‘PCOS’ is a lifelong complex disorder involving the endocrine system, metabolism, and ovaries in females. Polycystic Ovarian Syndrome was a condition first described in 1935 in women who were infertile, had no periods, had excessive hair growth, and ovaries which were enlarged and noted to have cysts. What this did is relegate a medical condition to a gynecological disease whereas now it is recognized as a widespread endocrine and metabolic disorder, hence the name change to PMOS or Polyendocrine Metabolic Ovarian Syndrome.
First, some explanations. What is PCOS?
The endocrine system is a set of glands scattered throughout your body that secrete hormones—that is, chemicals which are carried through the blood to act remotely from the site from which they originate. Examples of endocrine glands include the thyroid, the pancreas, and the reproductive organs.
Metabolism is the general term for chemical reactions in the body and can be divided into anabolism (processes that build up your system like exercising enlarging muscles) or catabolism (processes that break down your system like exercising breaking down sugars and fat for energy). A Metabolic Process is any process or action that drives metabolism in either direction, and a Metabolic Disorder (like diabetes or PMOS) disrupts healthy metabolism. Your metabolic health can be measured by vital signs, blood sugar or hemoglobin A1C levels, lipid profile or insulin levels.
Now, back to PMOS
While most women appear not to be properly diagnosed with this condition (and it is hard to get statistics on unknowns), it looks like perhaps up to ten percent of women suffer from this ailment. It turns out that the condition does not solely depend upon the ovaries and that many women with the condition lack cysts, but may have immature ovarian follicles.
Instead, these women have abnormalities in several endocrine pathways and metabolic pathways which includes:
- insulin resistance (so your pancreas makes more insulin)
- androgen production (increased male hormones, stimulated by the increased insulin)
- reproductive dysfunction and abnormal periods
- obesity
- dyslipidemia (abnormal levels of fats in the blood, including the classic cholesterol)
- type 2 diabetes
- metabolic syndrome
- fatty liver disease
- cardiovascular disease.
Some women may develop hirsutism (increased body/facial hair), depression, trouble sleeping (and sleep apnea), fatigue, and skin changes.
In May 2026, the condition was renamed by a consensus of multiple professional societies and patient organizations and published in the prestigious journal, The Lancet (Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: a multistep global consensus process, Lancet 2026; 407: 2329–39).
The old name led to preconceptions and misdiagnoses because it focused on the ovaries. Patients, and doctors, believed that ovarian cysts require surgery. Primary care doctors keyed in on fertility issues or menstrual issues and missed concurrent metabolic problems. Furthermore, there was a misconception that the disease ended when menopause finished and this is not the case. As a result, women often suffered delays in diagnoses and discombobulated care.
What does this mean for patients now?
Patients can now expect to be viewed in a more comprehensive light, with a multisystem disorder that will need lifelong management. It is no longer just a reproductive ‘disease’. Patients will—and should—have greater care with increased attention to insulin resistance and diabetes; to high blood pressure; lipid abnormalities as well as obesity; depression; and the risk of cardiovascular disease.
It means a multidisciplinary approach with a physician leading and coordinating care. Patients should have diabetes screening, regular blood pressure monitoring, lipid testing, weight management, mental health care, pregnancy counseling, enhanced nutrition and exercise as well as risk reduction for cardiovascular disease.
It will take a few years for PCOS terminology to fully convert to PMOS but with the change there will be less stigma, improved care and better research funding. Concierge physicians are ideal managers for this condition and coordinating the specialist care that patients need. We, at The Village Doctor, are ready to answer your questions about this condition and help manage your care.
Wishing you the best of health,
Dr Spira
Alan Spira, MD, DTM&H, August, 2026
Polycystic ovary syndrome (PMOS), formerly known as PCOS, can affect more than reproductive health—it may also have implications for your long-term metabolic and overall health. If you have questions about PMOS symptoms, risk factors, or treatment options, our Bay Area concierge medicine team can provide personalized guidance based on your health history and individual needs. Contact us today to schedule a consultation and take a proactive step toward managing your health.
Call The Village Doctor at (650) 851-4747 or Contact us to learn more about the practice.
