what's in a name? why pcos is now pmos and what it means for patients
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when it comes to pmos, especially, the hormonal and metabolic issues that often lead to the most problematic symptoms are far more important than what the name pcos would have people believe.
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polycystic ovary syndrome (pcos) has gotten a name change. it’s now being dubbed polyendocrine metabolic ovarian syndrome (pmos). why? because the name better reflects what the disorder actually is, what it involves and what’s going on in the body that drives symptoms.
for many, the name change is long overdue.
“polycystic ovary syndrome implies that the primary concern is cysts in the ovary. this is false,” said dr. margaret lippincott, a physician investigator in the reproductive endocrine unit at massachusetts general hospital.
in pmos/pcos, ovaries can have a lot of normal follicles that contain eggs, which are often called cysts based on ultrasound technology even though they’re completely normal. in some cases, pmos/pcos can exist even without cysts on the ovaries, making it “confusing for both providers and for patients.”
“the name change to pmos, polyendocrine metabolic ovarian syndrome, better reflects the primary concerns and struggles of people with pcos,” said dr. lippincott.
why the name matters
when patients and physicians are given one set of expectations about a disorder based on the name and the experience is far more complicated, it leaves gaps in what’s important.
when it comes to pmos, especially, the hormonal and metabolic issues that often lead to the most problematic symptoms are far more important than what the name pcos would have people believe.
for example, the metabolic part of the name now recognizes the insulin resistance that occurs in the majority of patients living with the condition, while the hormonal addition addresses excess androgens, or male hormones, which lead to imbalanced hormonal health and the ensuing symptoms.
alongside symptoms, the endocrine-metabolic condition can also have severe consequences in the long-term, increasing a person’s risk for several chronic diseases and ailments that affect quality of life and even life expectancy.
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“pmos is a risk factor for heart disease, diabetes, high cholesterol, high blood pressure, sleep apnea, obesity, liver disease and endometrial cancer,” said dr. lippincott. “rightly, women want the focus to be on their overall health.”
how a simple name change can benefit patients
overall health, especially in people with pmos, is all encompassing because of how challenging it can be to live with untreated endocrine and metabolic disorders. now that the name has been changed to a more accurate representation, things can change in how it’s diagnosed and treated.
for example, missed or late periods are a common symptom of pmos. the treatment often given for that is birth control. lifestyle modifications, such as weight loss and management, are also up there on the medical advice list for people with the disorder. but because of the hormonal and metabolic issues driven by pmos, weight loss can be a significant challenge. these first-line therapies do very little to address what’s really going on in the body, leaving women feeling defeated even when they are doing everything they can to get their condition under control.
in the worst-case scenarios, when there are no treatments offered to address those underlying drivers, it can lead women to believe that it’s their fault.
“it’s really important for patients to understand that pmos is a polygenic disease, so there are genes that build you as a human that you’ve inherited that have put you at risk for pcos. so, this is not your fault. this is not something that you cure,” said dr. lippincott. “this is something that, in collaboration with your providers, you actually come up with the best plan to lead the healthiest life possible for you.”
dr. lippincott says that she hopes the name change does more than change the textbooks, because when a condition is more accurately represented, it alters how it’s approached.
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“i hope that changing from pcos to pmos promotes increased awareness of the multidisciplinary care needed for patients with pmos. i also hope that we can fund more research into the endocrine and metabolic consequences of pmos to allow for new treatments.”
with more research into how the syndrome affects those who have it, physicians will have a better understanding, and researchers will be better able to develop treatments that work specifically for pmos. when physicians know what they’re working with and there are better therapies available, they are better able to treat patients with treatments that address hormonal and metabolic issues.
this landslide of improved understanding and treatments falls on patients, allowing them not only to better understand their bodies but also to receive better treatment, which, in turn, will improve their quality of life today and reduce their risk of the many chronic diseases that pmos can contribute to.
“we need funding … that supports metabolic research. we need innovation coming from medical drug and device companies,” said dr. lippincott, noting that when research is where it should be, they can really transform the care that patients can expect with pmos.
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