360-SYNCPodcast_PMOS

[00:00:00]

Welcome, friends, to this [00:01:00] episode of the Sync Your Life podcast. I should say welcome back. Hopefully, you’re enjoying this new content that we’ve been throwing out there here these last couple of weeks. I’ve given you a life update. We’ve gone deeper on bone density. Of course, we’re diving into genetics.

But we did take a little summer hiatus, and I have to be honest with you, there was a couple moments this summer that I wanted to just stop that plan entirely and do an episode on what we’re about to talk about today, because this is big news. If you haven’t already heard, PCOS is now PMOS. We’re gonna go through all of that, what that means.

But this announcement was made in May, and it was right at the time that we decided to take a pause on the podcast for the summer. So it’s been eating at me all summer long to, to get this information out to you because I know it affects so many women, myself included. Okay, so let’s go ahead and dive in.

PCOS, like I said, has a new name. It is now PMOS. Formerly, it was polycystic ovarian syndrome, and now it is polyendocrine metabolic ovarian syndrome. So when I heard this, my first thought was like, [00:02:00] “Okay,” like, “what actually changed?” Like, are we just changing the name, or does this represent some sort of meaningful change in how we’re gonna understand this condition?

Well, if you’re like me and you’ve been diagnosed with PCOS for the last, you know, five, 10, 20 years, you’re wondering, “How does this actually change my healthcare?” And that’s exactly what I wanna dig into today. There’s a lot packed into this name change, so we have to be thinking about it like there’s a much bigger story here, and so I wanna make sure that we are breaking it all down.

So let’s go through it step by step. Like I said, the new name is PMOS, polyendocrine metabolic ovarian syndrome. It was announced on May 12th, 2026, so just a couple months ago, in a major international consensus paper titled The Lancet. This is not just something that happened overnight. It’s not just like an article came out and somebody made the decision that they were gonna change this name, right?

Like, this has actually involved 56 academic, clinical, and patient organizations and thousands of clinicians and people with lived experience. So the final consensus process included more than [00:03:00] 14,000 survey respondents who have PCOS and multidisciplinary healthcare professionals. The broader global engagement has been described as involving more than 22,000 responses.

So this wasn’t somebody just sitting in a room saying, “Hey, you know, PCOS isn’t working for me. Let’s change it to something else.” This was actually an 11-year international process. And to be honest with you, what I love about it the most is that women with the condition, women like me or maybe you, were a major part of driving this change.

So let’s talk about why. Why was PCOS, polycystic ovarian syndrome, considered a bad name? Well, in my opinion, it starts with the word polycystic. This is probably the biggest misconception about this condition. When most people hear polycystic ovaries, they picture an ovary that’s full of cysts, and that’s not actually what’s going on.

The ovarian finding associated with PCOS is generally an increased number of small follicles. These are follicles containing immature eggs. They’re not the same thing as pathological ovarian [00:04:00] cysts. This matters because the name PCOS has led patients, and sometimes even clinicians, to think that the ovaries themselves are the primary problem.

But the condition is much, much broader than that. In fact, the 2026 consensus paper specifically says that the old name implied pathological ovarian cysts, obscured the endocrine and metabolic features of the condition, and contributed to delayed diagnosis, fragmented care, and stigma. Yeah, I hate saying it, but isn’t this kind of a broken record in women’s health?

So they took cystic out of the name. That’s the first major change. Now let’s talk about the polyendocrine part. This is really interesting because we’re saying this isn’t just an ovary problem. It’s an endocrine problem. We’re talking about multiple hormonal systems and pathways. We’re talking about androgen excess.

We’re talking about insulin and glucose regulation. We’re talking about sex hormones. We’re talking about ovulation. For those of you who have heard my four-legged chair analogy, this is more pertinent than ever in this conversation. We’re talking about the metabolic [00:05:00] consequences that can accompany this condition.

This is where the name change starts to make a lot more sense. Because if we call it polycystic ovary syndrome, where does your attention go? You start thinking about the ovaries. But if we call it polyendocrine metabolic syndrome, suddenly the ovary is one part of a much larger picture, and that is really the point of the name change.

