Prachi Sibal had been taking hormonal medications for three to four years, but no one warned her about the side effects. “I found the side effects more difficult to deal with than the condition,” says the 38-year-old anthropology student at SOAS University of London.
Polycystic ovary syndrome (PCOS) is one of the most common endocrine and metabolic diseases in women of reproductive age worldwide. It is more than just an ovarian abnormality. Aside from irregular menstruation and infertility, people with PCOS often have to deal with excessive hair growth, stubborn weight gain, and an increased risk of long-term insulin resistance and type 2 diabetes. The condition can also lead to long-term psychological distress.
For years, it has been treated primarily as a condition involving ovarian cysts. Now, there is a global rebranding effort that could change the urgency of PCOS diagnosis and treatment. The condition has been renamed polyendocrine metabolic ovary syndrome (PMOS), a shift that experts say goes beyond semantics.
“One of the most important things about changing the name is raising awareness. The new name is actually more medically accurate,” says Professor Helena Tiede, Director of the Monash Center for Health Research and Implementation in Australia, and a lead endocrinologist involved in the initiative. “The media reach of the name change has already touched nearly a billion people, a sharp departure from a situation that has, for decades, been treated as ‘business Secret female ovaries.
From ovaries to overall health
“This is not a new disorder; it’s just a name for correcting errors and keeping up with the science and patient experience,” explains Teddy.
PMOS affects approximately 170 million women of reproductive age globally and about 4 to 22.5 percent of women in India, according to one government estimate.
But this is only for those lucky enough to get a diagnosis at all. According to the World Health Organization, about 70 percent of women worldwide with PMOS don’t even know they have the condition.
Teddy adds that while a change in nomenclature is necessary, it is not “sufficient” to drive improved care. “We need to take it out of the category of gynecologic ovarian disease, which has limited research, medical education and care to date, and move it into a broader conceptual category where we look at all the attributes of the condition — new medications, guidelines, broader medical and health professional education, and provide much better care,” she says.
This broader framework is what doctors on the ground say can make a real difference in how patients understand and react to treatment. For years, it has been difficult to explain to young women why they were prescribed oral hypoglycemic drugs, or drugs used to lower blood sugar levels, because of what they thought was a “polycystic ovary” problem, says Dr Manju Gupta, senior consultant obstetrician and gynecologist at Maternity Hospitals in Noida. She believes the new name will make this conversation and patient compliance significantly easier.
Sibal’s consultations with several gynecologists reflect what many people with this condition go through. She changed six to seven gynecologists over the years, and none of them talked to her about her health holistically.
“I learned a lot about PCOS after reading on my own rather than from a gynecologist. They’re more interested in how it affects your appearance and your sex life.” In fact, one of her doctors suggested that having children might “cure” her.
While the exact cause of PMOS syndrome is unknown, medications and therapy only broadly help deal with the symptoms as there is currently no cure for the condition.
Will it speed up the diagnosis?
This is the central question, and the cautious answer from experts is “probably, yes.”
Since many women with PMOS first turn to their GPs, often long before they reach a gynecologist or fertility expert, “if primary care doctors start seeing the condition through hormonal and metabolic lenses, early recognition may improve,” says Dr Sulpa Arora, clinical director and fertility specialist at Nova IVF Fertility Center in Mumbai.
“In practice, there will likely be a greater focus on metabolic screening from the beginning. This includes tests such as blood sugar levels, lipid profiles, blood pressure monitoring, waist circumference or body mass index assessment, and screening for fatty liver disease or sleep disorders in selected patients,” she says, adding that diagnosis should remain “clinical and individualized.”
Teddy says there will likely be “less emphasis on ultrasound in diagnosis.”
However, experts are keen to point out the risks in the new framework – not every woman with PMOS is overweight. Dr. Arora points out that thin women with normal blood sugar can experience significant hormonal symptoms.
What stays the same?
Most importantly, Teddy and the Indian specialists were consistent on one point: While the treatment remains largely the same, the framework is changing.
“The first line of treatment remains the same, it will still be medications to improve metabolism,” says Dr. Gupta, adding that insulin testing, which is already part of PMOS diagnosis, will continue under the new name as well.
Hormonal contraceptives and metformin, long used in the management of PMOS, will continue to be prescribed, but Teddy stresses that patients should understand these as direct hormonal treatments for the underlying condition, not as tools to mask symptoms.
Even traditional medical systems seem unfazed by this change. Ayurvedic treatment, which is already rooted in assessing individual imbalances rather than biomedical signs, will continue largely unchanged, says Dr Pranjal Parab, an Ayurvedic consultant in Mumbai. He points out that the metabolic focus of PMOS is naturally consistent with Ayurveda’s longstanding holistic view of reproductive health.
Why are the risks higher in India?
While Victoria Beckham has previously spoken about her struggles with infertility due to PMOS, several Indian celebrities, including Sara Ali Khan, Sonam Kapoor, Bhumi Pednekar, Kriti Sanon, Masaba Gupta, and Shruti Haasan, have also been open about their struggles in dealing with PMOS.
India has a remarkably high prevalence of this condition and, separately, a high associated metabolic risk. “At lower BMI, people from India have higher metabolic complications overall and in PMOS,” Teddy explains, noting the higher risk of type 2 diabetes, gestational diabetes and heart disease among Indian women. She notes that Indian women with the condition, along with Indian doctors and patients, had “a lot of input” that went into developing the new framework.
But beyond clinical practice, doctors say the renaming has social weight. Dr. Aparna Govil Bhasker, a bariatric and metabolic surgeon at the MetaHill Clinic in Mumbai, says that shifting away from the “ovarian disease” framing could reduce the intense scrutiny Indian women face around marriageability and fertility, potentially alleviating the “blame, shame and triviality” associated with the condition.
Currently, the rebranding is the first of eight steps in a funded implementation plan that includes rewriting medical textbooks, modernizing electronic health record systems and, by 2028, revising the World Health Organization’s International Classification of Diseases and global treatment guidelines. Even then, Teddy said, it’s unlikely that a woman will walk into her doctor’s office tomorrow and “receive noticeably different care. It’s not going to change overnight, but it will change.”
