Written by: Natalie Hernandez, MD
Medically Reviewed by: Natalie Hernandez, MD;  Toni Kim, MD; Christi Gerhardt, MD; Kelli Davis, DO

PMOS (Formerly PCOS): A New Name for a Better Understanding

If you've recently heard the term PMOS instead of PCOS, you're not alone.

In 2026, an international panel of leading experts officially adopted Polyendocrine Metabolic Ovarian Syndrome (PMOS) as the new name for what has long been known as Polycystic Ovary Syndrome (PCOS).

The new name better reflects what physicians have understood for years: this is not simply an ovarian disorder. It is a complex condition involving the body's hormones, metabolism, insulin regulation, adrenal glands, and reproductive system.

For teenagers and their families, understanding PMOS early can make an enormous difference. Early diagnosis allows treatment to begin before long-term complications such as insulin resistance, type 2 diabetes, infertility, fatty liver disease, and cardiovascular disease develop.

At LIFE Pediatric Endocrinology, we specialize in diagnosing and treating adolescents with PMOS using evidence-based, individualized care focused on improving both immediate symptoms and lifelong health.

What Does PMOS Stand For?

PMOS stands for Polyendocrine Metabolic Ovarian Syndrome.

Each part of the name reflects an important aspect of the condition:

• Polyendocrine — Multiple hormone systems are involved, not just the ovaries.
• Metabolic — Insulin resistance and metabolic dysfunction are common drivers.
• Ovarian — Ovulation and ovarian hormone production are affected.
• Syndrome — A collection of related symptoms that vary from person to person.

Unlike the old name, PMOS no longer suggests that ovarian cysts are required for diagnosis.

In fact, many adolescents with PMOS never develop ovarian cysts, while many healthy teenagers have polycystic-appearing ovaries during normal puberty.

Why Was PCOS Renamed PMOS?

The international medical community recognized several problems with the old name:

• It was misleading. Most patients do not actually have ovarian cysts.
• It ignored the metabolic component that often drives the condition.
• It contributed to delayed diagnosis.
• It created unnecessary fear and stigma surrounding fertility and reproductive health.

The new name more accurately reflects the body's interconnected endocrine and metabolic systems.

How Common Is PMOS?

PMOS is the most common endocrine disorder affecting adolescent girls.

Depending on the diagnostic criteria used, studies estimate that 3–11% of teenage girls may have PMOS.

Because symptoms often overlap with normal puberty, many adolescents remain undiagnosed for years.

Symptoms of PMOS in Teenagers

Every teenager experiences PMOS differently.

Common symptoms include:

• Irregular or absent menstrual periods
• Excess facial or body hair (hirsutism)
• Persistent acne
• Weight gain or difficulty losing weight
• Dark, velvety skin patches (acanthosis nigricans)
• Hair thinning on the scalp
• Insulin resistance
• Prediabetes
• Fatigue
• Mood changes
• Difficulty ovulating

Many teens experience only a few symptoms, while others develop several over time.

The Four Types of PMOS

Although all forms of PMOS share overlapping features, physicians often recognize four common clinical patterns. These subtypes are helpful for understanding an individual's presentation, but they are not currently part of the official diagnostic criteria used by major endocrine societies.

1. Insulin-Resistant PMOS (Most Common)

Approximately 50–70% of patients fall into this category.

High insulin levels stimulate the ovaries to produce excess testosterone while interfering with normal ovulation.

Typical features include:

• Weight gain
• Difficulty losing weight
• Darkened skin around the neck or underarms
• Elevated insulin levels
• Prediabetes
• Increased risk of type 2 diabetes

This is the form most commonly encountered in pediatric endocrinology.

2. Inflammatory PMOS

Chronic, low-grade inflammation appears to contribute to increased androgen production.

Patients may experience:

• Fatigue
• Brain fog
• Joint discomfort
• Headaches
• Digestive complaints
• Acne
• Elevated inflammatory markers

Lifestyle modification aimed at reducing inflammation often plays an important role in treatment.

3. Adrenal PMOS

Rather than the ovaries producing excess androgens, the adrenal glands produce elevated DHEA-S, another androgen hormone.