Let’s talk about the word metabolic. Well, this is probably the most important word in the new name because metabolic dysfunction has been part of the PCOS conversation for a very long time. This is not brand-new science. In fact, in twenty twenty-three international guidelines, This is actually the guideline that underlies the current PMOS framework already recognized insulin resistance as an important pathophysiological feature. But there’s a really important nuance here. We shouldn’t turn around and say, “Well, PMOS is just insulin resistance.” It’s not. We also shouldn’t say every woman with PMOS is insulin resistant.

That’s also too simplistic. But metabolic dysfunction is common enough [00:06:00] and clinically reported enough that the international guideline recommends metabolic screening regardless of your BMI. in fact, the guideline identifies the seventy-five gram oral glucose tolerance test as the most accurate way to assess glycemic status in women with PMOS.

And here’s another point. The guideline does not recommend routinely measuring insulin levels as a way to diagnose insulin resistance. This is hugely important. This is something that I think gets lost online when we’re watching influencers. You see people ordering fasting insulin, or they’re calculating their HOMA-IR, and they’re saying things like, “Well, this must mean you have PCOS.”

And that’s not actually how the guidelines approach it. Insulin resistance is recognized as part of the underlying physiology, but currently available insulin assays aren’t considered clinically reliable enough for routine use. So the metabolic piece is very real. We have to be precise about what the science actually says.

Okay, so let’s talk about the ovaries because this is where I think the name change really gets interesting. The ovaries [00:07:00] haven’t been removed from the diagnosis. This isn’t saying that the ovaries don’t matter. They still matter. But we’re moving away from the idea that you need to see polycystic ovaries on an ultrasound in order to have this condition.

The diagnostic framework remains essentially the Rotterdam framework. You need two out of three features after excluding other causes. So number one, hyperandrogenism. This is either biochemical evidence or clinical signs such as hirsutism. Now, by the way, I have a whole episode on PCOS from a couple of years ago.

I will link up for you in the show notes so that you can go deeper on androgen excess. Number two is ovulatory dysfunction, which can show up as irregular menstrual cycles. And number three, polycystic ovarian morphology on ultrasound, or in adults, an elevated AMH can be used as an alternative marker.

Here is the really important practical point. If a woman has irregular cycles plus hyperandrogenism, this doesn’t necessarily need an ultrasound or AMH to make the diagnosis. There are two of the three markers clicked. [00:08:00] That is a significant clarification.

And AMH is one of the most interesting changes. This actually happened before the name change. The twenty twenty-three guideline incorporated AMH, which is anti-Mullerian hormone, as an alternative to ultrasound for defining PCOS in adults. But AMH is not a standalone PCOS test, and that’s important. You can’t just walk into a lab and get an AMH test and see that it’s elevated and be like, “Well, I have PMOS.”

No, the guideline specifically says that AMH should not be used as a single test to diagnose this condition. It is just one piece of the diagnostic algorithm. AMH is not recommended for diagnosis in adolescence because the specificity isn’t good enough. So if you’ve heard, “Well, there’s a new PCOS blood test,” that’s not really accurate.

That’s actually false marketing. There is additional tools for adult diagnosis, and it is not a magic blood test So let’s get to something that I think is really important. The name changed, but the diagnostic criteria did not get thrown out. This is not a situation where it’s PCOS is wrong, and [00:09:00] here’s the completely new disease called PMOS.

It’s the same condition. The name is changing because researchers and clinicians believe the old name did a poor job describing the condition. This distinction is really important. The updated international guidelines actually say that the recommendations and content remain unchanged with the terminology update.

So the guideline is still using the phrase PMOS or PCOS during this transition, with the next full guideline planned for twenty twenty-eight. So if you’re sitting here thinking, “Wait, my doctor diagnosed me with PCOS years ago, so do I have PMOS now?”

Yes, it’s the same condition. You’re not being diagnosed with something new. But here’s where I start asking questions because this is where I think we need to be a little skeptical. Will changing the name actually change healthcare? Because it could. It won’t automatically. Imagine if a woman walks into a doctor’s office with irregular periods, maybe some acne, hirsutism, weight gain, difficulty conceiving, maybe elevated glucose or high triglycerides, maybe even elevated blood pressure, and the doctor says, [00:10:00] “Well, you have PCOS.”

And then the treatment conversation is basically, “Here’s birth control,” or, “Let’s just try putting you on me-metformin,” right? Or, “Maybe just try losing some weight. Just cut back on your carbs.” And that’s the end of the conversation. Now we’ve changed the diagnosis in the chart from PCOS to PMOS. But if we’re still having the exact same conversation, have we really changed anything?

