Polyendocrine Metabolic Ovarian Syndrome (PMOS/PCOS)
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What is Polyendocrine Metabolic Ovarian Syndrome?
Polyendocrine Metabolic Ovarian Syndrome (PMOS), formerly called Polycystic Ovary Syndrome (PCOS), is one of the most common hormonal conditions in people with ovaries. It affects roughly 1 in 10 people of reproductive age and involves a complex interaction between hormones, metabolism, and ovarian function.
PMOS can look different from person to person — and because it affects multiple systems in the body, it often goes undiagnosed or misunderstood for years.
At University of Rochester Medicine, we take a whole-person approach to PMOS. Our specialists work across disciplines to build a care plan around your symptoms, your goals, and your long-term health.
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Call (585) 487-3378Strong Fertility PMOS Center
The PMOS Center within the Strong Fertility Center specializes in difficult-to-manage cases. The team of board-certified reproductive endocrinologists evaluates patients, recommends lifestyle changes that emphasize healthy behaviors, while also providing the support to make those changes last.
The PMOS Center requires referral from your primary care physician or an OB/GYN physician.
Why PCOS Is Now Called PMOS
You may have known this condition as Polycystic Ovary Syndrome, or PCOS. In 2026, a global consensus published in The Lancet officially recommended renaming it to Polyendocrine Metabolic Ovarian Syndrome (PMOS).
Why the change? The old name was misleading—cysts are not a feature of PCOS despite the name. More importantly, the name didn't reflect the broader hormonal and metabolic effects that drive the condition and shape long-term health risks.
The new name tells a more complete story:
- Polyendocrine recognizes that multiple hormone systems are involved — not just reproductive hormones
- Metabolic highlights the condition's significant impact on metabolism, including insulin resistance and increased diabetes and cardiovascular risk
- Ovarian acknowledges the ovarian component which can include ovulatory dysfunction and excess androgen production
If you've already been diagnosed with PCOS, nothing changes for you. You may still hear providers and resources use "PCOS" as the medical community transitions to the new terminology. Both names refer to the same condition.
Read the Full Story: Why PCOS Is Now PMOS
Can You Have PMOS/PCOS Without Ovarian Cysts?
Yes — and this is one of the key reasons the condition was renamed.
Despite the word "polycystic" in the original name, most women diagnosed with PCOS do not develop ovarian cysts. The small follicles sometimes seen on ultrasound are not true cysts, they're immature egg follicles that haven't released during ovulation. Some people with the condition have completely normal-looking ovaries on imaging.
What defines PMOS isn't the presence of cysts. It's a pattern of hormonal and metabolic disruption that can include irregular ovulation, elevated androgens (hormones), and insulin resistance. That's why the new name focuses on what's actually happening in the body — and why a thorough evaluation matters more than any single test.
Symptoms of PMOS
PMOS affects multiple systems in the body, which means symptoms can vary widely. You may experience some of these, or several at once:
Menstrual and Reproductive Symptoms
- Irregular, infrequent, or absent periods
- Difficulty getting pregnant or recurrent pregnancy loss
- Pelvic pain
Hormonal Symptoms
- Excess hair growth on the face, chest, or back (hirsutism)
- Persistent acne, especially along the jawline and chin
- Thinning hair or hair loss on the scalp
- Skin darkening increases of the neck, groin, or underarms (acanthosis nigricans)
- Skin tags
Metabolic Symptoms
- Unexplained weight gain, particularly around the midsection
- Difficulty losing weight
- Insulin resistance or elevated blood sugar
- High cholesterol or triglycerides
Emotional and Mental Health Symptoms
- Anxiety or depression
- Mood swings
- Fatigue
- Sleep disturbances, including sleep apnea
Because these symptoms overlap with other conditions, PMOS is often missed or misdiagnosed. If you're experiencing a combination of these signs, it's worth talking to a specialist.
Diagnosing PMOS
There is no single test for PMOS. Diagnosis is based on a combination of your symptoms, medical history, lab work, and sometimes imaging.
Your provider may:
- Review your menstrual history to identify irregular or absent cycles
- Order blood tests to check hormone levels, including androgens (like testosterone), as well as thyroid function and prolactin to rule out other conditions
- Assess metabolic health through fasting glucose, insulin levels, hemoglobin A1c, and a lipid panel
- Perform a pelvic ultrasound to evaluate the endometrium and the ovaries—to see if there are increased follicle numbers. An ultrasound is not necessary for diagnosis
- Screen for related concerns such as depression, anxiety, sleep apnea, and cardiovascular risk factors
Most providers use the Rotterdam criteria, which require at least two of the following three features:
- Irregular or absent ovulation
- Clinical or lab evidence of elevated androgens
- Polycystic-appearing ovaries on ultrasound
With the shift to PMOS, there is growing emphasis on metabolic screening as a standard part of evaluation for people at every stage of life, not just those trying to conceive.
