A global consensus initiative involving more than 14,000 patients and health professionals renamed polycystic ovary syndrome to polyendocrine metabolic ovarian syndrome after a multistep process concluded that the previous terminology inaccurately emphasized ovarian cysts while obscuring the disorder's endocrine and metabolic features.
The condition previously known as polycystic ovary syndrome (PCOS) affects an estimated 170 million women globally and remains underdiagnosed in up to 70% of affected patients, according to the report. Researchers argued that the term “polycystic ovary syndrome” contributed to delayed diagnosis, fragmented care, stigma, and confusion because pathological ovarian cysts are not a defining feature of the disorder.
Adults are diagnosed when at least two of three guideline criteria are present: oovulatory dysfunction, hyperandrogenism, or polycystic ovaries identified on ultrasound or elevated anti-Müllerian hormone concentrations.
Researchers emphasized that the disorder extends beyond reproductive dysfunction and is associated with endocrine, metabolic, cardiovascular, psychological, and dermatologic manifestations. Prior evidence cited in the report showed increased risks of composite cardiovascular disease, myocardial infarction, and stroke among affected patients.
The international initiative engaged 56 academic, clinical, and patient organizations across multiple world regions and used Delphi surveys and consensus workshops to evaluate potential terminology changes. Surveys conducted in 2025 and 2026 included more than 14,000 patients and health professionals.
The consensus process identified several guiding principles for the new terminology, including scientific accuracy, clarity, avoidance of stigma, cultural appropriateness, and implementation feasibility. Support for scientific accuracy reached 86% among health professionals and 60% among patients, while support for avoiding stigma reached 85% and 66%, respectively.
Most participants favored adopting a new symptom-based name rather than retaining the PCOS acronym. That approach was supported by 86% of patients and 71% of health professionals, although some expressed concern about abandoning the longstanding terminology.
Participants debated whether reproductive terminology should emphasize ovulatory or ovarian dysfunction. Investigators said “ovulatory” was ultimately considered too narrow because it did not capture broader endocrine and ovarian abnormalities or remain applicable after menopause.
The highest-ranked term in Survey B was “polyendocrine metabolic ovulatory syndrome,” but Workshop B revised the terminology to “polyendocrine metabolic ovarian syndrome” (PMOS). All but two workshop participants supported the final name; those two participants opposed renaming on scientific and practical grounds, citing evolving genetic science and concerns about terminology transition.
Researchers said the new terminology reflects the disorder’s multisystem endocrine and metabolic biology, including abnormalities in androgen production, insulin signaling, ovarian hormone regulation, and neuroendocrine function. Insulin resistance and compensatory hyperinsulinemia were reported in 85% of affected patients, including 75% of lean patients.
The report also emphasized links between PMOS and obesity,impaired glucose tolerance, type 2 diabetes, dyslipidemia, hypertension, metabolic dysfunction–associated steatotic liver disease, and cardiovascular disease.
Ovarian dysfunction remained central to the revised nomenclature because of abnormalities in folliculogenesis, ovulatory function, and ovarian steroidogenesis. Researchers stated that accumulation of small antral follicles and elevated AMH concentrations supported inclusion of “ovarian” in the final terminology. Psychological and dermatologic manifestations, including depression, anxiety, acne, alopecia, and hirsutism, were considered during the naming process but ultimately excluded because participants viewed them as secondary to the underlying endocrine disturbances.
The implementation strategy includes a 3-year transition period, multilingual educational materials, integration into electronic health records and medical education systems, and planned incorporation into the 2028 update of international guidelines currently used in 195 countries. Researchers noted that formal engagement with the World Health Organization regarding International Classification of Diseases coding is still underway, meaning existing coding and billing systems have not yet changed.
Researchers acknowledged several limitations, including disproportionate representation from higher-income regions and lower participation from Asia, Africa, and South America. They also noted that the purposive nonprobability sampling design and voluntary participation may limit generalizability despite broad international engagement.
“The condition formerly known as PCOS now has a new name: polyendocrine metabolic ovarian syndrome,” the researchers wrote. “This change has global implications for health-care systems, policy, and research, and for advancing understanding and treatment of the condition.”
Disclosures: Teede reported support from the Australian National Health and Medical Research Council and unpaid leadership roles with the International Society of Endocrinology and international PCOS guideline initiatives. Several coauthors reported grants, consulting fees, honoraria, travel support, or leadership roles with organizations including Verity, the Androgen Excess and PCOS Society, Astellas, Novo Nordisk, Eli Lilly, Bayer, Siemens, and others. Remaining authors reported no competing interests.
Source: The Lancet
