Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: a multistep global consensus process

Polycystic ovary syndrome (PCOS) affects an estimated 170 million women, with diagnosis based on combinations of ovulatory dysfunction, hyperandrogenism, and polycystic ovarian morphology or elevated anti-Müllerian hormone after exclusion of other disorders. Historically perceived as a gynecological or ovarian disorder, accumulating research and international guidelines demonstrate a multisystem endocrine basis involving insulin, androgens, neuroendocrine and ovarian hormones, with metabolic, reproductive, psychological, and dermatological manifestations. The term PCOS is inaccurate because pathological ovarian cysts are not increased, contributing to confusion, delays in diagnosis (with up to 70% undiagnosed), fragmented care, stigma, and policy and research misalignment. Since the 2012 NIH evidence-based methodology workshop, experts and patient groups have called for renaming to reflect scientific understanding and improve care. Previous attempts lacked coordinated global leadership, inclusive processes, and implementation strategies. This Health Policy reports a globally coordinated, rigorous, multistep consensus process to rename PCOS to better capture its pathophysiology and support improved clinical, research, and policy outcomes.

The paper synthesizes evidence that PCOS is a multisystem endocrine and metabolic condition: meta-analyses and guidelines show endocrine abnormalities (hyperandrogenism, neuroendocrine changes with increased GnRH/LH pulsatility), widespread insulin resistance and hyperinsulinemia (including in lean individuals), and cardiometabolic complications (impaired glucose tolerance, type 2 diabetes, dyslipidemia, hypertension, steatotic liver disease, elevated cardiovascular disease odds). Ovarian dysfunction includes disrupted steroidogenesis, impaired folliculogenesis, characteristic ultrasonographic appearance, and elevated AMH, underpinning ovulatory dysfunction and infertility. Psychological and dermatological features are common but downstream of endocrine disturbances. The literature also documents harms of the misnomer PCOS, including confusion, stigma, and delays in diagnosis and care, and longstanding calls from guidelines, experts, and patient organizations for renaming to improve scientific coherence, coding, research comparability, and policy.

Design: A structured, multistep global consensus and implementation planning process incorporating modified Delphi surveys, nominal group technique workshops, and marketing/communication analyses, aligned with James Lind Alliance-style processes and implementation science frameworks (CFIR and ERIC). Governance and Funding: Funded by the NHMRC Centre for Research Excellence in Women’s Health in Reproductive Life; led by Monash University with the Androgen Excess and PCOS Society and Verity (UK patient charity). An international steering group (chair, people with PCOS, multidisciplinary experts) and advisory board oversaw processes. Ethics approval: Monash Health Ethics Committee (07070C and 78892). Stakeholder Engagement: Engagement of 56 organizations across world regions and disciplines, including patient groups and professional societies. Participants: People with PCOS (patients and advocates) and multidisciplinary health professionals (obstetrics/gynecology, reproductive endocrinology, adult and pediatric endocrinology, primary care, dermatology, imaging, nutrition/exercise, nursing/midwifery, psychology, academia/laboratory). Sampling and Recruitment: Purposive, stratified non-probability sampling via organizations, newsletters, conferences, social media, and networks; extended timelines; multilingual dissemination. Surveys: Two new global surveys built on 7708 prior responses. Survey A (Apr 1–Oct 1, 2025) delivered on Qualtrics, Google Forms, and WeChat in English, Chinese, German, Persian, and Malaysian; included demographics, informed consent, principles (accuracy, communication, stigma avoidance, cultural appropriateness, feasibility), naming approaches (generic, accurate/symptom-based, retain PCOS acronym), candidate terms and combinations; Likert scales and free text. Survey B (Jan 20–31, 2026) targeted unresolved issues (reproductive/ovary-related terms; final name). Workshops: Two serial online workshops (Workshop A: Nov 2025; Workshop B: Feb 2026) via Zoom with code of conduct, preparatory materials, independent observers, and IT support. Breakout groups were preassigned to balance region, discipline, and lived experience; patient co-chairs and health professional co-chairs led groups; observers ensured adherence. Individual timed contributions; confidential online voting after discussions; iterative testing of terms, combinations, and acronyms considering accuracy, acceptability, cultural appropriateness, stigma, duplication, pronunciation. Marketing/Communication Analysis: Pro bono global marketing experts assessed candidate names using branding and communication frameworks, advising evolutionary rebranding over revolutionary rebranding and flagging problematic acronyms/associations (e.g., EMOS, overlap with “emo” subculture; avoidance of MERS acronym). Implementation Planning: Co-designed with consumers and implementation experts using CFIR and ERIC; eight-stage global strategy drafted and refined with workshop feedback. Participants and Numbers: Survey A: 9358 people with PCOS and 3656 health professionals; Workshops: ~90 attendees (27 people with PCOS, 63 health professionals); Survey B: 1053 people with PCOS and 293 health professionals (1346 total; 49% response among recontacted). Cumulative new responses: 14,360 (10,411 patients; 3,949 health professionals). Representation: Broad global reach with multilingual access; health professionals from multiple disciplines (see Table 1 in paper). Data Handling: Descriptive statistics for support/priority rankings; iterative carry-forward of prioritized principles, approaches, and terms; qualitative thematic analysis of free text to assess stigma, cultural considerations, and communication clarity; results fed into subsequent rounds and workshops.

