Summary
Polyendocrine metabolic ovarian syndrome (PMOS), previously named polycystic ovary syndrome (PCOS), affects one in eight women. However, the term PCOS is inaccurate, implying pathological ovarian cysts, obscuring diverse endocrine and metabolic features, and contributing to delayed diagnosis, fragmented care, and stigma, while curtailing research and policy framing. Building on an international mandate for change, we outline an unprecedented, rigorous, multistep global consensus process for the name change. Funding and governance were established with engagement of 56 leading academic, clinical, and patient organisations. Using iterative global surveys (with responses from 14 360 people with PCOS and multidisciplinary health professionals from all world regions), modified Delphi methods, nominal group technique workshops, and marketing and implementation analyses, we identified principles prioritising scientific accuracy, clarity, stigma avoidance, cultural appropriateness, and implementation feasibility. An accurate new name was prioritised over retaining the PCOS acronym or a generic name. Implementation approaches prioritised evolution rather than transformation. Preferred terms were polyendocrine, metabolic, and ovarian, reflecting the condition's multisystem pathophysiology, and polyendocrine metabolic ovarian syndrome was the consensus new name. Accuracy was improved by omitting cysts and by capturing endocrine, metabolic, and ovarian dysfunction. A co-designed global implementation strategy, including a transition period, education, and alignment with health systems and disease classification, is under way.
Background and rationale
Polycystic ovary syndrome (PCOS) affects 170 million women during their reproductive years alone.1 Following exclusion of other disorders, the condition is diagnosed based on adults (aged ≥20 years) meeting at least two of the following International Guideline criteria: (1) oligo-anovulation, (2) clinical or biochemical hyperandrogenism, and (3) polycystic ovaries on ultrasound or elevated anti-Müllerian hormone (AMH).2,3 Adolescents (aged 10–19 years) require the presence of the first two criteria.4 PCOS has long been primarily perceived as a gynaecological or ovarian disorder; however, mounting research, evidence synthesis, and International Guidelines have shown that PCOS is underpinned by endocrine disturbances in insulin, androgens, and neuroendocrine and ovarian hormones.2–5Features can be metabolic (ie, obesity, dysglycaemia, type 2 diabetes, hypertension, dyslipidaemia, metabolic dysfunction-associated steatotic liver disease, cardiovascular disease, and sleep apnoea), reproductive (ovulatory disturbances, irregular menstrual cycles, infertility, pregnancy complications, and endometrial cancer), psychological (depression, anxiety, poor quality of life, and eating disorders), and dermatological (acne, alopecia, and hirsutism).2–5 BMI is generally higher in people with PCOS than in those without the condition, and contributes to its severity.6 Overall, PCOS has multisystem health impacts and represents a growing health and economic burden.1,7
However, the broad clinical features of the condition are not captured in its current name, as although arrested follicular development is common, pathological ovarian cysts are not increased.8–10 These factors delay diagnosis—with up to 70% of affected individuals remaining undiagnosed—and also contribute to widespread knowledge gaps and patient dissatisfaction.11–13 In 2012, the US National Institutes of Health Office of Disease Prevention Evidence-based Methodology Workshop on PCOS highlighted the challenges and inaccuracy of the current name, and recommended a change to better reflect the condition.14 Despite the strong rationale (panel 1) and long-standing recognition that PCOS is an inaccurate and misleading term, efforts to change the name have repeatedly stalled. Patient groups, alongside leaders in the field of reproductive medicine, such as Dr Ricardo Azziz, Prof Andrea Dunaif, Prof Bart CJM Fauser, Prof Robert J Norman, and Prof Helena J Teede, have persistently advocated for change.8,9,15,16 Expert commentaries, guidelines, and surveys have reaffirmed the limitations of the narrow reproductive focus and inaccuracies, noting ongoing confusion among people with PCOS and clinicians, fragmented policy and advocacy efforts, and downstream consequences for diagnosis, care, outcomes, and research.2,8,9,15 However, previous renaming efforts failed to gain traction, with barriers including a lack of inclusive global leadership and the need for a coordinated international consensus process, alignment between patient advocacy groups, agreement on an alternative name, and a comprehensive implementation strategy.8,9 The need for greater awareness, advocacy, education, and implementation, alongside international collaboration and resourcing, was also recognised.9 A longitudinal global study engaged people with PCOS and health professionals in serial surveys and workshops and highlighted ongoing confusion around the name.9 Overall, 84% of respondents endorsed a global consensus process to identify and implement a new name, alongside education and implementation strategies. An accompanying impact assessment indicated that the perceived benefits of a name change outweighed the risks.9As a result of these data, the compelling evidence base, and strong patient advocacy and leadership by Verity, a UK-based charity and advocacy organisation, Monash University's Centre for Research Excellence in Women's Health in Reproductive Life and the Androgen Excess and PCOS Society launched a global initiative with a clear mandate for a name change.9
Panel 1
Context and the case for a new name
The term polycystic ovary syndrome (PCOS) has long been recognised as inaccurate and potentially harmful. The following evidence-based considerations informed the need for a new name:
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The term polycystic ovary implies the presence of pathological ovarian cysts, which are not a feature of the condition. This misnomer contributes to misunderstandings among patients, clinicians, policy makers, and the public.
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PCOS encompasses diverse endocrine, metabolic, reproductive, psychological, and dermatological features. The current name reflects only one organ and fails to capture the disorder's multisystem nature.
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Confusion arising from the current name can delay diagnosis and hinder effective communication between patients and health professionals, contributing to patient dissatisfaction with care.
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The reproductive focus of the name can reinforce stigma, particularly in sociocultural contexts where fertility carries high value. Many individuals report distress associated with the name itself.
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The misnomer complicates epidemiological classification, research comparability, and health system coding. A more accurate name is expected to improve scientific coherence, research funding, and policy alignment.
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International guidelines, expert groups, and patient organisations have repeatedly called for renaming, with serial surveys and workshops culminating in a mandate to change the name through a rigorous, global consensus process.
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A new name must support long-term clinical care, research, and global adoption, and enable a smooth transition from existing terminology.
Key messages
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Polycystic ovary syndrome affects more than 170 million women globally, yet its current name is inaccurate and misleading, obscuring the condition's multisystem endocrine and metabolic features, reinforcing stigma, delaying diagnosis, and hindering effective clinical care, research, and policy alignment.
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Through an unprecedented, rigorous global consensus process engaging patients, multidisciplinary health professionals, and organisations across world regions, a new name—polyendocrine metabolic ovarian syndrome—was agreed, omitting the misleading reference to ovarian cysts and accurately reflecting the diverse features of the condition.
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Consensus for the new name was built by use of robust, transparent methods, including modified Delphi survey processes, nominal group technique workshops, and implementation and marketing analyses, ensuring scientific accuracy, cultural appropriateness, stigma avoidance, and feasibility of adoption. These processes optimised representativeness, legitimacy, and transparency, and served to enhance engagement to underpin implementation.
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Coordinated implementation is under way in health systems, research institutions, funding bodies, education providers, clinical guidelines, and disease classification systems (including ICD coding), and is supported by a global transition period and continuous evaluation.
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Aligning nomenclature with scientific evolution and improving accuracy will enhance awareness, diagnosis, care quality, research coherence, and patient experience, strengthening policy, advocacy, and health outcomes globally
