For nearly a century, we have called it polycystic ovary syndrome, or PCOS. That name is now changing.
In May 2026, an international consensus group formally renamed PCOS Polyendocrine Metabolic Ovarian Syndrome, or PMOS. The change was published in The Lancet and reflects something clinicians and patients have recognized for years.
This condition was never just about the ovaries.
It is a complex endocrine and metabolic syndrome that can affect menstrual cycles, fertility, insulin sensitivity, androgen levels, cardiovascular risk, body composition, skin, hair, mood and long-term metabolic health. So yes, the name matters. Because when we name a condition incorrectly, we often think about it incorrectly too.
The Problem With Calling It “Polycystic Ovary Syndrome”
The term PCOS has always been somewhat misleading. The “cysts” seen on ultrasound are usually not true ovarian cysts. They are immature follicles that have not progressed normally through ovulation.
Even more importantly, not every woman with PMOS has polycystic-appearing ovaries. For years, women have been told they did not have PCOS because their ultrasound looked normal. Others were given birth control pills and told to come back when they wanted to get pregnant. Still others heard the classic recommendation: “Just lose weight.”
That approach misses the larger picture. The ovaries are involved, but they are not acting alone.
What PMOS Actually Means
The new name gives us a much better framework.
Polyendocrine
Multiple hormone systems may be involved. This can include insulin, testosterone and other androgens, luteinizing hormone, follicle-stimulating hormone and broader neuroendocrine signaling.
This helps explain why PMOS does not look the same in every woman. One woman may struggle with acne and irregular cycles. Another may have infertility and elevated testosterone. Another may have metabolic dysfunction without obvious weight gain.
There is no single PMOS phenotype.
Metabolic
This may be the most important addition to the name.
Insulin resistance and metabolic dysfunction play a significant role for many women with PMOS. When cells become less responsive to insulin, the pancreas often compensates by producing more.
Higher circulating insulin can stimulate ovarian androgen production and lower sex hormone-binding globulin, or SHBG. That can lead to higher levels of free testosterone and contribute to symptoms such as acne, facial or body hair growth, scalp hair thinning, irregular ovulation and difficulty conceiving.
It can also contribute to abnormal glucose regulation, dyslipidemia and increased long-term cardiometabolic risk.
Not every woman with PMOS has insulin resistance. But it absolutely deserves to be evaluated.
Ovarian
The ovaries are still part of the story. Irregular ovulation, menstrual disruption and polycystic ovarian morphology remain important features of the syndrome.
The difference is that we are no longer pretending the ovaries are the whole problem. They are one part of a larger physiologic system.
That distinction matters.
Food Matters, But It Is Not a Cure-All
Nutrition can be incredibly helpful in PMOS. It can support blood sugar regulation, insulin sensitivity, inflammation, muscle health and cardiometabolic function.
But this is where we need to stay grounded. There is no single perfect “PMOS diet.”
For many women, a useful nutritional foundation includes adequate protein, high-fiber foods, minimally processed carbohydrates, healthy fats and fewer ultra-processed foods.
The goal is not perfection. The goal is better metabolic signaling.
That may mean pairing carbohydrates with protein and fat, increasing fiber, reducing sugar-sweetened beverages, eating enough protein to support lean muscle, avoiding chronic under-fueling and cultivating a way of eating that can actually be sustained.
Food is a powerful tool. It should not become another source of punishment or obsession.
Muscle Is Part of the Treatment Plan
This deserves more attention than it usually gets.
Skeletal muscle is one of the body’s primary sites for glucose disposal. The more metabolically healthy muscle you maintain, the better equipped your body is to handle glucose and insulin.
That makes resistance training especially valuable for women dealing with insulin resistance or metabolic dysfunction.
Walking matters. Cardiovascular exercise matters. Sleep matters. Stress matters. But strength training needs a seat at this table too.
Not because you need to earn your food. Because muscle is metabolically protective for our bones, our brains and our entire body.
What About Supplements and Botanicals?
This is where we need both science and common sense.
Nutraceuticals are not automatically ineffective because they are not pharmaceuticals. They are also not automatically safe because they are “natural.”
Some compounds have real biological activity. That is exactly why they may help. It is also why they need to be used thoughtfully.
Two commonly discussed options in PMOS are inositol and berberine.
Inositol
Inositol is involved in intracellular signaling, including insulin signaling.
Research suggests that inositol may improve some metabolic, hormonal and reproductive outcomes in women with PMOS. A 2026 umbrella review found encouraging improvements in insulin-related measures and hormone profiles.
But the evidence is not perfect. Many outcomes were supported by low or very low-quality evidence, and current international guidelines do not recommend one specific dose, formulation or ratio for every woman.
This matters because Inositol may be useful, but it’s not magic.
Berberine
Berberine is a plant-derived compound that has been studied for its effects on glucose metabolism, insulin sensitivity and lipids.
Some studies in women with PCOS, now PMOS have shown improvements in insulin resistance, waist circumference, lipid profiles and androgen-related markers.
Promising? Yes. Definitive? Not yet.
Berberine also has the potential to interact with medications and may not be appropriate during pregnancy or in certain medical conditions.
Natural does not mean harmless. It means biologically active. And biologically active substances require clinical judgment.
This Is What Functional Medicine Should Look Like
Functional medicine should not mean handing every patient a bag of supplements. Traditional medicine should not mean ignoring nutrition, sleep, movement, stress and metabolic health, or relying solely on prescription medications.
There is plenty of room in the middle for thoughtful, evidence-informed care.
That means asking better questions. Are you ovulating? What is your menstrual pattern? What do your glucose and insulin markers look like? What is happening with your lipid profile? Are your androgen levels elevated? Are you sleeping well? Are you chronically stressed? Are you under-eating? Are you building muscle? Do medications make sense? Could a nutraceutical be useful?
And most importantly: What is actually happening in your body?
That is the question that matters.
The Power-of-One Health Take
Changing PCOS to PMOS does not solve every problem in women’s health. But it changes the lens.
For decades, the name pointed us toward the ovaries. Now it points us toward the whole woman: her hormones, her metabolism, her reproductive health, her cardiovascular health, her mental health and her ability to reclaim agency over her future health.
That is a much better place to start.
At Power-of-One Health, we do not treat symptoms, laboratory values, weight or hormones as separate problems. We connect the dots.
We use food. We use movement. We use sleep and stress physiology. We use medications when appropriate. We may use nutraceuticals and botanicals when the evidence and the individual situation support them.
And we stop pretending that one thing fixes everything.
Good functional medicine is not anti-medication. Good conventional medicine is not anti-nutrition. Supplements are not voodoo. But they are also not the answer to every problem.
The goal is not to chase perfect hormones. The goal is to understand your physiology well enough to make better decisions about your health.
One choice. One action. One change.
And sometimes, one very overdue name change.
