After about 90 years, medicine has finally given polycystic ovary syndrome (PCOS) a name that matches what the condition actually is. The term PCOS was first introduced in 1935 by American gynaecologists Irving Stein and Michael Leventhal, who described a cluster of symptoms in women with enlarged, cyst-bearing ovaries. That gynaecological framing has persisted, largely unchanged, ever since; until now. A landmark consensus published in The Lancet on 12 May 2026, the result of a 14-year global effort involving 56 organisations and more than 22,000 stakeholders across six continents, has officially renamed PCOS to polyendocrine metabolic ovarian syndrome, or PMOS. The change is not an exercise in nomenclature. It is a reckoning, and for those of us who have long argued that this condition is far more than a reproductive disorder, it opens a conversation that is well overdue.
PCOS was always a partial description dressed up as a diagnosis. What ultrasound typically reveals is not pathological cysts but clusters of immature follicles, a consequence of disrupted ovulation rather than structural damage. Many women with the condition have no characteristic ovarian findings at all. What it consistently involves is insulin resistance, elevated androgens, chronic low-grade inflammation, and impaired glucose metabolism. The Lancet consensus states plainly that the old terminology was “inaccurate”, obscuring metabolic features and contributing to delayed diagnosis, fragmented care, and stigma. The new name is more honest. “Polyendocrine” recognises that multiple interacting hormonal systems are involved. “Metabolic” centres the insulin resistance and cardiometabolic risk present in an estimated 50 to 70% of affected women, including many who are not overweight. Understanding the condition this way changes what good treatment looks like.
PMOS affects between 10 and 13% of women of reproductive age worldwide. In urban India, some studies suggest prevalence as high as 22% among adolescents. Women with PMOS carry a significantly elevated lifetime risk of type 2 diabetes, cardiovascular disease, depression, anxiety, Alzheimer’s and certain cancers. Infertility, the outcome patients most often fear, is the visible surface of a much deeper metabolic problem. In India, these risks are compounded by a genetic predisposition to insulin resistance that is well documented in Asian Indian populations, and by clinical practice that has historically prioritised the reproductive dimensions of the condition over its cardiometabolic ones.
The 2023 International Evidence-Based Guideline for Assessment and Management of PCOS recommends lifestyle intervention as a core and early component of management, recognising that physical activity, dietary change, and weight management improve reproductive, metabolic, and psychological outcomes across all PCOS phenotypes.
Research comparing exercise modalities is instructive. A 2025 meta-analysis found no significant difference between high-intensity interval training and moderate-intensity continuous exercise across metabolic, hormonal, and anthropometric outcomes in women with PCOS. Both are effective. The key factor, therefore, is adherence. Consistency over years matters more than intensity. This is where yoga, pranayama, and mindfulness-based practice offer something meaningful alongside other forms of exercise. PMOS is, in significant part, a stress-metabolic disorder.
Cortisol dysregulation and sympathetic nervous system overactivity worsen insulin resistance, disrupt hormonal signalling, and impair sleep. A 2026 systematic review in Frontiers in Reproductive Health, examining nine randomised controlled trials (RCTs), found yoga produced improvements in insulin resistance, fasting blood glucose, lipid profiles, free testosterone, menstrual regularity, and, most consistently, psychological outcomes including anxiety, depression, and quality of life.
Ninety years of the wrong name narrowed clinical attention in ways that cost women dearly. The renaming to PMOS creates a clear obligation: expand metabolic screening at first presentation, treat physical activity as a medical prescription, and include yoga and pranayama explicitly among evidence-supported options discussed with patients. Formal guideline updates are expected in 2028. There is no reason to wait.
For the millions of young women in India living with a condition their health care system has not always explained well, this is a meaningful moment. A better name is a beginning. A better, more holistic approach must follow.
(The views expressed are personal)
This article is authored by Dr Rima Dada, professor, Department of Anatomy, All India Institute of Medical Sciences, New Delhi.