The answer is no. The metabolic piece isn’t new, but it may shape the way women become treated by their doctors. We’ve known for years that women with PCOS have increased metabolic risk. We’ve known about insulin resistance, type two diabetes. We’ve known about hypertension and sleep apnea, psychological health, pregnancy complications.

Right? We’ve known this forever. So the science doesn’t suddenly discover metabolism now. What we have done is we’ve changed the emphasis in the language, which can be powerful because language drives attention. And in this case, it could be driving attention to the right factors, those factors being metabolic.

Our health is metabolic health. [00:11:00] Hopefully, you’re in the hands of a doctor who sees it that way, who is proactive in your wellness, who’s really looking at functional root cause and overall metabolic disease risk factors. Then something has happened– And then something happened this summer that really just makes this whole conversation piece even harder to ignore.

In July of twenty twenty-six, a very large U.S. study looked at more than two point four million women, including more than four hundred and thirteen thousand women with this condition, and examined the risk of atherosclerotic and examined the risk of cardiovascular disease. The finding was striking. Women with PMOS had an adjusted hazard ratio of four point four for cardiovascular disease compared with the matched comparison group.

We’re talking about cardiovascular disease, including coronary artery disease, cerebrovascular disease, peripheral arty- peripheral artery disease. Like we’re talking about all the things that we ultimate… We’re talking about all the things that we ultimately worry about as women. Heart attacks, strokes, all that kind of stuff.[00:12:00]

Importantly, the association remained after adjustment for traditional cardiovascular risk factors. Now, this is an observational claims-based study. It does not prove that PMOS causes heart attacks or strokes, and it doesn’t mean that an individual woman with PMOS has a four point four fold guaranteed risk of having a heart attack.

That is not how we’re gonna interpret this, but it is a very strong signal that cardiovascular health needs to be taken seriously in this population. This is exactly why I think that the word metabolic in the new name really matters. So what should happen differently now in the doctor’s office? Well, this is where I wanna get really practical.

If you’re like me and you have PMOS, I don’t want the conversation to stop at, “Well, are your periods regular?” I want them to keep asking questions. I want the doctor that you’re working with to be asking things about your glucose regulation, perhaps offering a constant glucose monitor to regulate yourself, to watch your blood sugar highs and lows and to manage it through nutrition.

I want them to be asking you about your blood pressure, your lipids, your menstrual patterns, [00:13:00] whether or not you’re ovulating. Hopefully, you’re tracking ovulation, right? Ovulation is a fifth vital sign. You’re tracking ovulation, not just menstrual bleeds. Hopefully, they’re asking you if you have signs of androgen excess, m- whether that’s hirsutism, hair on the face, acne.

Hopefully, they’re asking about your sleep, your snoring. Are you snoring? Are you waking up exhausted? How’s your mental health? Are you planning pregnancy? And also importantly, what is your individual cardiovascular risk profile? This is a whole body condition We know that this condition is associated with prevalence of obstructive sleep apnea independent of BMI.

We know now that it’s also associated, associated with heightened cardiovascular risk. So let’s talk though about the lean PCOS conversation. This is really important to me as well. This has always been my MO. This is probably one of the biggest practical problems with the metabolic framing. There’s a tendency to think that metabolic condition equals an overweight woman, and that is not accurate.

You can have PMLS at a lower [00:14:00] body weight. You can have significant metabolic dysfunction without looking metabolically unhealthy. You can have PMLS without having the stereotypical presentation that people associate with the condition. But if metabolic becomes code for, well, this is a condition that happens to just women in larger bodies, we’ve created a new problem.

The diagnostic criteria aren’t based on BMI. Metabolic risk assessment shouldn’t be replaced by looking at someone’s body size. So what about the menstrual cycle? Well, this is another part of this that I think is fascinating because one of the most visible signs of PMLS is actually the menstrual cycle, not a woman’s body type.

You might have cycles that are thirty-five days, forty-five days, sixty days. You might skip periods. You might ovulate inconsistently. And sometimes women are told, “Well, your periods are irregular because you have PCOS.” But I would flip that around. Your menstrual cycle is giving you information. The irregularity can be a clinical sign of an underlying endocrine and metabolic pattern.

