September is Polycystic Ovarian Syndrome (PCOS) Awareness Month. On 12 May 2026, the condition was renamed Polyendocrine Metabolic Ovarian Syndrome (PMOS) so this month’s blog explains what the condition is and why the name change matters. There is currently a three-year transition period while the new name is introduced, so you may see both PCOS and PMOS used across different platforms.
Around 1 in 8 women in the UK are affected by PMOS and millions workdwide1. Symptoms can range from very mild to severe, so experiences vary widely. For some, PMOS can also affect self-esteem, quality of life, and both physical and mental health.
What is PCOS?
PCOS, now known as PMOS, is a complex endocrine, or hormone-related, condition linked to hormonal imbalance and a wide range of possible symptoms. The term “polycystic ovaries” refers to the small follicles that can sometimes be seen just below the surface of the ovaries. These are usually less than 8mm in size and are not cysts in the usual sense. They do not need to be removed, and they do not increase the risk of cancer. Instead, they are follicles that have not matured enough to release an egg. Importantly, these follicles are not present in everyone with PMOS, which is one reason the name PCOS can be misleading.
It was once thought that the “cysts” caused the condition, but they are now understood to be one possible symptom rather than the cause. PMOS can run in families and, if not well managed, may increase the risk of other health problems over time. It is also a leading cause of fertility difficulties in women. Although symptoms can be managed, PMOS is a lifelong condition without a cure, so treatment and support need to take a life-course approach.
How do we diagnose PMOS
Historically, many women have not received a diagnosis of PMOS until they experience fertility difficulties. Although this is changing and earlier diagnosis is becoming more common, the average time it takes for a woman to receive a PMOS diagnosis is still more than two years. Many women also report seeing at least three different healthcare professionals before they finally receive an answer.
A timely diagnosis is important because it allows women to access the support they need to manage symptoms and protect their long-term health. Early intervention may help slow the progression of potential comorbidities, including cardiovascular disease, type 2 diabetes, sleep apnoea, and mental health disorders. Receiving a diagnosis earlier can also support women in making informed decisions about family planning.
PMOS is diagnosed using the Rotterdam Criteria. According to these criteria, two out of the following three features must be present for a diagnosis:
- Irregular or absent ovulation
- Excess androgens and/or physical signs of excess androgens
- Polycystic ovaries
You may be offered an ultrasound scan to check for polycystic ovaries, although this is not always necessary if PMOS can be diagnosed based on your symptoms and biochemical test results. Biochemical tests usually involve blood tests that assess hormone levels and can help identify signs of excess androgens.2
It is important to remember that not all women with PMOS have polycystic ovaries. In fact, polycystic ovaries are only one of the three diagnostic criteria and are not required for a diagnosis. This is one of the reasons why many experts have questioned whether the term Polycystic Ovarian Syndrome (PCOS) accurately reflects the condition and why the proposed change to Polyendocrine metabolic Ovarian Syndrome (PMOS) may provide a better description of its wider health implications.
Receiving a diagnosis can feel overwhelming, but for many women it is also the first step towards understanding their body, making sense of their symptoms, and accessing the support they need to improve their health and wellbeing.
What are the symptoms of PCOS (PMOS)?
The symptoms of PMOS can be wide ranging, but there are some common themes. Some women experience all of the symptoms and others only a few. Some common symptoms include:
- Irregular periods or no periods
- Irregular ovulation, or no ovulation
- Reduced fertility, leading to difficulties in becoming pregnant
- Unwanted dark or thick facial or body hair (hirsutism)
- Oily skin, acne
- Thinning hair or hair loss from the scalp (alopecia)
- Weight management issues (weight gain, difficulty losing weight )
- Depression and mood changes
- Body image concerns and disordered eating
- Fatigue
- Cravings
What causes PMOS?
The exact cause of PMOS is still unknown. PMOS is primarily a hormonal condition with metabolic consequences. While researchers understand a great deal about the hormonal and metabolic pathways involved, we still do not fully understand what triggers these changes in the first place.
Current evidence suggests that PMOS develops as a result of a complex interaction between genetic, environmental, and lifestyle factors. For example, having a family history of PMOS may increase your risk of developing the condition. Environmental influences and lifestyle factors, including stress, may also play a role in how the condition develops and presents.
It is important to recognise that, while our behaviours may influence the development and management of PMOS, it is impossible to say that any one factor directly caused you to develop the condition. This means that PMOS is not something you caused, and it is not your fault if you have been diagnosed with it.
