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Polyendocrine Metabolic Ovarian Syndrome (PMOS): What Is It and Is It the Same As PCOS?

If you have heard of polycystic ovary syndrome (PCOS), you may already have started seeing a new name for it: Polyendocrine Metabolic Ovarian Syndrome (PMOS). This new name does not mean that PCOS has become a different condition. Instead, it reflects a shift in how the condition is understood, with greater recognition of its hormonal and metabolic features.

Globally, PCOS/PMOS is estimated to affect about 1 in 8 women1, making it one of the most common endocrine conditions among women of reproductive age. In Singapore, PCOS/PMOS has been reported to affect around 5% to 15% of women of reproductive age2.

In this article, we explain what PMOS is, why PCOS has been renamed, whether they are the same condition, and what this change in terminology may mean for you. Keep reading to find out more.

What Is Polyendocrine Metabolic Ovarian Syndrome (PMOS)?

Polyendocrine Metabolic Ovarian Syndrome (PMOS) is a long-term endocrine and metabolic condition that can affect your hormones, menstrual cycle, skin, hair growth, metabolism and reproductive health.

The way PMOS presents can differ from one person to another. Some may first notice irregular periods, acne, excess facial or body hair, or thinning hair on the scalp. Others may seek medical advice because of difficulty conceiving, weight-related concerns or signs of insulin resistance.

In adults, PMOS is commonly diagnosed using the Rotterdam criteria. This generally means that at least two of the following are present, after other possible causes have been excluded:

Diagnostic featureWhat this may involve

Irregular ovulation

Irregular, infrequent or absent menstrual periods

Higher androgen levels

Acne, excess facial or body hair, scalp hair thinning, or raised androgen levels on blood tests

Polycystic ovarian appearance

Multiple small follicles seen on ultrasound

Beyond day-to-day symptoms, the condition may also be linked to longer-term health risks, including insulin resistance, type 2 diabetes, lipid abnormalities, high blood pressure, sleep apnoea and endometrial concerns. Not everyone with PMOS will experience these complications, but recognising the condition early can help you manage the aspects that are most relevant to your health.

⇨ Read more about the renaming of PCOS.

The term Polycystic Ovary Syndrome (PCOS) has long been criticised for being misleading. “Polycystic” suggests that ovarian cysts are the main feature, even though not everyone with PCOS has polycystic ovaries. The name can also make the syndrome sound primarily reproductive, when it often involves wider hormonal and metabolic changes.

The updated term, Polyendocrine Metabolic Ovarian Syndrome (PMOS), provides a broader description and highlights three important areas:

  • Polyendocrine: The involvement of multiple hormonal pathways
  • Metabolic: The effects on metabolism, insulin, weight regulation, and cardiovascular health
  • Ovarian syndrome: Ovarian and reproductive function remain important features of this condition


This change is significant because it may help shift attention beyond periods, ovaries and fertility alone. For many, PMOS can also involve acne, excess hair growth, scalp hair thinning, weight-related changes, insulin resistance and associated metabolic risks. By using a more complete name, PMOS encourages earlier recognition of these wider symptoms and supports a more holistic approach to care.

PMOS Is More Than a Reproductive Condition

PMOS is now recognised as a complex hormonal and metabolic condition involving interactions between the brain, ovaries, adrenal glands, insulin regulation, and body metabolism. Common hormonal and metabolic features may include:

  • Elevated androgens, sometimes referred to as “male-type” hormones
  • Irregular ovulation or menstrual cycles
  • Acne, increased hair growth, or scalp hair thinning
  • Insulin resistance 
  • Weight gain or difficulty losing weight
  • Fertility challenges 


These changes can occur even if you are not overweight. 

The Role of Insulin Resistance in PMOS

Insulin resistance is one of the key features that may contribute to PMOS in many individuals. When insulin levels rise, this may stimulate the ovaries to produce more androgens, which can worsen hormonal imbalance and affect ovulation.

Over time, PMOS may also be associated with increased risks of: 


This is why modern management increasingly focuses not only on menstrual symptoms but also on long-term metabolic health.

