PMOS Is the New PCOS: Why the Name Change Matters
The decision to officially rename polycystic ovary syndrome (PCOS) as polyendocrine metabolic ovarian syndrome (PMOS) marks a significant shift in how this common condition is understood and discussed. Published on May 12, 2026, a landmark Lancet paper1 led by an international consortium recognised that the previous terminology was scientifically inaccurate and clinically limiting.
Retiring the Old Name
The term PCOS has been criticised for years, with much of the debate centred on ovarian appearance on ultrasound. In PCOS, women commonly present with an increased number of small antral follicles rather than true pathological ovarian cysts. However, the condition’s name has long reinforced the misconception that ovarian cysts are essential for diagnosis. This may contribute to delayed diagnosis, with up to 70% of affected individuals reportedly remaining undiagnosed. Despite this, International Guidelines require only two of the following criteria to be met for diagnosis, after exclusion of other disorders:
• Oligo-anovulation
• Clinical or biochemical hyperandrogenism
• Polycystic ovaries on ultrasound or elevated anti-Mullerian hormone (AMH)
Importantly, this means that not all women with the condition demonstrate polycystic ovarian morphology. Considering the condition affects more than 170 million women globally, the misleading terminology has likely contributed to widespread knowledge gaps, diagnostic confusion and patient dissatisfaction.
How PMOS Paves the Way
The newly adopted name, PMOS, intentionally incorporates the terms “polyendocrine” and “metabolic” to better reflect the syndrome’s complex multisystem pathophysiology. Rather than framing the disorder primarily as a reproductive condition involving ovarian cysts, the new terminology acknowledges the broader endocrine and metabolic dysfunction underpinning the presentation. Insulin resistance plays a central role and contributes to androgen excess. Together with low-grade inflammation, altered adipokine signalling and sympathetic nervous system (SNS) dysregulation, this drives metabolic dysfunction in PMOS and is associated with a range of cardiometabolic complications. Reproductive features – including ovulatory disturbances, irregular menstrual cycles, and infertility – support the inclusion of “ovarian” within the name. While psychological (e.g. depression) and dermatological (e.g. acne and hirsutism) remain important aspects of the condition, they are generally considered downstream manifestations of the underlying endocrine-metabolic dysfunction.
The renaming process itself was extensive and globally collaborative. Following on from an earlier survey (n=7708) that found 85.6% of patients and 76.1% of health professionals agreed that the name should be changed,2 the Lancet paper describes a rigorous, multistep consensus process involving 56 leading academic, clinical and patient organisations, along with feedback from more than 14,000 patients and multidisciplinary health professionals worldwide. Principles guiding the name change included scientific accuracy, clarity, stigma avoidance, cultural appropriateness, and feasibility of implementation. Transition to the new name will take place over a three-year period, with integration planned for the 2028 update of the International Guidelines. Overall goals include better awareness, diagnosis, care quality and patient satisfaction, and outcomes across the broad features of the condition now called PMOS.