And that’s one reason that I think menstrual cycle literacy is so [00:15:00] important. The period isn’t necessarily the disease. It’s one of the places where the disease becomes visible. Here’s another misconception. You don’t need to have cysts. You don’t need to have an ultrasound that says polycystic ovaries.

You don’t have to have a body type of big or small. The diagnosis is based on the overall pattern: hyperandrogenism, ovulatory dysfunction, and/or polycystic ovarian morph-morphology or elevated AMH in adults. This is very different from you have PCOS because you have this body type, or you have PCOS because you have cysts on ultrasound.

This is not the diagnostic framework So what does this mean for someone who’s already diagnosed? Well, honestly, probably less immediately than you might think and more long-term than you might think. If you have a PCOS diagnosis today, you don’t need to panic. You don’t need to go get re-diagnosed or anything.

The condition is still the same. Your treatment doesn’t automatically change just because the acronym changed. The international guideline recommendations haven’t suddenly been rewritten. But I would use the name change as an opportunity to [00:16:00] revisit your care. If you’ve been treated as though this is purely a reproductive problem, ask, “Have we actually assessed my metabolic health?

Have we assessed my cardiovascular risk? Have we checked my glucose appropriately? Do my symptoms fit the current diagnostic framework? Are we monitoring my blood pressure and my lipids? If I’m trying to conceive, what should I be doing before pregnancy?” These are all questions that are useful versus saying, “Well, I guess I have PMOS now.”

So what about treatment? Well, the name change doesn’t mean that there’s suddenly a new medication or that everyone needs metformin or a birth control pill or anything else. It doesn’t mean that everyone needs an aggressive weight loss intervention either. The guideline emphasizes individualized care based on the person’s symptoms, goals, and risk factors.

And in case I haven’t said it lately, health is individual. Hopefully, you’re working with a practitioner who treats you as an individual. For some women, the biggest issue is gonna be cycle regulation. For others, it’ll be androgen symptoms. For someone else, it could be fertility. But for someone [00:17:00] else, it could be metabolic risk.

For many women, it’s several of these all at the same time, and that’s why calling it a syndrome is actually useful. There isn’t just one single type of PMOS patient. So here’s the bottom line. I actually think that the name change is important, but I don’t think that we should confuse a better name with better healthcare.

The new name is more scientifically descriptive. It removes the emphasis on cysts, right? It acknowledges the endocrine component. It puts metabolic health in the frame, and it keeps ovarian function in the picture. But now we have to see what happens next. Will this change medical education? Will it change how primary care doctors screen women?

Will it change how cardiologists think about younger women with cardiovascular risk? Will it change how fertility specialists approach these patients? Does it reduce the number of women who spend years being told that irregular cycles are just normal? Does it reduce weight stigma? Does it improve access to metabolic screening?

Does it change research funding? Do we finally start researching women [00:18:00] on this topic? Does it change the way insurance systems classify and reimburse care? That is where the real test of PMOS begins. So if you’re listening to this and you’re thinking, “Wait, I have this,” just know it’s the same condition.

Don’t get hung up on the acronym. Instead, ask yourself, “Is my healthcare addressing the whole situation? Not just my ovaries, not just my fertility, the whole picture.” I actually think that that’s the most interesting part of this whole story. The name changed from something that essentially said there’s something going on with your ovaries to something that’s just a broader endocrine and metabolic condition.

As someone who talks about women’s health, hormones, fertility, menstrual cycle, I think this is really worth paying attention to because sometimes the name of a condition determines the questions that we remember to ask, and maybe that’s why this name change is really powerful.

We’re not pretending that we’ve discovered a brand-new disease. We’re finally giving a much more accurate name to something that we’ve been studying for decades and unfortunately living. . So PCOS, PMOS, until it finally [00:19:00] transitions and PMOS becomes common language, that’s where we’re heading.

We’re heading into a bright future of women’s health, where we finally stop feeling bad and start looking at the big picture, and it starts with simple things like this. Until then, my friends, keep paying attention to what your body is telling you. Your symptoms aren’t random. They are data, and the more that we understand the data, the better we can advocate for the care that we actually need.

I hope you found value in this episode. Until next time, my friends, we’ll talk soon. Bye-bye. [00:20:00]