This form is often associated with:

• Chronic stress
• Poor sleep
• Elevated cortisol signaling
• High DHEA-S levels
• Acne
• Irregular periods

Evaluation by a pediatric endocrinologist is important because other adrenal disorders may mimic this presentation.

4. Post-Pill PMOS

Some young women develop temporary PMOS-like symptoms after stopping hormonal birth control.

Symptoms may include:

• Acne
• Irregular periods
• Delayed ovulation

For many patients, hormone regulation gradually improves over several months, although some ultimately meet diagnostic criteria for PMOS independent of prior contraceptive use.

How Is PMOS Diagnosed in Teenagers?

Diagnosing PMOS in adolescents differs from diagnosing adults.

Because puberty naturally causes hormonal fluctuations, physicians use age-specific criteria.

Current international recommendations require both:

• Persistent irregular menstrual cycles at least two years after the first menstrual period (menarche), and
• Evidence of excess androgen hormones, either clinically (such as significant acne or excess hair growth) or through laboratory testing.

Importantly:

Ultrasound should NOT be used to diagnose PMOS in adolescents.

Likewise, anti-Müllerian hormone (AMH) levels should not be used for diagnosis because both may appear abnormal during normal puberty.

What Other Conditions Must Be Ruled Out?

Several medical conditions can mimic PMOS.

A pediatric endocrinologist may evaluate for:

• Congenital adrenal hyperplasia
• Thyroid disorders
• Elevated prolactin
• Cushing syndrome
• Androgen-secreting tumors
• Other endocrine disorders

This is why expert evaluation is so important before making the diagnosis.

What Laboratory Tests May Be Recommended?

Every patient is different, but evaluation commonly includes:

• Total testosterone
• Free testosterone
• DHEA-S
• Androstenedione
• LH and FSH
• Estradiol
• Thyroid studies
• Prolactin
• 17-Hydroxyprogesterone
• Hemoglobin A1c
• Fasting glucose
• Fasting insulin
• Lipid panel
• Liver function testing

Testing is individualized based on age, symptoms, and medical history.

How Is PMOS Treated?

Treatment focuses on improving hormone balance, restoring healthy ovulation, reducing symptoms, and lowering long-term health risks.

Depending on the patient, treatment may include:

Lifestyle & Nutrition

Lifestyle modification remains the foundation of treatment.

Goals include:

• Balanced nutrition
• Regular physical activity (weight-bearing exercises)
• Healthy sleep
• Weight optimization when appropriate

Even modest improvements in insulin sensitivity can significantly improve hormone regulation.

Metformin

Metformin helps improve insulin resistance and may:

• Improve menstrual regularity
• Reduce insulin levels
• Lower androgen production
• Improve metabolic health

Hormonal Therapy

Combined oral contraceptive pills remain one of the first-line treatments for:

• Irregular periods
• Acne
• Excess hair growth

Treatment should always be individualized based on patient goals and medical history.

Anti-Androgen Therapy

For selected patients, medications such as spironolactone may help reduce:

• Excess facial hair
• Acne
• Elevated androgen symptoms

These medications require careful monitoring.

Long-Term Health Risks

Without treatment, PMOS may increase the risk of:

• Type 2 diabetes
• Prediabetes
• Metabolic syndrome
• High cholesterol
• Fatty liver disease
• Sleep apnea
• Infertility
• Anxiety
• Depression
• Cardiovascular disease

Early diagnosis can dramatically reduce many of these risks.

Why See a Pediatric Endocrinologist?

PMOS is much more than irregular periods.

It is a complex endocrine disorder involving hormones, metabolism, insulin signaling, growth, and reproductive health.

A pediatric endocrinologist has specialized training to:

• Confirm the diagnosis
• Rule out other endocrine conditions
• Develop an individualized treatment plan
• Monitor growth and puberty
• Screen for long-term metabolic complications
• Help adolescents transition into healthy adulthood

Frequently Asked Questions (FAQ)

Is PMOS the same thing as PCOS?

