A New Perspective on Hormonal Health

At INcircle Health, I spend a lot of time talking with patients who are frustrated by symptoms such as irregular periods, acne or other skin changes, excess hair growth, difficulty managing weight, or concerns about fertility.

For decades, the condition commonly associated with these symptoms was known as polycystic ovary syndrome, or PCOS. In 2026, an international consensus process led to a new name: Polyendocrine Metabolic Ovarian Syndrome, or PMOS.

The change is more than semantics. It reflects a better understanding that this is a complex endocrine and metabolic condition that can affect much more than the ovaries or menstrual cycle.

Why the Name Change Matters

The term “Polycystic Ovary Syndrome” has long been misleading. Despite the old name, you do not need ovarian cysts to have PMOS. The findings sometimes seen on ultrasound are usually multiple small ovarian follicles rather than the type of ovarian cysts people commonly think of.

The old name also placed too much emphasis on the ovaries. PMOS can affect ovulation and menstrual patterns, reproductive hormones, insulin sensitivity and metabolic health, skin and hair, fertility, and long-term risks related to diabetes and cardiovascular disease.

Even menstrual cycles that appear relatively regular do not always mean that ovulation is occurring regularly.

The new name helps emphasize what clinicians have increasingly understood: this is not simply a reproductive or gynecologic condition. It is a broader endocrine and metabolic syndrome that can look different from one person to another.

Treatment Should Be Individualized

There is no single treatment plan for PMOS because people do not all experience it in the same way.

For one person, the biggest concern may be irregular or unpredictable periods. For another, it may be acne, excess hair growth, fertility, weight, insulin resistance, or long-term metabolic health.

Treatment may include nutrition and physical activity, medications to regulate menstrual cycles or address androgen-related symptoms, treatment of insulin resistance when appropriate, fertility treatment, or medications used to treat obesity.

GLP-1 receptor agonists are one example. These medications may be useful for some people with PMOS who also have overweight or obesity and can improve weight and several metabolic measures. They are not a cure for PMOS and are not appropriate for everyone. Pregnancy intentions, contraception when applicable, medication risks, and individual health goals should all be considered when deciding whether they are appropriate.

Most importantly, treatment should not simply consist of telling someone to “lose weight” or automatically prescribing birth control without first understanding their symptoms, health risks, and goals.

Your Health Is More Than a Diagnosis

A diagnosis should help us understand what is happening in your body and what we can do about it. It should not reduce you to a label.

When I evaluate someone with possible PMOS, I am interested in the whole picture: menstrual and reproductive history, symptoms, medications, family history, metabolic health, sleep, nutrition, physical activity, and appropriate laboratory testing. We can then decide together what deserves attention and which treatments actually make sense.

For some patients, the priority is fertility. For others, it is reducing diabetes or cardiovascular risk. Others simply want to understand symptoms they may have been dealing with for years.

PMOS is a good example of why individualized primary care matters. The goal is not simply to treat a laboratory value, a menstrual cycle, or a number on the scale. It is to understand how all of those pieces fit together and develop a plan that supports your health over time.