What Practitioners Already Knew
For natural medicine practitioners, this development is particularly important because it aligns more closely with the holistic and systems-based understanding that many clinicians have long applied to the condition. The name PMOS provides stronger justification for healthcare practitioners to lead with an endocrine-metabolic approach to management, rather than a narrow reproductive focus. Outside of pharmacological management and exercise,3 the list of key herbs and nutrients indicated for PMOS includes:
• Alpha-lipoic acid (ALA) and inositol together, with evidence for improvement in those with insulin resistance and poor ovarian function, including those undergoing in vitro fertilisation (IVF)4-6
• Mineral supplements, specifically magnesium, chromium, zinc, and selenium, for improving insulin sensitivity, metabolic parameters, inflammation, and oxidative stress7,8
• Carnitine, able to support weight loss and reduce insulin resistance9,10
• Vitamin D, shown to reduce insulin resistance, inflammation, total testosterone, and potentially lipid levels11-13
• Coenzyme Q10 (CoQ10) for improving insulin sensitivity, testosterone levels and lipid profile14
• Vitex agnus-castus (Chaste Tree) for normalising menstrual cycle duration; improving menstrual frequency; and reducing dehydroepiandrosterone sulfate (DHEA-S) levels, oxidative stress and insulin resistance15,16
• Cinnamon spp. for reducing insulin resistance,17,18 and improving menstrual cycle frequency and ovulation,19 antioxidant status and lipid profile.20 A randomised, controlled trial in 122 overweight women with PMOS combined lifestyle intervention (diet modification and exercise) with extracts from Cinnamomum verum (Cinnamon), Glycyrrhiza glabra (Licorice), Paeonia lactiflora (Paeonia), Hypericum perforatum (St John’s Wort), and Tribulus terrestris (Tribulus). A significant reduction in oligomenorrhoea compared with controls was reported, alongside other significant improvements in body weight, body mass index (BMI), waist circumference, fasting insulin, luteinising hormone (LH), blood pressure, quality of life, psychological morbidity (depression, anxiety and stress scores), and conception rates.21
Ultimately, the transition from PCOS to PMOS reflects a more accurate understanding of the condition’s multisystem nature. This change could facilitate earlier diagnosis, broader therapeutic strategies and improved patient outcomes.
References
1. Teede HJ, Khomami MB, Morman R, Laven JSE, Joham AE, Costello MF, et al. Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: a multistep global consensus process. Lancet. 2026 May:S0140-6736(26)00717-8. DOI: 10.1016/S0140-6736(26)00717-8
2. Teede HJ, Moran LJ, Morman R, Gibson M, Dokras A, Berry L, et al. Polycystic ovary syndrome perspectives from patients and health professionals on clinical features, current name, and renaming: a longitudinal international online survey. EClinicalMedicine. 2025 May;84:103287. DOI: 10.1016/j.eclinm.2025.103287
3. Shukla A, Rasquin LI, Anastasopoulou C. Polycystic ovarian syndrome [Internet]. Treasure Island: StatPearls; 2025 [cited 2026 May 27]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459251/
4. Fruzzetti F, Capozzi A, Canu A, Lello S. Treatment with D-chiro-inositol and alpha lipoic acid in the management of polycystic ovary syndrome. Gynecol Endocrinol. 2019 Jun;35(6):506-510. DOI: 10.1080/09513590.2018.1540573
5. Rago R, Marcucci I, Leto G, Caponecchia L, Salacone P, Bonanni P, et al. Effect of myo-inositol and alpha-lipoic acid on oocyte quality in polycystic ovary syndrome non-obese women undergoing in vitro fertilization: a pilot study. J Biol Regul Homeost Agents. 2015;29(4):913-923.
6. Cianci A, Panella M, Fichera M, Falduzzi C, Bartolo M, Caruso S. D-chiro-Inositol and alpha lipoic acid treatment of metabolic and menses disorders in women with PCOS. Gynecol Endocrinol. 2015 Jun;31(6):483-486. DOI: 10.3109/09513590.2015.1014784
