leech: That whole-body aspect feels really important because PMOS can affect people in so many different ways. What are some of the main signs and symptoms to look out for?

Dr Emma Sloan: One of the most important things to understand is that PMOS can look very different from one woman to another.

Some women live in a leaner body and others in a larger body. Some experience irregular periods and others don’t. There isn’t one particular picture of someone with PMOS.

There can be reproductive symptoms, including irregular periods, periods that are spaced further apart, missed periods or no periods at all. Some women may experience fertility difficulties and, for some, that is actually the first point at which PMOS is identified.

There can also be hair and skin changes, including unwanted facial or body hair, acne and thinning hair.

Then there is the metabolic aspect, which is such an important reason for the change in name. This can include insulin resistance, high blood pressure, changes in cholesterol, fatty liver and sleep apnoea. There can also be longer-term implications for cardiovascular health and type 2 diabetes.

And we shouldn’t overlook emotional wellbeing. Living with these symptoms can have a significant impact on mood and anxiety too. 

How is PMOS diagnosed?

Sally Leech: This is clearly a complex condition, so how is PMOS actually diagnosed?

Dr Emma Sloan: Diagnosis looks at three main criteria and a woman needs to meet two out of the three.

The first is irregular or infrequent periods.

The second is evidence of higher androgen levels. This can be identified through blood tests or through signs of higher testosterone, such as excessive facial or body hair.

The third is the characteristic appearance of follicles on the ovaries on an ultrasound.

So it’s really important to understand that you do not have to have follicles visible on an ultrasound to have PMOS.

That is another reason why the change in terminology is helpful. It moves us away from the idea that this is simply about what the ovaries look like. 

What can help manage PMOS?

Sally Leech: Once someone has a diagnosis, what are some of the approaches that can help them manage their symptoms?

Dr Emma Sloan: Treatment needs to be individual because women experience PMOS very differently.

Nutrition, exercise and sleep can all be important. We want to look at good overall nutrition, including enough fibre, protein and healthy fats. Exercise can be particularly helpful for metabolic health and insulin resistance, including resistance exercise and weights.

But there are also medical treatments depending on someone’s individual symptoms.

The contraceptive pill can be helpful for regulating periods and may also help with excess hair. There are anti-androgen treatments that can be considered for symptoms such as acne and unwanted hair.

Metformin can also be used where insulin resistance is part of the picture and can help with period regulation as well as metabolic health.

The important point is that treatment should reflect the individual woman and her particular signs and symptoms. It isn’t simply a case of giving everyone the pill. 

Why “just lose weight” isn’t good enough

Sally Leech: One of the things we hear a lot from people living with PMOS is how difficult weight management can be. Yet so many people have simply been told, “You need to lose weight.”

That can feel incredibly dismissive when the condition itself may be making weight management much harder.

Dr Emma Sloan: Absolutely. We need much more understanding and empathy around this.

Weight management can make a difference for some women with PMOS, but it isn’t as simple as telling somebody to lose weight when their body may be working against them.

And equally importantly, not every woman with PMOS lives in a larger body.

Women in leaner bodies can have PMOS too and sometimes their diagnosis can actually be missed because of the misconception that everybody with the condition will struggle with their weight.

There is no one-size-fits-all picture of PMOS. 

What about GLP-1 weight management medication?

Sally Leech: We had lots of questions about GLP-1 weight management medications. Do we know yet whether they could become part of the treatment for PMOS?

Dr Emma Sloan: GLP-1 medications are not currently licensed specifically for treating PMOS.

They are used for weight management and, for eligible women, weight loss may indirectly improve aspects of PMOS, including period regularity and hormonal balance.

We know that losing around five per cent of body weight can make a significant difference to period regularity and hormonal balance for some women.

But we don’t yet have the data to use GLP-1 medications as a specific PMOS treatment. It is an area to watch as the evidence develops.

Sally Leech: And it’s important to underline that weight loss isn’t relevant to everyone with PMOS. We had people in the session saying, quite rightly, that they didn’t have five per cent of their body weight to lose.

That comes back to the fact that everyone’s experience is different and treatment needs to reflect the individual, rather than assuming there is one route that works for everyone. 

How can you get more from an appointment with your GP?

Sally Leech: We’ve had lots of people sharing how difficult it has been to get help – feeling dismissed, going back several times or waiting a long time for a diagnosis. What advice would you give someone who is trying to get the right support?

Dr Emma Sloan: GPs are incredibly stretched, so preparation can really help you make the most of your appointment.

While you’re waiting, write down your symptoms. Think about what you really need to ask and go into the consultation focused on those questions.

They might be as simple as:

• Could my symptoms be PMOS?

• Can you help me get a diagnosis?

• What treatment or support is available to me?

And ask for a follow-up appointment if you need one.

You can also take somebody with you if having that support will help you find your voice and make sure you cover what matters to you.

It’s about making those precious minutes with your healthcare professional work as well as possible. 

Do you have PMOS for life?

Deborah Garlick: I’ve been watching the conversation in the chat and there are so many people recognising things in what you’re describing.

There’s one very straightforward question I wanted to ask: do you have PMOS for life?

Dr Emma Sloan: Yes.

Some aspects will change throughout life. When someone reaches menopause, periods and fertility are obviously no longer presenting in the same way, but the metabolic and wider health aspects of PMOS don’t simply disappear.

That’s why ongoing health monitoring is important.

And this isn’t about frightening people. Having PMOS doesn’t mean you will experience every possible health problem.

Understanding the condition gives us an opportunity to diagnose it, manage it better, provide preventative care and match treatments to an individual’s symptoms rather than taking a one-size-fits-all approach. 

PMOS or perimenopause?

Deborah Garlick: Something else that came through strongly in the chat was people saying, “This sounds like perimenopause.”

How do PMOS and perimenopause fit together?

Dr Emma Sloan: PMOS usually begins much earlier in life, whereas perimenopause typically happens later.

But of course, someone who has PMOS will eventually reach perimenopause too. So the two can exist together and their effects can amplify one another.

The important distinction is that PMOS spans a woman’s life. Perimenopause is a particular stage within that life. 

Why does the name change matter so much?

Deborah Garlick: I think one of the things that has struck all of us during this conversation is just how many people are recognising their own experiences in what you’re saying.

We’ve had people who have struggled for years to get a diagnosis, people who haven’t felt heard and people suddenly wondering whether symptoms they have lived with for years might be connected.

One person in the chat said, “I certainly feel not so alone.”

And that feels incredibly important.

Dr Emma Sloan: It is. This new terminology is an opportunity for women to understand the condition better, but also for healthcare professionals to understand it better.

PMOS doesn’t look the same in every woman. You won’t necessarily tick every box and there is no one-size-fits-all experience.

The more we understand that, the better chance we have of women being diagnosed and supported appropriately. 

What to remember about PMOS

The move from polycystic ovary syndrome (PCOS) to polyendocrine metabolic ovarian syndrome (PMOS) is much more than a change of name.

It reflects a fundamental shift in how the condition is understood: not simply as something affecting the ovaries, but as something that can affect multiple systems throughout the body.

If you have previously been diagnosed with PCOS, your condition hasn’t changed because the name has changed.

And if you’re recognising some of these experiences for the first time, it may be worth keeping a record of your symptoms and talking to your GP or healthcare professional.

Most importantly, PMOS looks different for different people. You don’t have to fit a particular body type, experience every symptom or have follicles visible on an ultrasound.

As the discussion during this Lunch & Learn showed, simply understanding that can be powerful – helping people recognise what they are experiencing, advocate for themselves and know that they are not alone.