For many years, this condition was called polycystic ovary syndrome, or PCOS. In 2026, experts around the world agreed on a new name: polyendocrine metabolic ovarian syndrome, or PMOS. You may still see the old name in many places, and lots of people still know it as PCOS.

Having polycystic-looking ovaries on an ultrasound on its own does not mean you have PMOS. Many people have this appearance without the condition. PMOS can affect you at any stage of your reproductive life, from the teenage years through to menopause.The name was changed because the old one was misleading. It suggested the condition is mainly about cysts on the ovaries, but that is not the case. Research has confirmed there is no increase in harmful cysts on the ovaries, and the condition affects much more than the ovaries alone. The new name reflects that it involves several hormone systems (polyendocrine), the way the body handles insulin and weight (metabolic), and the ovaries.

The change is being rolled out worldwide over a few years, so you will hear both names for some time. If you were told you have PCOS, you have what is now called PMOS. Nothing about your diagnosis or your care has changed because of the name.

Polyendocrine metabolic ovarian syndrome (PMOS) is a common hormonal condition. Despite the name, it is not really a problem of the ovaries, and it does not involve true cysts. It is better understood as a condition with four sides to it: it can affect your periods and fertility, how your body handles insulin and weight, your skin and hair, and your emotional wellbeing. Because it works in several ways at once, care looks at the whole picture rather than one symptom on its own.

Having polycystic-looking ovaries on an ultrasound on its own does not mean you have PMOS. Many people have this appearance without the condition. PMOS can affect you at any stage of your reproductive life, from the teenage years through to menopause.

PMOS is one of the most common hormonal conditions in women, affecting about 1 in 8 women in Australia. It is still often missed or diagnosed late, partly because the symptoms vary so much from person to person. If you recognise some of the signs below, it is worth talking to a doctor.

PMOS looks different in each person. Some people have only mild signs, while others have several. Symptoms often fall into a few groups.

• Periods that are irregular, infrequent, or absent
• Difficulty falling pregnant, which is linked to less frequent ovulation

• Excess hair on the face or body (hirsutism)
• Acne
• Thinning hair or hair loss from the scalp

• Weight gain, or difficulty losing weight
• Signs linked to insulin resistance, where the body has to make more insulin than usual

Not everyone with PMOS has weight gain or insulin problems, and you do not need every symptom to have the condition. Low mood, anxiety, and the impact on day-to-day life are also common and are taken seriously as part of care.

There is no single test for PMOS. It is diagnosed by looking at your symptoms together with some tests, and by ruling out other conditions that can cause similar signs. It can take time to reach a diagnosis, which many people find frustrating.

Depending on your situation, this may include:

• Blood tests to check hormone levels, including testosterone and other hormones that can cause similar symptoms, such as thyroid hormones and prolactin
• Blood tests to check how your body handles sugar and to look at cholesterol, as PMOS is linked to insulin resistance
• An ultrasound of the ovaries, in some cases

A pelvic ultrasound is often done through the vagina (a transvaginal ultrasound) so the ovaries can be seen clearly. This is discussed with you first, and it is your choice.

For adults, a diagnosis of PMOS is made when at least two of the following three features are present, and other causes have been ruled out:

• Irregular or absent periods (a sign that ovulation is not happening regularly)
• Signs of higher androgen ("male-type" hormone) levels, either on a blood test or from symptoms such as excess hair or acne
• Ovaries that show many small follicles on ultrasound — sometimes called polycystic-looking ovaries — or a raised level of a hormone called AMH (anti-Müllerian hormone) on a blood test. Despite the old name, these are not harmful cysts, and this finding on its own does not mean you have PMOS.

Under the current Australian-led guideline, an AMH blood test can now be used as an alternative to ultrasound in adults. And if you already have both irregular periods and clear signs of higher androgen levels, neither an ultrasound nor an AMH test is needed to confirm the diagnosis. Diagnosis in teenagers is more careful, because irregular cycles and some other features can be a normal part of puberty.

PMOS cannot be cured, but it can be managed well. There is no single treatment, because the right plan depends on your symptoms, your general health, and whether you are hoping to become pregnant. Care usually combines healthy-lifestyle steps with treatment aimed at the symptoms that bother you most. Do not start or stop a prescribed medicine without medical advice.

A healthy lifestyle is the foundation of PMOS care at every stage of life. Regular activity and balanced eating can help with insulin resistance, cycle regularity, and general wellbeing, and they lower long-term health risks. No single diet or exercise plan works best for everyone, so the aim is a pattern you can keep up. People with PMOS can find weight harder to shift, because of the hormone changes involved. So support is focused on health, not on a number on the scales.

When periods are very infrequent, the lining of the uterus is not shed regularly, which over many years can raise the risk of changes in the lining. Bringing on regular bleeds helps protect it. The combined pill is a common first choice for managing irregular periods and for helping with acne and excess hair. A hormonal intrauterine device is another option that protects the lining. Which option suits you depends on your symptoms and your plans, and it is worth talking through.

Excess hair and acne can be helped by the combined pill, and, where needed, by anti-androgen medicines that lower the effect of male-type hormones. These treatments take a few months to show their full effect. Some people also choose cosmetic options for hair, such as laser, waxing, or shaving, alongside or instead of medicine.

Metformin, a medicine also used in diabetes, can help the body respond to insulin. It may also support cycle regularity, particularly when the combined pill is not suitable. It is used mainly for the metabolic side of PMOS rather than as a weight-loss treatment. Some people ask about inositol, a supplement; the current evidence for a clear benefit is limited, so it is worth discussing before spending money on it.

PMOS can affect how you feel, and rates of low mood and anxiety are higher in people with the condition. This is a recognised part of PMOS, not a personal failing. Dr Mahadik can check in on how you are coping. If it would help, your GP can arrange a mental health care plan. This gives access to Medicare-rebated sessions with a psychologist. You do not have to manage the emotional side on your own.

Many people with PMOS have children. Because ovulation can be less regular, it can take longer to fall pregnant, but there is a lot that can help.

For those hoping to conceive, a healthy lifestyle comes first. Even a modest weight loss, around 5 to 10 per cent of your body weight, can help restore ovulation for some people. If that is not enough, a medicine can be used to encourage the ovaries to release an egg. Under the current guideline, letrozole is the preferred first medicine for this, and other options may be considered if needed. Some people go on to have treatment such as IVF. Ovulation-inducing medicines and IVF are provided through a specialist fertility service, and Dr Mahadik can discuss your options and referral.

PMOS is a lifelong condition, and managing it well is not only about today's symptoms. Over time, PMOS is linked to a higher chance of some other health conditions, which is why regular check-ups matter. These include type 2 diabetes, high blood pressure and heart health, changes in the lining of the uterus when periods are very infrequent, and sleep apnoea. The good news is that the steps that help your symptoms also help lower these risks. That means staying active, looking after your weight, and having regular reviews. Dr Mahadik can keep an eye on the things worth watching and adjust your plan as your life changes.