• Consensus new name: Polyendocrine Metabolic Ovarian Syndrome (PMOS) chosen to accurately reflect multisystem endocrine and metabolic pathophysiology and ovarian dysfunction while omitting misleading reference to ovarian cysts. Workshop B achieved consensus support (all but two participants). Survey B’s top-ranked candidate before final adjustment was polyendocrine metabolic ovulatory syndrome (66%). Workshop B revised to “ovarian,” prioritizing broader and lifelong relevance and cultural considerations.
• Principles: Strong support for guiding principles across patients and health professionals, prioritizing scientific accuracy, ease of communication, avoidance of stigma, cultural appropriateness, and feasibility of implementation. Health professionals weighted accuracy highest; patients emphasized stigma avoidance.
• Naming approach: Majority favored adopting a new accurate, symptom-based name over retaining the PCOS acronym or adopting a generic disease label. In Survey A, accurate name was preferred by 86% of patients and 71% of health professionals; generic name by 45% and 54%, respectively; retaining PCOS acronym by 20% of patients and 40% of health professionals.
• Key terms: Endocrine/polyendocrine and metabolic terms were consistently prioritized. Reproductive/ovulatory/ovary terms required further deliberation due to stigma and scope; final consensus selected “ovarian” (Workshop B: 70% overall ranked first; patients 85%; health professionals 65%), encompassing endocrine, follicular, and ovulatory disturbances across the lifespan.
• Scale of engagement: Two new global surveys yielded 14,360 responses (10,411 patients; 3,949 health professionals) with broad regional and disciplinary representation; ~90 participants in workshops; 56 organizations engaged.
• Implementation strategy: An eight-stage, co-designed global implementation plan was finalized, emphasizing evolutionary rebranding, a 3-year transition, resource development, integration into health information systems, policy and research alignment, and pursuit of ICD adoption.
• Rationale reinforced by evidence: The name change aligns with robust evidence of polyendocrine and metabolic underpinnings (e.g., insulin resistance present in ~85% overall, including ~75% of lean women; increased cardiometabolic risks with elevated odds ratios for CVD 1.68, myocardial infarction 2.50, stroke 1.71), and with ovarian dysfunction as a defining clinical feature.

The consensus process addresses longstanding inaccuracies and harms associated with the term PCOS by adopting PMOS, which better reflects multisystem endocrine and metabolic mechanisms and ovarian dysfunction without implying pathological cysts. This change is expected to reduce confusion, stigma, and diagnostic delays; improve communication among patients, clinicians, and policymakers; and enhance research coherence, coding, and funding alignment. The global, transparent process—spanning Delphi surveys, nominal group workshops, and marketing analyses—ensured representativeness and legitimacy, overcoming barriers that stalled prior renaming efforts. Selecting “polyendocrine,” “metabolic,” and “ovarian” balances scientific accuracy, cultural and linguistic appropriateness, and feasibility of adoption, while evolutionary rebranding and a structured implementation roadmap support practical integration into clinical practice, research, and health systems. The strategy anticipates improved awareness, diagnosis, care quality, and patient experience, with continuous evaluation during the transition and potential refinement as evidence evolves (including consideration of subtypes).

Through a rigorous, inclusive global process engaging patients, multidisciplinary professionals, and 56 organizations, the condition formerly known as PCOS has been renamed polyendocrine metabolic ovarian syndrome (PMOS). This accurate, stigma-sensitive nomenclature captures multisystem endocrine and metabolic features and ovarian dysfunction, correcting a long-recognized misnomer. A coordinated eight-stage implementation plan—including a 3-year transition, multilingual education, integration into health information systems, policy and research alignment, ICD engagement, and incorporation into the 2028 International Guideline update—is underway. Future work will monitor uptake, evaluate impact on diagnosis and care, and refine terminology as scientific understanding evolves, including potential subtyping.

• Representation: Lower participation from low- and middle-income countries and from some regions (Asia, Africa, South America) and certain disciplines may limit generalizability.
• Sampling: Purposive, non-probability sampling and voluntary participation introduce potential selection bias.
• Response rates: Survey A response rate could not be determined due to broad, multichannel dissemination.
• Minority dissent: A small number of workshop participants did not support a name change.
• Translation and cultural nuances: Careful attention to language translation and cultural contexts is needed for global adoption. Despite these limitations, regional analyses did not reveal major differences in preferred terms or the final name, and the overwhelming majority supported a name change and the adopted principles and approach.