PCOS is the most common hormonal condition in women of reproductive age and one of the most frequently missed — the WHO estimates that up to 70% of affected women are undiagnosed. Part of the reason is in the name: it points at the ovaries, when the condition reaches well past them.
What PCOS is, and what it is now called
Polycystic ovary syndrome affects 10 to 13% of women of reproductive age. In May 2026 an international consensus published in The Lancet renamed it polyendocrine metabolic ovarian syndrome — PMOS — to reflect a reality that reaches well beyond the ovaries. The rename changed the name and nothing else: the diagnostic criteria and the management stayed as they were. Both terms are expected to coexist through a three-year transition, up to the 2028 international guideline update. If you see either on a medical document, it describes the same clinical reality.
The most frequent symptoms
Irregular cycles, or no regular ovulation. Hormonal acne, often on the lower face. Increased hair growth on the face or chest, driven by androgen excess. Weight gain or difficulty losing weight, tied to the insulin resistance frequently found alongside. Male-pattern hair loss in some cases. How intense these are and how they combine varies enormously between women — some have very few visible symptoms at all.
How the diagnosis is made
Diagnosis rests on at least two of three criteria — the Rotterdam criteria, still in force: irregular cycles or absent ovulation; clinical or biological signs of androgen excess; and polycystic ovarian morphology. Since 2023 the international guideline allows that third criterion to be established by a blood marker, anti-Müllerian hormone, as an alternative to ultrasound in adults — one or the other, never both, to avoid over-diagnosis. And it never suffices on its own: many women with the diagnosis do not have it, which is part of why the word polycystic was misleading and why the name was changed.
What it means beyond the cycle
Insulin resistance is frequently present rather than something that arrives later, and PMOS carries a raised long-term risk of type 2 diabetes. That is why the international guideline asks for glycaemic status to be assessed at diagnosis, and why follow-up should reach past the gynaecological question — precisely what the new name is trying to capture: an approach that takes the metabolism into account, not only the cycle.
- Do not rely on an ultrasound alone to confirm or rule out PCOS — it is one criterion out of three.
- Track your cycles, your skin and your hair growth over several months before a consultation.
- If PCOS is diagnosed, ask for follow-up that includes the metabolic side, not only the cycle.
- Do not be thrown by seeing the older name on medical paperwork — it is the same clinical reality during the transition.
Reviewed by the OVEA medical committee