Recognise the signs of Polyendocrine Metabolic Ovarian Syndrome

Peerless Hospital Guwahati *

As PCOS/PMOS Awareness Month is observed, specialists highlight the 2026 global terminology update, the condition’s wider reproductive, metabolic and emotional impact, and the importance of early diagnosis and long-term management

Polycystic Ovary Syndrome (PCOS), now renamed Polyendocrine Metabolic Ovarian Syndrome (PMOS), is one of the most common endocrine conditions affecting women of reproductive age, yet a large proportion of people living with the condition remain undiagnosed.

Following a global consensus process that culminated in May 2026, the condition has been renamed to reflect its endocrine, metabolic, and ovarian dimensions, as well as its wider impact on health. As PCOS/PMOS Awareness Month is observed in September, Peerless Hospital Guwahati is highlighting the importance of recognising the condition beyond its commonly known association with irregular periods and infertility, and encouraging women to seek professional medical advice when symptoms persist.

According to the updated international PMOS guideline, the condition affects approximately one in eight women of reproductive age, or more than 170 million women worldwide, while up to 70% of affected individuals may remain undiagnosed. The new terminology follows a multistep global consensus process involving professional and patient organisations, healthcare professionals and people with lived experience.

The May 2026 update changes the terminology and framing; the clinical recommendations and content of the international guideline remain unchanged, with PMOS to be incorporated as standard terminology in the next International Guideline in 2028.

The change in terminology reflects decades of research showing that the condition extends far beyond the ovaries. The term 'polycystic ovary' can be misleading, as the ovarian appearance associated with the condition reflects arrested follicular development rather than pathological ovarian cysts.

The previous reproductive-centred name could also obscure the metabolic, cardiovascular, dermatological and psychological features of the condition, contributing to delayed diagnosis, fragmented care and stigma.

PMOS can present differently from one woman to another. Irregular or infrequent periods, difficulty conceiving, acne, excess facial or body hair, scalp hair thinning and weight changes may be among the signs. However, the absence of one particular symptom does not rule out the condition.

“The change from PCOS to Polyendocrine Metabolic Ovarian Syndrome, or PMOS, is important because it better reflects what we understand about the condition today. PMOS is not simply a problem of irregular periods, nor is it synonymous with infertility or being overweight. It is a complex endocrine and metabolic condition, and its presentation can vary considerably from one woman to another.

Some women may primarily experience menstrual irregularity, while others may notice acne, excessive facial or body hair, hair thinning or difficulties with ovulation and conception. Importantly, women who are lean or have a normal body weight can also have PMOS.

Therefore, symptoms should be assessed in their entirety rather than being judged on weight or on one symptom alone,” said Dr. Ishita Das, Consultant Gynaecologist, Peerless Hospital Guwahati.

She further emphasised that diagnosis should be based on appropriate clinical assessment rather than an ultrasound report alone.

“A common misconception is that seeing multiple small follicles on an ultrasound automatically means a woman has PMOS. That is not necessarily the case. In adults, diagnosis involves assessing features such as ovulatory dysfunction and clinical or biochemical signs of hyperandrogenism, with ovarian morphology on ultrasound or, where appropriate, AMH serving as a diagnostic component. Other conditions that can produce similar symptoms also need to be excluded. This is why self-diagnosis based on an ultrasound, irregular periods or internet information can be misleading,” Dr. Das added.

The condition also has implications that extend beyond reproductive health. Women with PMOS have an increased risk of impaired glucose tolerance and type 2 diabetes, while cardiovascular risk factors such as high blood pressure and abnormal cholesterol levels also warrant attention. PMOS has additionally been associated with sleep disorders and psychological concerns, including anxiety, depression, eating disorders and negative body image.

“One of the most important messages during PCOS/PMOS Awareness Month is that managing PMOS is not only about making periods regular or addressing fertility when pregnancy is desired. We also need to look at a woman’s metabolic, cardiovascular, psychological and overall health. Current guidelines recommend assessment of glycaemic status and cardiovascular risk factors in women with PMOS, irrespective of their age or BMI. This is particularly important because metabolic risks can exist even when a woman does not appear overweight,” said Dr. Das.

While there is currently no single cure for PMOS, the condition can be effectively managed through an individualised combination of lifestyle measures and medical treatment, depending on a woman’s symptoms, reproductive goals and metabolic health.

“There is no one-size-fits-all treatment for PMOS. Healthy eating, regular physical activity, adequate sleep and prevention of excess weight gain are important components of long-term care, but lifestyle management should not be reduced to weight loss alone. Depending on the individual, medical treatment may be required for menstrual irregularity, hyperandrogenic symptoms, metabolic concerns or fertility. The objective is to develop a long-term health plan rather than simply treating one symptom at a time,” Dr. Das explained.

She also stressed that a diagnosis of PMOS does not mean that a woman will be unable to conceive.

“PMOS is a leading cause of ovulatory infertility, but infertility is not inevitable. Many women with PMOS conceive naturally, while others may require medical assistance to restore or induce ovulation. Seeking medical advice early can help identify the specific cause of difficulty in conceiving and allow appropriate treatment. Women should therefore not assume that a PMOS diagnosis means they cannot become mothers,” she said.

Adding to the importance of awareness, Dr. Pranab Barua, Medical Superintendent at Peerless Hospital Guwahati, said, “At Peerless Hospital Guwahati, we believe that awareness and timely access to appropriate healthcare are important parts of preventive healthcare.

Conditions such as PMOS can have implications across different stages of a woman’s life, and creating greater awareness can encourage women to seek guidance rather than normalise persistent symptoms. The recent global terminology update also reinforces the importance of understanding this condition in its full clinical context. We endeavour to support patients with informed, compassionate and comprehensive care.”

Peerless Hospital Guwahati encourages women experiencing persistent menstrual irregularities, unexplained acne or excess facial/body hair, difficulties with conception or other concerning symptoms to consult a qualified healthcare professional rather than relying on self-diagnosis or unverified online information.

The hospital also emphasises that the May 2026 terminology update represents a change in name and framing, not a change to the current evidence-based recommendations for assessment and management.