By Dr Hazel Batten, Integrative GP at Remede Wellness Medicine
It’s Not PCOS Anymore. And the New Name Finally Tells the Truth.
For decades, millions of women were handed a diagnosis that didn’t quite fit. Polycystic ovary syndrome (PCOS) conjured images of cyst-riddled ovaries, but the name was misleading from the start. The “cysts” aren’t cysts at all. They’re arrested follicles, eggs that never got the hormonal signal to release. And the ovaries aren’t really the problem. They’re just where some of the symptoms show up.
In May 2026, after a global consensus process involving 56 leading academic, clinical, and patient organisations and surveys of over 14,000 women and healthcare professionals, the medical community officially retired the term PCOS. The new name is PMOS: Polyendocrine Metabolic Ovarian Syndrome.
It’s not a small tweak. It’s a fundamental reframing of what this condition actually is.
Why the Old Name Did Real Damage
The Lancet paper announcing the change described PCOS as “inaccurate, implying pathological ovarian cysts, obscuring diverse endocrine and metabolic features, and contributing to delayed diagnosis, fragmented care, and stigma.” Research showed the misleading terminology contributed to diagnostic delays in up to 70% of those with the condition.
PMOS is a far more honest name. Polyendocrine recognises that multiple hormonal systems are involved. Metabolic acknowledges the condition’s roots in how the body processes energy and glucose. Ovarian retains the reproductive dimension without overstating it. Syndrome captures a constellation of features, not a single disease.
What’s Actually Driving PMOS?
This is where the science gets important, and where practitioners like Dr. Felice Gersh, dual board-certified OB-GYN and Integrative Medicine physician, have been ahead of the curve for years. Dr. Gersh has long argued that PMOS is not a single-cause condition. It is, in her words, a state of “metabolic chaos” driven by multiple intersecting forces.
Insulin resistance is often named as the central driver, and it’s certainly significant. When cells stop responding to insulin, the pancreas overproduces it, signalling the ovaries to produce excess androgens (testosterone and related hormones). This disrupts ovulation and drives many hallmark symptoms: irregular periods, acne, and excess hair growth. But as Dr. Gersh points out, insulin resistance is a consequence as much as a cause. Something had to trigger it.
Endocrine disruptors are among the most underappreciated triggers. Chemicals like BPA, phthalates, and pesticide residues, found in plastics, food packaging, cosmetics, and cleaning products, interfere with the body’s hormone signalling at a fundamental level. Dr. Gersh describes this as “oestrogen receptor resistance,” where the body’s oestrogen receptors are compromised by chemical exposure in the same way insulin receptors are compromised in insulin resistance. Because oestradiol has receptors in every organ system, including the gut, brain, cardiovascular system, and skin, when those receptors malfunction, the effects cascade everywhere. Women with PMOS appear to have a heightened susceptibility to these disruptors, meaning the toxic load of modern life can be a key trigger in genetically or nutritionally vulnerable women.
Hormonal imbalances in PMOS extend well beyond androgens. Oestradiol is often low or poorly utilised, progesterone is deficient due to lack of ovulation, the LH/FSH ratio is frequently skewed, cortisol is chronically elevated through stress, melatonin is disrupted, and thyroid dysfunction is common and frequently overlooked. Dr. Gersh has described excess testosterone as altering the gut microbiome and triggering inflammation, which then worsens insulin resistance in a self-reinforcing cycle. Treating any one of these hormones in isolation rarely works.
Oxidative stress and mitochondrial dysfunction sit at the cellular heart of the condition. The mitochondria become less efficient, producing excess reactive oxygen species (ROS) that damage cells and further impair insulin signalling and hormone production. Dr. Gersh has described this chronic inflammatory state as “accelerated ageing,” or what researchers are callingmeta-flammation, a low-grade metabolic dysfunction that promotes early-onset chronic disease.
Gut microbiome disruption ties many of these threads together. Excess androgens alter the gut microbiota. A disrupted microbiome increases intestinal permeability, allowing inflammatory molecules into the bloodstream, worsening insulin resistance and hormonal signalling. It also impairs oestrogen metabolism, adding further imbalance to an already burdened system.