7. Ye J, Cen S, Qi Q, Wang C, Wang J, Wang J, et al. Effectiveness of mineral supplements (magnesium, chromium, zinc, selenium, chromium picolinate) in reducing insulin resistance in polycystic ovary syndrome: a meta-analysis of randomized controlled trials. BMC Endocr Disord. 2026 Jan;26(1):74. DOI: 10.1186/s12902-025-02158-x
8. ElObeid T, Awad MO, Ganji V, Moawad J. The impact of mineral supplementation on polycystic ovarian syndrome. Metabolites. 2022 Apr;12(4):338. DOI: 10.3390/metabo12040338
9. Sangouni AA, Pakravanfar F, Ghadiri-Anari A, Nadjarzadeh A, Fallahzadeh H, Hosseinzadeh M. The effect of L-carnitine supplementation on insulin resistance, sex hormone-binding globulin and lipid profile in overweight/obese women with polycystic ovary syndrome: a randomized clinical trial. Eur J Nutr. 2022 Apr;61(3):1199-1207. DOI: 10.1007/s00394-021-02659-0
10. Samimi M, Jamilian M, Ebrahimi FA, Rahimi M, Tajbakhsh B, Asemi Z. Oral carnitine supplementation reduces body weight and insulin resistance in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. Clin Endocrinol (Oxf). 2016 Jun;84(6):851-857. DOI: 10.1111/cen.13003
11. Wu B, Yao J. A meta-analysis of the effects of vitamin D supplementation on endocrine metabolic and inflammatory markers in patients with polycystic ovarian syndrome. Medicine (Baltimore). 2026 Jan;105(1):e46892. DOI: 10.1097/MD.0000000000046892
12. Luo J, Li T, Yuan J. Effectiveness of vitamin D supplementation on lipid profile in polycystic ovary syndrome women: a meta-analysis of randomized controlled trials. Ann Palliat Med. 2021 Jan;10(1):114-129. DOI: 10.21037/apm-20-2492
13. Miao CY, Fang XJ, Chen Y, Zhang Q. Effect of vitamin D supplementation on polycystic ovary syndrome: a meta-analysis. Exp Ther Med. 2020 Apr;19(4):2641-2649. DOI: 10.3892/etm.2020.8525
14. Zhang T, He Q, Xiu H, Zhang Z, Liu Y, Chen Z, et al. Efficacy and safety of coenzyme Q10 supplementation in the treatment of polycystic ovary syndrome: a systematic review and meta-analysis. Reprod Sci. 2023 Apr;30(4):1033-1048. DOI: 10.1007/s43032-022-01038-2
15. Hatami A, Seidi F, Khosrowbeygi A, Moslemi A, Jalali-Mashayekhi F. The effect of Vitex agnus - castus plant on some markers of oxidative stress, lipid profile and insulin resistance in women with polycystic ovary syndrome: a randomized, double-blind controlled clinical trial study. JBRA Assist Reprod. 2026 Jan;30(1):70-78. DOI: 10.5935/1518-0557.20250165
16. Shahnazi M, Khalili AF, Hamdi K, Ghahremaninasab P. The effects of combined low-dose oral contraceptives and Vitex agnus on the improvement of clinical and paraclinical parameters of polycystic ovarian syndrome: a triple-blind, randomized, controlled clinical trial. Iran Red Crescent Med J. 2016;18(12):e37510. DOI: 10.5812/ircmj.37510
17. Hajimonfarednejad M, Nimrouzi M, Heydari M, Zarshenas MM, Raee MJ, Jahromi BN. Insulin resistance improvement by cinnamon powder in polycystic ovary syndrome: a randomized double-blind placebo controlled clinical trial. Phytother Res. 2018 Feb;32(2):276-283. DOI: 10.1002/ptr.5970
18. Wang JG, Anderson RA, Graham GM 3rd, Chu MC, Sauer MV, Guarnaccia MM, et al. The effect of cinnamon extract on insulin resistance parameters in polycystic ovary syndrome: a pilot study. Fertil Steril. 2007 Jul;88(1):240-243. DOI: 10.1016/j.fertnstert.2006.11.082
19. Kort DH, Lobo RA. Preliminary evidence that cinnamon improves menstrual cyclicity in women with polycystic ovary syndrome: a randomized controlled trial. Am J Obstet Gynecol. 2014 Nov;211(5):487.e1-6. DOI: 10.1016/j.ajog.2014.05.009
20. Borzoei A, Rafraf M, Niromanesh S, Farzadi L, Narimani F, Doostan F. Effects of cinnamon supplementation on antioxidant status and serum lipids in women with polycystic ovary syndrome. J Tradit Complement Med. 2017 May;8(1):128-133. DOI: 10.1016/j.jtcme.2017.04.008
21. Arentz S, Smith CA, Abbott J, Fahey P, Cheema BS, Bensoussan A. Combined lifestyle and herbal medicine in overweight women with polycystic ovary syndrome (PCOS): a randomized controlled trial. Phytother Res. 2017 Sep;31(9):1330-1340. DOI: 10.1002/ptr.5858