At University of Rochester Medicine, we don't stop at a diagnosis. We look at the full picture — your hormones, your metabolism, your mental health, and your personal goals — so we can build a plan that actually fits your life.
Treatments for Polyendocrine Metabolic Ovarian Syndrome (PMOS/PCOS)
PMOS is a lifelong condition, but it's highly manageable, especially with a care team that understands its complexity. Treatment is always personalized, because no two people experience PMOS the same way.
Medications
Depending on your symptoms and goals, your provider may recommend:
- Hormonal contraceptives (birth control pills, patches, or hormonal IUDs) to regulate periods, reduce androgen levels, and protect the uterine lining
- Anti-androgen medications (such as spironolactone) to address acne, excess hair growth, and hair thinning
- Metformin to improve insulin sensitivity and lower blood sugar — particularly for people with insulin resistance or prediabetes
- Ovulation-inducing medications (such as letrozole or clomiphene) for patients who are trying to conceive
- GLP-1 receptor agonists or other newer therapies, when appropriate, for metabolic management
Lifestyle Modifications
For many, targeted changes in nutrition and physical activity are the foundation of PMOS management. For some, losing 5 to 10 percent of body weight can significantly improve insulin sensitivity, restore ovulation, and reduce androgen levels.
Mental Health Support
PMOS is associated with higher rates of anxiety, depression, and body image concerns. We can connect you with mental health professionals who specialize in the psychological impact of chronic hormonal conditions.
Dermatologic Care
For skin and hair concerns that don't respond to first-line treatments, our dermatology team can offer additional options, including topical therapies, laser treatments, and other targeted approaches.
Long-Term Metabolic Monitoring
Because PMOS increases your risk for type 2 diabetes, cardiovascular disease, and other metabolic conditions, ongoing monitoring is essential. We'll work with you to establish a screening schedule and adjust your plan as your needs evolve over time.
What Sets Us Apart?
At University of Rochester Medicine, we see PMOS for what it truly is: a complex, whole-body condition that deserves more than a one-size-fits-all approach.
Specialists Who See the Full Picture
Our team includes reproductive endocrinologists, gynecologists, endocrinologists, dietitians, dermatologists, and mental health professionals—all working together.
A Research-Driven Approach
As part of one of the nation's leading academic health systems, our providers stay at the forefront of PMOS science. Our researchers are actively studying the hormonal and metabolic mechanisms behind PMOS to develop better treatments and improve outcomes.
Rooted in Whole-Person Medicine
University of Rochester Medicine pioneered the biopsychosocial model of care; the idea that your physical, mental, and social well-being are deeply connected. That philosophy is woven into everything we do for people with PMOS, from the questions we ask at your first visit to the way we coordinate your care over time.
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Frequently Asked Questions
Yes. The new name more accurately reflects the hormonal and metabolic nature of the condition. You may still hear both names used as the medical community transitions.
PMOS stands for polyendocrine metabolic ovarian syndrome. "Polyendocrine" refers to the involvement of multiple hormone systems. "Metabolic" highlights the condition's impact on metabolism, including insulin resistance. "Ovarian" acknowledges the functional role of the ovaries.
The original name, polycystic ovary syndrome, was considered misleading. It emphasized ovarian cysts, which are not part of the syndrome, and it didn't capture the condition's broader hormonal and metabolic effects. The rename aims to reduce stigma, improve understanding, and encourage earlier, more comprehensive care.
No. PMOS and PCOS refer to the same condition. The name has changed, but the condition itself — its symptoms, diagnostic criteria, and treatment approaches — remains the same. Think of it as a more accurate label for something doctors have been diagnosing and treating for decades.
Your current treatment plan does not need to change based on the name alone. Over time, the new name may lead to greater emphasis on metabolic screening and earlier intervention, which could enhance how the condition is managed.
Yes. The small follicles sometimes seen on ultrasound are immature egg follicles, not true cysts. Diagnosis is based on a combination of symptoms, hormone levels, and metabolic markers.
It can. PMOS is one of the most common causes of ovulatory infertility, meaning it can interfere with regular ovulation and make it harder to conceive. However, many people with PMOS do get pregnant.
PMOS has a significant metabolic component. Many people with the condition experience insulin resistance, elevated blood sugar, abnormal cholesterol levels, and increased risk for type 2 diabetes and cardiovascular disease. The inclusion of "Metabolic" in the new name reflects how central these are to PMOS and long-term health management.