PMOS is a complex, multifactorial condition that even experts do not yet fully understand. Rather than focusing on what may have caused the condition, it can be more helpful to focus on the factors that can be influenced now to support your health, manage symptoms, and improve long-term wellbeing.
Contributing factors
Insulin Resistance
Insulin resistance is seen in up to 80% of people with PMOS and is considered one of the key drivers of symptoms.
Insulin is a hormone produced by the body to help regulate blood sugar levels. A simple way to think about insulin is as a key that unlocks cells, allowing glucose from the food we eat to move from the bloodstream into the cells where it can be used for energy.
With insulin resistance, it is as though the key no longer fits the lock properly. As a result, glucose struggles to enter the cells and begins to build up in the bloodstream. In response, the body produces more insulin in an attempt to lower blood sugar levels, leaving both insulin and blood sugar levels elevated.
This is particularly important in PMOS because higher insulin levels stimulate the ovaries to produce more testosterone. Elevated testosterone levels can disrupt ovulation, which is why irregular or absent periods are such common symptoms of the condition.
Higher testosterone levels can also contribute to other symptoms associated with PMOS, including acne, excess facial or body hair growth, and hair thinning on the scalp.
Inflammation
Women with PMOS often have higher levels of inflammatory markers within the body. It is still unclear whether inflammation contributes to the development of PMOS, whether PMOS drives inflammation, or whether both processes occur together. However, inflammation is recognised as a key feature of the condition.
Chronic low-grade inflammation is associated with an increased risk of cardiovascular disease and type 2 diabetes. In the ovaries, inflammation and oxidative stress may impair follicle maturation and disrupt ovulation. Inflammation can also contribute to insulin resistance and interfere with important hormonal pathways, including those involved in appetite regulation and energy balance, which may make weight management more challenging.
Stress
PMOS is primarily influenced by the body’s hormonal systems. One of the main systems involved is the hypothalamic-pituitary-ovarian (HPO) axis, which is simply the communication pathway between the brain and the ovaries.
The HPO axis works closely alongside the hypothalamic-pituitary-adrenal (HPA) axis, which controls communication between the brain and the adrenal glands. The adrenal glands sit above the kidneys and produce hormones including cortisol and this in turn increases testosterone. These systems are also closely linked to the sympathetic nervous system, which regulates our fight-or-flight response.
While this is a complex network involving many hormonal pathways, the key takeaway is that stress can have a significant impact on PMOS symptoms. When the brain perceives stress, it signals the release of cortisol. In some women with PMOS, this may contribute to hormonal imbalances, including elevated testosterone levels, which can worsen symptoms and further disrupt ovulation.
For this reason, women with PMOS may be particularly sensitive to the effects of chronic stress. Increased stress can contribute to symptom flare-ups and may also negatively affect insulin sensitivity, creating another challenge in managing the condition.
The take-home message is that managing stress is a crucial part of managing PMOS symptoms.
Weight
Many women I have supported in clinic tell me that they have been advised by a healthcare professional that their weight is the cause of their PMOS and that they simply need to lose weight.
This can leave women in a very difficult position. They often feel blamed for their condition while simultaneously struggling with the very factors that can make weight management more challenging in PMOS. This can create feelings of guilt, shame, frustration, anxiety, and poor body image.
Research also shows that disordered eating behaviours are more common in women with PMOS. Between 12% and 35% of women with PMOS are affected by disordered eating, and around 60% experience binge eating behaviours. Women with PMOS are also at increased risk of eating disorders, including bulimia nervosa.
Understanding that weight is not the cause of PMOS is an important step in helping women approach both themselves and their condition with greater compassion. It allows space to focus on realistic, sustainable behaviours that support health and wellbeing, rather than pursuing approaches driven by blame or guilt.
We know that weight alone cannot be the cause of PMOS because there is a subtype known as lean PMOS, where women meet the diagnostic criteria despite not experiencing weight gain. We also continue to see insulin resistance and many of the same hormonal and metabolic features in women with lean PMOS.
Rather than viewing weight as the cause, it is more accurate to recognise that weight, hormones, insulin resistance, inflammation, genetics, lifestyle factors, and environmental influences all interact in complex ways within the condition.
While these factors can influence how PMOS develops and presents, the good news is that many of them can be supported through targeted nutrition and lifestyle strategies. This is where personalised support can make a real difference.