How PMOS Can Affect Ovarian Function

In PMOS, hormonal signalling between the brain and the ovaries can become disrupted. This may lead to: 

  • Irregular or absent ovulation
  • Irregular menstrual cycles 
  • Difficulty conceiving 
  • Increased small follicles seen on ultrasound 


Some individuals may also have elevated Anti-Müllerian Hormone (AMH) levels, which can support assessment in selected adults.

If you recognise possible signs of PMOS in yourself, booking an appointment with an endocrinologist can be a helpful first step towards understanding your symptoms and whether further assessment may be appropriate.

There is technically no difference between PCOS and PMOS as a condition. PMOS is the updated name for what was previously known as PCOS, so the symptoms, diagnostic approach and health considerations remain broadly the same.

The main difference is in the terminology. You may still see “PCOS” used in older articles, medical resources or clinic materials, while “PMOS” may appear more often as the updated name becomes more widely adopted. Both terms currently refer to the same underlying syndrome.

For you, this means that existing information about PCOS may still be relevant, but PMOS offers a more current way to describe the condition. If you are unsure whether a symptom, diagnosis or treatment option applies to you, it is best to discuss this with an endocrinologist who can interpret the information in the context of your health needs.

No two experiences of PMOS are exactly the same. Concerns may range from irregular periods, acne and excess hair growth to fertility concerns, insulin resistance, weight-related changes or future metabolic risks.

As such, PMOS care should be tailored to your symptoms, health risks, stage of life and personal goals. Since PMOS can affect both metabolic and reproductive endocrine health, evaluation may include hormonal assessment, metabolic screening, menstrual history, symptom review and discussion of your fertility or long-term health goals.

Living with PMOS can feel confusing, especially when symptoms overlap with other hormonal or metabolic conditions. If you suspect that you may have PMOS, speaking with an endocrinologist can be a helpful first step towards making sense of your symptoms and exploring care options suited to your needs.

Is PCOS a metabolic disorder?

Yes. PCOS/PMOS is not only a reproductive or fertility-related condition. It can also involve metabolic concerns such as insulin resistance and cardiometabolic risks, which is one reason the updated term PMOS is now being used.

What are the first signs of PMOS?

The first signs of PMOS can vary. Common symptoms include irregular, infrequent or absent periods, acne, excess facial or body hair, thinning hair on the scalp, weight-related changes and difficulty conceiving. 

Some people may also have signs of insulin resistance, although these may not always be obvious at first. If you notice persistent changes in your cycle, skin, hair growth or metabolic health, speaking with an endocrinologist can help you understand what may be contributing to your symptoms.

What are the complications of PMOS?

Possible complications include insulin resistance, type 2 diabetes, lipid abnormalities, high blood pressure, sleep apnoea, endometrial concerns and fertility challenges. Not everyone with PMOS will develop these complications, but early recognition can help guide appropriate monitoring and care.

How is PMOS diagnosed?

PMOS is usually diagnosed through a combination of medical history, symptom review, physical examination, blood tests and, where appropriate, ultrasound imaging. In adults, diagnosis is commonly based on the Rotterdam criteria, where at least two key features are present after other possible causes have been excluded: irregular ovulation, higher androgen levels or polycystic ovarian appearance. 

If you are unsure whether your symptoms may be related to PMOS, an endocrinologist can guide you through the appropriate tests and next steps. Book an appointment today.

How is PMOS treated?

PMOS treatment depends on your symptoms, health risks and personal goals. 

Management may include: 

  • Lifestyle and nutrition strategies 
  • Exercise and weight management support (where appropriate)
  • Assessment of insulin resistance and metabolic health 
  • Treatment for acne or excess unwanted hair 
  • Evaluation of reproductive and hormonal concerns 
  • Individualised medical treatment when clinically indicated


Early evaluation may help identify contributing factors and support long-term health planning. Your care plan should be tailored to what matters most for your health.

Disclaimer 
This information is provided for general education. It does not replace personalised medical advice. Please consult your doctor for guidance on the medications that may be appropriate for you.

1Retrieved from Endocrine Society
2Retrieved from SingHealth

Dr Linsey profile picture

Dr Linsey Gani is an endocrinologist experienced in conditions related to hormonal imbalances, including those affecting fertility, menstrual health, and reproductive function. Dr Gani completed her residency in Melbourne, Australia. She is a fellow of the Royal Australian College of physician and the Academy of Medicine, Singapore.