From Polycystic Ovary Syndrome (PCOS) to Polyendocrine Metabolic Ovarian Syndrome (PMOS): What Obstetricians and Gynecologists Need to Know.

Abstract

Polycystic ovary syndrome (PCOS) has been renamed polyendocrine metabolic ovarian syndrome (PMOS) following a multistep international consensus process endorsed by 56 professional and patient organizations. The new name corrects a longstanding misnomer. The characteristic ovarian morphology reflects numerous arrested antral follicles, not pathologic cysts, and the legacy term has reinforced an overly ovarian and fertility-centered view of a lifelong endocrine-metabolic condition. For obstetrician-gynecologists (OBGYNs), this reframing has immediate clinical relevance. PMOS affects approximately 10%-13% of reproductive-age women, yet it remains underdiagnosed and inconsistently documented in routine care. It is associated with insulin resistance, hyperandrogenism, ovulatory dysfunction, psychological morbidity, and cardiometabolic risk across the life course. During pregnancy, PMOS is linked to higher risks of miscarriage, gestational diabetes, hypertensive disorders of pregnancy, cesarean delivery, preterm birth, fetal growth restriction, low birthweight, and small-for-gestational-age infants, with many associations persisting after adjustment for age and body mass index. Despite this evidence, PMOS is not routinely captured as an obstetric risk modifier at the first obstetric visit, nor is it consistently embedded in antenatal decision-support pathways. Patients also remain inconsistently screened and counseled for psychological, metabolic, and long-term cardiometabolic risks. This Special Report discusses the rationale for the PCOS-to-PMOS rename, reviews evidence linking PMOS with adverse pregnancy and offspring outcomes and outlines practical implications for obstetric and gynecologic care. Diagnostic criteria remain unchanged; namely, two of the following three: irregular menstrual cycles and ovulatory dysfunction, clinical or biochemical hyperandrogenism, and elevated anti-Müllerian hormone (AMH) levels or multiple follicles on ovarian ultrasound in adults. What changes is the clinical frame. OBGYNs are uniquely positioned to improve earlier diagnosis, risk recognition, counseling, and coordinated care from adolescence through menopause and beyond.