For nearly five decades, the term polycystic ovarian syndrome (PCOS) has been used to define one of the most common disorders that affects approximately one to five young Indian women. Yet, despite its prevalence, many women have lived with the condition without fully understanding what it truly entails, largely because the name itself tells only half the story. Medical terminology plays a powerful role in shaping public understanding, clinical priorities, and even treatment approaches. Seen in that context, the proposed renaming of PCOS to polyendocrine metabolic ovarian syndrome (PMOS) is a long-overdue based on our current knowledge and evidence available in how we understand one of the most complex and misunderstood disorders affecting women today.
The new terminology carries a far greater significance than merely being a reproductive or ovarian disorder (primarily associated with irregular periods, infertility, or ovarian cysts). It reflects the evolution of scientific understanding from viewing PCOS as primarily a reproductive disorder to recognising it as a lifelong multisystem syndrome with metabolic, hormonal, cardiovascular, dermatological and psychological consequences. In a nutshell, the disorder impacts the entire body, and PMOS finally acknowledges this wider systemic involvement.
Over the years, scientific understanding of the syndrome has steadily evolved. Its nomenclature too has changed — from Stein-Leventhal Syndrome to polycystic ovarian disease (PCOD), then to PCOS and now to PMOS. Each transition reflects a deeper appreciation of the disorder’s complexity and the growing recognition that its impact extends far beyond reproductive health. This shift in understanding is now reshaping the way clinicians approach diagnosis, treatment and long-term management of the condition.
On the other hand, public understanding, however, still has a long way to go. It has taken years to help women recognise that PCOS is a syndrome, not a disease, and, therefore, should not be casually termed PCOD. The transition from PCOS to PMOS will require another sustained effort in awareness and education. Women must understand that while the name may change, the condition remains the same; only the lens through which we view it has always been wider, though appreciated by women. This is what the PCOS Society of India has been focusing on, creating awareness on this very important public health issue, which if not assessed completely could cause health risks in the future for women themselves and their future generation.
Today, young girls and women first seek medical attention from gynaecologists for irregular periods, heavy bleeding, infertility, recurrent pregnancy loss, or menopausal bleeding abnormalities. The diagnosis of PCOS at a young age comes after clinical evaluation using the Rotterdam criteria (most widely used guidelines for diagnosing PCOS). A large number of women with PCOS undergoing ultrasound evaluation show polycystic ovaries. Importantly, these are not tumours or dangerous cysts, but immature follicles or trapped eggs that become visible because ovulation has not occurred normally or because of imbalanced hormones. Yet, ironically, the striking ultrasound image often becomes the trigger that finally motivates women to seek gynaecological help.
This is a significant finding, which is most useful in identifying women who have polycystic ovarian morphology (PCOM) which is an integral part of diagnosing PCOS.
But what follows is equally important, we need to assess the broader metabolic and hormonal implications of the syndrome. This becomes particularly critical for women planning a pregnancy. Insulin resistance, obesity and diabetes associated with PCOS, (PMOS) can influence the intrauterine environment during pregnancy, increasing long-term metabolic risks for the unborn child. Emerging evidence suggests that these epigenetic influences may predispose children to diabetes and metabolic disorders later in adulthood. Therefore, addressing metabolic health before conception is no longer optional, it is essential.
The transition from PCOS to PMOS ultimately reflects a broader shift in medical thinking. It encourages both health care professionals and women to recognise that this is not merely an ovarian condition but a complex whole-body health disorder with hormonal, metabolic, reproductive, and psychological implications. It signals a decisive shift away from viewing women’s health solely through the prism of reproduction and towards recognising the interconnected nature of hormonal, metabolic, cardiovascular and mental health. And that, ultimately, is progress worth embracing.
(The views expressed are personal)
This article is authored by Dr Duru Shah, president, PCOS Society of India and director, Gynaecworld–Centre for Women’s Health & Fertility.
