Polycystic Ovary Syndrome

Contents

1. The old name described cysts that are not there
2. Diagnosis rests on two of three findings
3. Insulin sits near the center
4. The heart carries part of the risk
5. What a new name cannot change

The common belief about polycystic ovary syndrome is that it is a disease of cysts on the ovaries, and it is a fair belief, since the name says exactly that and the irregular cycles behind it belong to the menstrual disorders Candace Cooley has treated over her years of practice. The belief is still wrong in two ways. The ovaries in this condition do not carry an excess of abnormal cysts, and the disorder reaches well beyond the pelvis, into insulin, weight, skin, mood and the heart. In May 2026 an international effort renamed the condition to say so.

The old name described cysts that are not there

The Endocrine Society announced that the condition will now be called polyendocrine metabolic ovarian syndrome, or PMOS, and that it affects about one in eight women, more than 170 million worldwide.¹ The new name came out of 14 years of collaboration among 56 patient and professional organizations and more than 22,000 survey responses, with a three year transition ending in the 2028 update of the international guideline.¹ Helena Teede of Monash University, who led the process, said research had found no increase in abnormal ovarian cysts in the condition, and that the old label had fed missed diagnoses and inadequate treatment.¹

What an ultrasound actually shows is something else. Melanie Cree told NPR that the structures seen on the ovary are immature egg follicles rather than cysts, which made the old name confusing for clinicians who care for teenagers, since the ovaries are not imaged in that age group at all.² CNN’s report on the change quotes a Yale gynecologist on the stigma and myth that grew around the label, with patients believing they carried large cysts they did not have.⁸ Under either name the condition is common: CNN, citing the World Health Organization, puts it at 10 to 13 percent of women of reproductive age, and estimates that 70 percent of them do not know they have it.⁸

Figure

Two names for one condition

	Polycystic ovary syndrome	Polyendocrine metabolic ovarian syndrome
What the name stresses	Cysts on the ovary	Hormones, metabolism and the ovary
Ovarian cysts	Implied by the name	No increase in abnormal cysts found
Status	Phased out over three years	Fully adopted in the 2028 guideline update

Diagnosis rests on two of three findings

In adults the diagnosis needs two of three features, Cree explained: cycles that are not monthly, arriving too far apart or too close together; signs or blood work showing high testosterone, such as severe acne, coarse facial hair or hair loss in a male pattern; and many immature follicles on the ovaries, a criterion applied only to adults.² The NHS overview lists the wider picture, including long gaps between periods, excess hair growth or hair loss, weight gain or difficulty losing weight, oily skin, tiredness, depression or anxiety, and thick dark patches of skin on the neck or armpits. It notes that symptoms usually start around puberty and may be mild, severe or absent.⁷ Testing, in the NHS account, means blood tests for hormone levels and insulin resistance, with an ovarian ultrasound offered only after age 18.⁷

Irregular cycles are often the clearest early signal. One endocrinologist quoted by CNN treats eight or fewer cycles a year, or cycles longer than 40 days, as a reason for a hormonal evaluation.⁸ Mood symptoms that rise and fall with the cycle belong to a different diagnosis, described in the entry on premenstrual dysphoric disorder.

Insulin sits near the center

The metabolic side of the condition was recognized long after the reproductive side. Andrea Dunaif of Mount Sinai told CNN that the syndrome was first seen as a reproductive disorder tied to modestly raised male hormones, and that in the 1980s researchers found it was also linked to insulin resistance, in which the body must produce more insulin to keep up and may eventually develop diabetes.⁸ The NHS describes the cause as unknown but probably bound up with insulin and testosterone not working properly, and more likely when a close relative has the condition.⁷

An Endocrine Society release from 2005 described a chart review finding that women with the condition were nearly twice as likely as the general population to have the metabolic syndrome, and that those with both had more severe insulin resistance; the senior author called for routine screening.⁶ Two decades later, Cree told NPR she hoped the new name would prompt checks for prediabetes, diabetes, fatty liver disease and obstructive sleep apnea, which she said this group often misses.²

The heart carries part of the risk

Two large studies reported in 2026 measured the cardiovascular side. A Nordic study described by News Medical followed 127,517 women with the condition and 587,810 without for an average of ten years across Denmark, Finland and Sweden, and found a 32 percent higher risk of heart disease; among women of normal weight or without type 2 diabetes the excess was 40 percent.⁵ The lead researcher, Dorte Glintborg, suggested that the biology of the condition, including high testosterone, may stiffen blood vessels regardless of weight.⁵

Figure

Excess heart disease risk by country in a Nordic study

• Denmark37.7
• Sweden41.7
• Finland48.6

A United States claims study went further. The University of Rochester reported that researchers compared 413,450 women with the condition with 2,067,250 age matched women without it, all between 18 and 50, and found a fourfold higher risk of atherosclerotic events such as heart attack and ischemic stroke.⁴ ABC News in Australia added that blood pressure, cholesterol and diabetes explained only about a third of the link, and that an observational design shows association rather than cause. Teede told ABC her team found virtually no heart disease guidelines naming the condition as a risk factor.³

What a new name cannot change

A name cannot treat anything. The NHS states plainly that there is no cure, only treatments and lifestyle changes that ease symptoms, among them hormonal treatment for irregular periods, medicines that reduce unwanted hair, and talking therapy when the condition weighs on mood.⁷ Diet and exercise remain the usual starting point, and Dunaif told CNN that most current care manages symptoms rather than the underlying cause.⁸ She also doubted that even the new label captures the disorder, since family histories hint that relatives without ovaries can share its metabolic features.⁸

Nor can a name close the gap between specialties. The condition touches gynecology, endocrinology, dermatology, cardiology and mental health, and the heart findings show how easily one can be left out. Other pelvic conditions share the same pattern of slow recognition, as the entry on endometriosis and diagnostic delay describes. How any one woman’s symptoms and risks are weighed is a matter for her and her own clinician. What the renaming can do is change the first question asked, from what the ovaries look like to what the hormones and metabolism are doing, and the evidence so far suggests that is the better question.