Why the name change matters
The term Polycystic Ovarian Syndrome (PCOS) was first introduced in the 1930s following the surgical observation of multiple fluid-filled structures on the ovaries of women who were not having periods. However, decades of research have shown that this condition extends far beyond the ovaries. We now understand it to be a complex hormonal and metabolic disorder that can affect many aspects of health, meaning the original name no longer reflects our current understanding of the condition.
The proposed name change to Polyendocrine Metabolic Ovarian Syndrome (PMOS) was the result of an unprecedented global consensus and was published in The Lancet. Researchers, healthcare professionals, and women living with the condition recognised that the term PCOS can cause harm in several ways and does not accurately represent the condition as we understand it today.
Scientific inaccuracies
The term polycystic ovary suggests that ovarian cysts are a defining feature of the condition. In reality, the structures seen on ultrasound are not pathological ovarian cysts but developing follicles that have not matured as expected. Furthermore, not everyone with the condition has polycystic ovaries, meaning the name can be misleading for both healthcare professionals and those seeking a diagnosis.
Delayed diagnosis and a narrow focus on the ovaries
The name PCOS places a strong emphasis on the ovaries, despite the fact that the condition affects far more than reproductive health. This narrow focus can contribute to delays in diagnosis and fragmented care, as symptoms affecting other areas of health may be attributed to different causes or overlooked altogether.
It is estimated that up to 70% of women with the condition remain undiagnosed. When symptoms are viewed solely through the lens of fertility or menstruation, opportunities to identify and manage the wider metabolic and hormonal aspects of the condition can be missed.
Sadly, women’s health concerns can still be dismissed as something that women simply have to put up with. Failing to recognise PMOS as the complex hormonal and metabolic condition that it is can leave women feeling unheard, unsupported, and without access to the care they need.
Stigma and emotional impact
A name centred around reproduction can also reinforce stigma, particularly in cultures and communities where fertility is highly valued. Many women report feeling distressed by the name PCOS, especially when concerns about fertility become the dominant focus of conversations about their health.
The proposed name PMOS helps shift attention towards the broader health implications of the condition and acknowledges that it is more than a reproductive disorder. It highlights the lifelong hormonal and metabolic aspects of PMOS and encourages healthcare professionals across different specialties to take a more whole-person approach to care.
Why this matters
The move from PCOS to PMOS is about much more than changing a name. It reflects a growing understanding that this condition affects the whole body, not just the ovaries. A more accurate name has the potential to improve awareness, reduce stigma, support earlier diagnosis, and help women access the comprehensive care they deserve.
Living with PMOS: Why a Whole-Body Approach Matters
As we’ve explored throughout this article, PMOS is not simply an ovarian condition. It can affect blood sugar regulation, hormone balance, inflammation, stress resilience, mental wellbeing, and cardiovascular health. This is why, when I work with women in clinic, I take a whole-person approach rather than focusing on symptoms in isolation.
While there is no one-size-fits-all approach, nutrition and lifestyle strategies can play an important role in supporting many of the processes involved in PMOS. Depending on an individual’s symptoms, goals, and health history, support may focus on:
- Improving insulin sensitivity and blood sugar regulation
- Supporting regular eating habits and a positive relationship with food
- Managing inflammation
- Supporting stress resilience and nervous system regulation
- Addressing nutritional deficiencies where appropriate
- Supporting sustainable movement and lifestyle habits
- Improving energy levels and overall wellbeing
Importantly, support should be tailored to the individual. PMOS can present differently from one woman to another, which means the most effective approach is often one that considers the whole person rather than just the diagnosis.
Final Thoughts
The move from PCOS to PMOS reflects a growing understanding that this condition is far more than a problem affecting the ovaries. It is a complex hormonal and metabolic condition that can influence many aspects of health throughout a woman’s life.
If you have PMOS, it is important to remember that this is not your fault, and you are not alone. While the condition can feel overwhelming, understanding what is happening in your body is often the first step towards finding an approach that works for you.
Through personalised nutrition and lifestyle support, many women find they are able to better manage symptoms, improve their relationship with food and their body, and feel more confident in supporting their long-term health.
If this resonates with you, and you’d like support with your PMOS, you can book a free, no-obligation discovery call here. This is an opportunity to talk through your symptoms, ask questions, and explore whether nutritional therapy could help you achieve your health goals.
- Verity (2026) PCOS is now PMOS. Accessed 19.08.26
- 2. NICE (2025) PCOS Guidelines. Accessed 19.08.26
Disclaimer
The information in this blog is for general guidance only and not a substitute for personalised medical advice. Always discuss health concerns with your GP or qualified professional. If you or someone you know is struggling with an eating disorder, please seek specialist support.
