What’s in a Name? From PCOS to Polyendocrine Metabolic Ovarian Syndrome: A Metabolic Reframing, Promise, Controversies, and Challenges Ahead

In medicine, nomenclature shapes diagnostic reasoning, clinical pathways, research priorities, and patients' understanding of their condition. Polycystic ovary syndrome (PCOS), the most common endocrine disorder in women of reproductive age, affecting one in eight women and more than 170 million individuals worldwide, has long carried a name that foregrounds ovarian morphology and implies pathological cysts. This framing has narrowed clinical attention, contributed to delayed diagnosis in up to 70% of affected individuals, and obscured the broader endocrine, metabolic, psychological, and cardiometabolic dimensions of the syndrome. A recent global consensus process led by the Global Name Change Consortium, involving 56 organizations, patients, clinicians, and researchers, has renamed the condition polyendocrine metabolic ovarian syndrome (PMOS). The new terminology recognizes interacting disturbances in androgen production, insulin signaling, neuroendocrine regulation, and ovarian function, while centering metabolic features such as insulin resistance, dysglycemia, dyslipidemia, cardiovascular risk, and metabolic dysfunction-associated steatotic liver disease. This editorial examines the historical evolution of diagnostic criteria from the 1990 NIH criteria through the 2003 Rotterdam consensus to the 2023 International Evidence-Based Guideline, reviews the structured renaming process, and draws parallels with the transition from non-alcoholic fatty liver disease (NAFLD) to metabolic dysfunction-associated steatotic liver disease (MASLD). It discusses controversies surrounding the new name, implementation challenges, and the infrastructure needed to ensure that PMOS improves diagnostic accuracy, broadens multidisciplinary care, and reduces stigma without compromising the existing evidence base.