From Reproductive Disorder to Metabolic Syndrome: The Evolution of Polycystic Ovary Syndrome (PCOS) into Polyendocrine Metabolic Ovarian Syndrome (PMOS)

Abstract

Polycystic Ovary Syndrome (PCOS) has long been recognized as one of the most common endocrine disorders affecting women of reproductive age. Traditionally, PCOS was primarily considered a reproductive disorder characterized by menstrual irregularities, hyperandrogenism, infertility, and polycystic ovarian morphology. However, growing scientific evidence has demonstrated that the syndrome extends far beyond ovarian dysfunction and reproductive abnormalities. Increasing recognition of insulin resistance, obesity, dyslipidemia, cardiovascular complications, chronic inflammation, and psychological disturbances has transformed the understanding of the condition into a multisystem metabolic-endocrine disorder. In 2026, following a global consensus process involving international experts and patient advocacy groups, the term Polyendocrine Metabolic Ovarian Syndrome (PMOS) was introduced to replace PCOS. The new terminology reflects the broader endocrine and metabolic nature of the disorder and addresses the limitations and misconceptions associated with the previous nomenclature. This review article discusses the historical evolution of PCOS, the pathophysiological transition from a reproductive syndrome to a metabolic disorder, the scientific basis for renaming PCOS to PMOS, clinical manifestations, diagnostic criteria, associated metabolic complications, management strategies, and future perspectives. The review emphasizes the importance of adopting a multidisciplinary approach for early diagnosis, personalized treatment, and prevention of long-term metabolic consequences.