By Professor Roger Hart, National Medical Director and Perth fertility specialist
Polyendocrine metabolic ovarian syndrome, or PMOS, is the new name for PCOS.
The new name is more accurate and better reflects the condition, which previously focused on the ovary and fertility. For a long time, doctors and patient advocates have long felt that the name does not accurately reflect the complexity of the condition. Specialists like myself have wanted a name change to shift the focus from the ovaries and reframe it to a hormonal condition that has long-term health implications for some women.
What is PMOS?
PMOS is a common hormonal and metabolic disorder that affects about 1 in 8 women worldwide. While many people associate the condition with fertility challenges, it is only one part of the story, and it does not apply to many women with PMOS who conceive without medical assistance. PMOS is a metabolic condition with broader health implications. For some women, these include difficulty in maintaining a healthy weight, sometimes suffering with greasier skin, a predisposition to insulin resistance, and, in the longer term, a possible increased risk of type 2 diabetes, high blood pressure, and cardiovascular diseases such as heart attacks and strokes. Often related to these concerns, PMOS can also have an adverse impact on mental health and wellbeing.
How do we diagnose PMOS?
Diagnosis of PMOS remains unchanged. A diagnosis is made when at least two of the following three features are present:
- Irregular periods or absent ovulation
- Elevated androgens (male hormones), such as acne, excess facial or body hair, or hair thinning, may be detected on a blood test.
- Multiple follicles on ultrasound (commonly known as polycystic ovaries)
With these factors in mind, it is hoped that, for healthcare professionals and patients alike, there will be a new focus on metabolic screening, which may include assessing blood sugar levels, liver function, insulin levels, and blood pressure.
How does PMOS affect fertility?
Many women with PMOS will have irregular or absent menstrual cycles, and hence will need some assistance with ovulation when they are trying to conceive. Provided her male partner has a normal sperm sample, and she has normal fallopian tube function, most women with PMOS will just need some assistance to help them ovulate. This may involve adopting a healthier lifestyle; sometimes a weight and dietary management intervention is required, and often it may just require providing knowledge of the fertile time in the cycle.
However, many women with PMOS will need assistance to help them ovulate. This may be through the use of metformin to address insulin resistance and her ovulatory disorder or commencing medication such as letrozole (a tablet) or injections of gonadotrophins. Most women with an ovulatory disorder will conceive without the use of IVF if they are assisted by an expert fertility specialist. However, some women with PMOS may need, for various reasons, to undergo a form of IVF, and they may be suitable to undergo a procedure called in-vitro maturation of oocytes (IVM). IVM treatment is not available at all clinics, and not all patients are suitable for this treatment.
What does the name change to PMOS mean for you?
For women living with PMOS, the name change does not alter the diagnosis or available treatments. What it does is change the conversation.
The new name helps healthcare professionals look beyond fertility and ovarian symptoms to consider the wider health impacts of the condition. This can lead to earlier diagnosis, more comprehensive screening and better long-term management of associated health risks.
As a gynaecologist and fertility specialist, I welcome this change. This new name is about improving clarity for patients, supporting earlier care, and ensuring complex health conditions are represented more accurately.
It ensures that PMOS is not simply a reproductive condition – it’s a complex hormonal and metabolic disorder.