Yes. PMOS is the new international name for the condition formerly known as PCOS. The disease itself has not changed—only the terminology has been updated to better reflect its endocrine and metabolic nature.

Why was the name changed?

Experts determined that "Polycystic Ovary Syndrome" was misleading because many patients do not have ovarian cysts, while the condition involves multiple hormone and metabolic systems beyond the ovaries.

Can teenagers develop PMOS?

Yes. PMOS commonly begins during adolescence, although diagnosing teenagers requires different criteria than adults because puberty naturally causes hormonal changes.

Can someone have PMOS without being overweight?

Absolutely. Although insulin resistance is common, many adolescents with PMOS have a normal body weight.

Does PMOS cause infertility?

Not necessarily.

Many women with PMOS become pregnant naturally. Early diagnosis and appropriate treatment can improve ovulation and reproductive health over time.

Is PMOS curable?

There is currently no cure, but symptoms and long-term health risks can often be managed very successfully through lifestyle interventions, medications when appropriate, and ongoing endocrine care.

Take the Next Step

If your daughter has irregular periods, persistent acne, excessive hair growth, unexplained weight gain, insulin resistance, or concerns about hormone health, early evaluation can make a significant difference.

At LIFE Pediatric Endocrinology, Dr. Natalie Hernandez provides comprehensive evaluation and individualized treatment for adolescents with PMOS and other hormone and metabolic disorders.

Schedule a consultation today to receive expert pediatric endocrine care focused on your child's long-term health, confidence, and future.

About the Author

Dr. Natalie Hernandez, MD

Dr. Natalie Hernandez is a board-certified pediatrician and board-certified pediatric endocrinologist with advanced training in pediatric endocrinology, obesity medicine, metabolism, diabetes, and hormone disorders. She serves as the physician leader of the Confident Body Program at LIFE Pediatric Endocrinology, where she specializes in insulin resistance, obesity, PMOS (formerly PCOS), puberty disorders, and pediatric metabolic health.

Her clinical approach combines evidence-based medicine with compassionate, individualized care to help children and adolescents build lifelong metabolic health and confidence.

References

1. Teede HJ, Khomami MB, Morman R, et al. Polyendocrine Metabolic Ovarian Syndrome, the New Name for Polycystic Ovary Syndrome: A Multistep Global Consensus Process. The Lancet. 2026.
2. Chan JL, Masini I, Pisarska MD. Polyendocrine Metabolic Ovarian Syndrome (PMOS)/Polycystic Ovary Syndrome (PCOS): Current and Future Trends. Journal of Clinical Investigation. 2026.
3. Machado IFR, Tinano FR, Latronico AC, Gomes LG. Approach to the Diagnosis and Treatment of Polycystic Ovarian Syndrome in Adolescent Patients. Journal of Clinical Endocrinology & Metabolism. 2026.
4. Peña AS, Witchel SF. Update on Diagnosis of Polycystic Ovary Syndrome During Adolescence. Fertility and Sterility. 2025.
5. DiVall SA. Practical Considerations for Diagnosis and Treatment of Polycystic Ovary Syndrome in Adolescence. Current Opinion in Pediatrics. 2023.
6. Ibáñez L, Oberfield SE, Witchel S, et al. An International Consortium Update: Pathophysiology, Diagnosis, and Treatment of Polycystic Ovarian Syndrome in Adolescence. Hormone Research in Paediatrics. 2017.
7. Hampl SE, Hassink SG, Skinner AC, et al. Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity. Pediatrics. 2023.
8. Prosperi S, Chiarelli F. Insulin Resistance, Metabolic Syndrome and Polycystic Ovaries: An Intriguing Conundrum. Frontiers in Endocrinology. 2025.
9. Cioana M, Deng J, Nadarajah A, et al. Prevalence of Polycystic Ovary Syndrome in Patients With Pediatric Type 2 Diabetes: A Systematic Review and Meta-analysis. JAMA Network Open. 2022.
10. Arslanian S, Bacha F, Grey M, et al. Evaluation and Management of Youth-Onset Type 2 Diabetes: A Position Statement by the American Diabetes Association. Diabetes Care. 2018.