Elsa Angel Rose
“Polycystic Ovarian Syndrome (PCOS) is a chronic metabolic and hormonal disorder, with insulin resistance being a key factor in its development. It impacts reproductive hormonal balance, leading to excess androgen production over female hormones, thus affecting the normal development and maturation of the ovaries,” said Dr Manasa G V, a gynaecologist from Dona Paula. The old name PCOS led to many occurrences of underdiagnosis or over-labelling, as doctors and patients tended to focus heavily on the cysts in the ovaries, making it an ovarian syndrome. Most importantly, not everyone who has the disease may have cysts in their ovaries. The new name suggests how the disorder is a whole-body hormonal and metabolic disorder, and not just an ovarian problem. The name change was announced at the European Congress of Endocrinology in Prague and published in The Lancet, a medical journal. The objective was to adopt a more accurate term instead of continuing with the PCOS acronym or using a generic label. The preferred terminology aimed to highlight the metabolic, ovarian and polyendocrine aspects of the condition to better represent its multisystem impact. This ultimately resulted in a consensus on the new name, PMOS.
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WHAT IS PMOS? WHY THE NAME CHANGE IS PERTINENT?
The new nomenclature was necessary so as to not to make the disease just about ovarian issue. The disorder is beyond an ovarian issue; it is hormonal and a metabolic condition which affects overall and long-term health. “PMOS stands for Polyendocrine Metabolic Ovarian Syndrome and is the new name for what we used to call PCOS. It is a hormonal–metabolic condition affecting periods, skin, weight, fertility and long-term health. ‘PCOD’ is an informal term often used for any irregular periods with multiple follicles on scan, giving appearance like multiple cysts though actually they are developing eggs in follicles and not cysts, while PMOS refers to the full syndrome with clear hormonal and metabolic features,” explained Dr Kinjal Avdhut Kothari, Consultant of Obstetrics and Gynaecology at Manipal Hospital. The new name PMOS highlights how it is a whole-body hormonal and metabolic syndrome and not just an ovarian syndrome. This would gradually lead to earlier screening, better treatment and less stigma.
ANY CHANGES IN TREATMENT DUE TO NAME CHANGE?
The name change also pinpoints the opportunity to provide a holistic treatment for PMOS. “PMOS signifies it is not a condition which is just confined to ovaries , but, it is a metabolic diseases affecting various endocrine system , thus making one understand that it is great opportunity to provide holistic services to patient by involving physician, endocrinologist , gynaecologist, nutritional expert in group in treating and managing the burden of the condition, preventing the misguidance of just aiming one sector of treatment and missing the hidden core element of insulin resistance being educated and treated,” said Dr Manasa. Certainly, this is an opportunity to provide a holistic treatment, but at the core, the treatment options for PCOS do not entirely change because of the name change. In effect, it widens the scope of treatment while the existing treatment remains unchanged. “Treatment is individualised and includes lifestyle changes like healthy diet, regular exercise, good sleep, medicines for hormone balance like birth control and insulin sensitivity pills for instance, metformin, and fertility drugs or assisted reproduction when pregnancy is desired. Regular checks for blood sugar, cholesterol and blood pressure are also important to prevent long-term complications,” Dr Kinjal shared.
LIFESTYLE, DIET, AND PMOS MANAGEMENT
The major symptoms of PMOS include, “Irregular or absent periods, acne, excess facial or body hair, scalp hair loss, weight gain (especially around the waist), and sometimes dark skin patches in body folds. There are also long-term risks like diabetes and heart disease if not managed, and many women struggle with mood, self-image and fertility,” explained Dr Kinjal. About 70-80% women with PCOS have insulin resistance which drives both hormonal and metabolic issues, which explains that lifestyle is a cornerstone for the maintaining health. “Diet should focus on low-glycemic, anti-inflammatory foods such as whole grains, lean protein, healthy fats, and foods rich in fibre. Reducing refined carbohydrates and sugar helps lower insulin spikes, which in turn reduces ovarian androgen production. Physical activity is also important, as even 30 minutes of brisk walking daily improves insulin sensitivity. Strength training is excellent because muscle mass helps glucose uptake, while exercise also regulates cortisol and improves mood. Poor sleep worsens insulin resistance and increases cravings, whereas 7–9 hours of quality sleep help maintain leptin/ghrelin balance and lowers stress hormones. Chronic stress raises cortisol, which worsens insulin resistance and androgen levels, making stress management through yoga, meditation, or even hobbies beneficial. Together, these measures do not just manage symptoms, they target the root metabolic driver of PMOS,” explained Dr Mithila Kudchadkar, physician of Preventive and Social Medicine, Health Check Department, Manipal Hospital.