Circadian rhythm disruption may be the most overlooked driver of all. The body’s master clock governs virtually every hormonal process: insulin sensitivity, cortisol patterns, melatonin production, reproductive hormone pulses, and gut function. Continuous light exposure, late nights, irregular eating, and poor sleep all produce measurable hormonal and metabolic disruption. Women with PMOS have significantly higher rates of sleep disorders, and poor sleep exacerbates every parameter of the condition. As Dr. Gersh writes, “The timing of meals may be as important for health as is diet composition.”
What Healing Actually Looks Like
Because PMOS has multiple drivers, healing requires a whole-body response. Dr. Gersh’s approach, rooted in her PCOS SOS programme, is to address root causes rather than suppress symptoms. Conventional medicine often reaches for the oral contraceptive pill or metformin, which may have a role, but used alone they treat the surface while the underlying fire continues to burn.
The foundation is a clean, low-toxin, antioxidant-rich lifestyle that works with the body’s biology. In practice this means reducing chemical load by choosing organic produce, avoiding heated plastics, and switching to toxin-free personal care products. It means nourishing the gut with a fibre-rich, plant-forward diet full of vegetables, legumes, fermented foods, and antioxidant-rich fruits and herbs. It means prioritising sleep with consistent wake times, morning light, and minimal screens after dark. It means time-restricted eating aligned with daylight hours to support circadian rhythm and insulin sensitivity. And it means regular movement, including resistance training, alongside stress practices that lower the cortisol-androgen burden.
Dr. Gersh uses pharmaceuticals as a last resort. Her view: restore the conditions for healing, and the body has a remarkable capacity to rebalance itself.
Is This Just Big Pharma Cashing In?
If you’ve seen Instagram posts claiming this rename is a pharmaceutical industry ploy to create new drug markets, it’s worth addressing directly.
Scepticism of the pharmaceutical industry is not irrational, and its influence on medicine is worth watching. But the evidence here tells a different story. The rename was driven by Professor Helena Teede at Monash University, alongside UK patient charity Verity, the Androgen Excess and PCOS Society, and the Endocrine Society. It took over a decade, starting with a contentious expert debate in Sicily in 2015, and gathered input from roughly 22,000 patients, clinicians, and researchers across the globe. STAT News called it “the most robust and extensive disease-renaming process in history.”
Pharmaceutical companies were involved at the implementation stage, alongside governments, regulators, and journal editors, which is standard for any major diagnostic change. They did not lead it, fund it, or initiate it. The argument for change came from the bottom up: from the 70% of affected women going undiagnosed, from clinicians frustrated by inadequate care, and from patient advocates who had spent years fighting to be taken seriously.
Could a more accurate diagnosis eventually benefit pharmaceutical companies? Possibly. But the best treatments for PMOS are largely not patentable. Clean food, good sleep, toxin reduction, and movement don’t generate pharmaceutical profits. They generate healthy women. And that’s exactly the point.
Even if you remain suspicious of the institutions involved, the name is still right. PMOS describes what is actually happening in women’s bodies far better than PCOS ever did. That truth stands independent of who benefits from it.
A Shift Towards a More Complete Understanding
PMOS is not just a rebranding exercise. It is an invitation, finally, to understand this condition correctly. When a woman receives a diagnosis of “polycystic ovary syndrome,” she imagines something wrong with her ovaries. She may be offered the pill, told to lose weight, and sent away. The real story, the endocrine disruption, the metabolic dysfunction, the circadian misalignment, goes unaddressed.
When she is told she has polyendocrine metabolic ovarian syndrome, a different conversation becomes possible. One that reflects the full complexity of what she is living with, and opens the door to real, lasting change.
Dr. Felice Gersh has been practising and teaching that approach for years. The world is finally catching up.
If you suspect you may have PMOS, seek out a practitioner willing to look at the full picture: hormones, metabolic markers, gut health, toxic load, sleep, and lifestyle. Dr. Felice Gersh’s books PCOS SOS and PCOS SOS Fertility Fast Track are excellent places to start.