From PCOS to PMOS: perspectives on the new nomenclature

The group led by Helena J Teede should be commended for undertaking a rigorous international effort through surveys and expert consensus to reconsider the nomenclature of polycystic ovary syndrome (PCOS).¹ The proposed term polyendocrine metabolic ovarian syndrome (PMOS) represents an important attempt to move beyond historically inaccurate terminology. However, renaming alone does not resolve one of the central challenges of PCOS: the marked biological and clinical heterogeneity of the condition itself. Genetic, endocrine, and metabolic phenotyping studies show substantial variability among women diagnosed with PCOS, complicating efforts to establish uniform diagnostic frameworks and management strategies.^2,3

Although the term polycystic is clearly misleading, PMOS could also be considered biologically imprecise. Polyendocrine lacks clearly defined biological boundaries, metabolic risks disproportionately emphasising cardiometabolic manifestations despite recognised phenotypic heterogeneity, and ovarian continues to localise a fundamentally systemic disorder to a single organ. Importantly, the proposed terminology underemphasises hyperandrogenism, arguably the most consistent defining feature across phenotypes.^2,3

Although complete global representation is difficult to achieve in large international initiatives, the limited representation of Latin American populations is notable for a proposal intended to support globally applicable recommendations.⁴ Importantly, survey instruments were not translated into Spanish, despite Spanish being the world's second most spoken native language. This omission is particularly relevant because “cultural and linguistic appropriateness” was identified as a core guiding principle for the new nomenclature.¹ Greater linguistic and regional inclusivity could strengthen future efforts towards achieving a truly global consensus before implementing terminology intended to redefine one of the world's most prevalent endocrine disorders.