Are We Treating PMOS All Wrong?

When Megan Rodriguez was 24, she came to a crossroads with her health.

She had gained 40 pounds after getting a birth control injection. That coupled with a flare-up of cystic acne signaled to her that something was wrong. Her gynecologist ran labs showing what they called a hormonal imbalance. But instead of explaining what the imbalance was or how it may have caused her symptoms, the doctor simply told her to lose weight.

"Literally doctors just told me that I was fat, and that was it. There was no explanation of what was happening, no explanation of the inflammation beyond just being fat,” says Rodriguez, now 36, from Pittsburgh.

Years of specialists followed with more testing and no real answers.

But in May 2026, something shifted for people in Rodriguez’s situation. After a 14-year process involving more than 22,000 patients and clinicians, an international consensus was reached to rename Polycystic Ovarian Syndrome (PCOS) to Polyendocrine Metabolic Ovarian Syndrome (PMOS). It corrected a 90-year-old misnomer that had resulted in missed diagnoses for patients like Rodriguez who had the condition but not its most telltale sign: visible ovarian cysts seen on an ultrasound.

(Debunking the Biggest Myths About PMOS.)

Science is now clear that doctors were missing the metabolic hurricane happening inside the body.

PMOS is a metabolic disorder where the pancreas overcompensates for insulin resistance by producing too much insulin, which in turn signals the ovaries and adrenal glands to overproduce androgens, a type of sex hormone more commonly found in men such as testosterone. It affects 7 to 10 percent of women of reproductive age according to the Endocrine Society. High androgens disrupt ovulation, trigger weight gain, and cause acne, to name a few symptoms. PMOS is one of the leading causes of infertility in women.

While the official name change took effect in May, institutional guidelines and medical coding updates are expected to take up to three years to fully be in effect. But experts and patients alike hope that the new name will aid in diagnosing PMOS, as well as prompt more research into its causes and a whole-body approach to treating it.

This doesn’t necessarily mean we’ll see a change in the criteria that clinicians use to diagnose PMOS. "Our diagnostic criteria is not the problem," says Pardis Hosseinzadeh, a reproductive endocrinologist and infertility specialist at Johns Hopkins, explaining doctors still rely on the modified Rotterdam criteria, which require two of three markers: irregular cycles, the polycystic appearance of the ovaries on ultrasound, and elevated androgens found through bloodwork. But the name change may shift the weight placed on each of these diagnostic markers.

For instance, some researchers argue that blood-based markers deserve more diagnostic weight than imaging.

Hosseinzadeh adds that the name change hopefully will allow doctors to screen more broadly for the metabolic conditions that come with PMOS, including a lipid panel, glucose testing, and screening for sleep and mood disorders—which rarely happened when the condition was thought to be strictly a reproductive issue.

Experts are also hopeful that future care could finally move away from a one-size-fits-all treatment protocol.

Historically people were prescribed birth control or told to lose weight to manage their symptoms. And even today diet and exercise are considered the first-line approach for treatment as there are no medications approved by the U.S. Food and Drug Administration to treat PMOS.

(Science Is Finally Confirming the Most Mysterious Symptoms of Endometriosis.)

“I had no real way to help them other than saying like you could see a registered dietitian,” says Franziska Haydanek, an OB/GYN in Rochester, New York.

But "not everyone with PCOS is the same," says Hosseinzadeh. A study published in February 2026 in Frontiers in Endocrinology underscored that fact by showing that PMOS is not just one disease but at least two distinct ones. One type of PMOS is driven primarily by insulin resistance, while the other is linked to more androgenic symptoms or irregular cycles. The finding suggests that doctors may eventually be able to match patients to treatment based on which pathway is driving their specific disease.

Haydanek says the name change is also prompting doctors from different specialties—reproductive endocrinologists, rheumatologists and gynecologists—to work together to address how PMOS affects the entire body, not just the ovaries. She hopes that science will start treating PMOS as a whole-body condition instead of a gynecologic one.

Reframing PMOS as a systemic condition may also help spur new research and development of drugs to treat it.

That lack of investment has prompted some clinicians to prescribe off-label use of medications like metformin, which has been shown to improve insulin resistance and restore regular menstruation. These efforts have shown some promise: a retrospective cohort study of 130 PCOS patients showed that metformin combined with lifestyle changes reduced their BMI, blood sugar, and insulin levels in six months.

Now GLP-1s have made their debut as another potential treatment. A 2024 study found GLP-1-based treatments more effective than metformin alone at improving metabolic complications. Another study published in the International Journal of Diabetes and Endocrinology found that tirzepatide, sold as Zepbound or Mounjaro, showed a decrease in weight, BMI, and a drop in fasting blood sugar.

(The Breakthrough That Could End Preeclampsia.)

Prescriptions for GLP-1s in women with PMOS have increased significantly since 2021, according to Truveta, a health data firm. Certain formulations of these drugs can be prescribed for people with overweight or obesity who also have PMOS. But because GLP-1s are not currently FDA-approved for PMOS specifically, patients often navigate significant hurdles, including inconsistent insurance coverage and the uncertainty of accessing these drugs.

And it’s unclear if that is likely to change even with the new designation.

Novo Nordisk, the makers of Wegovy, tells National Geographic the company is not currently investigating the use of its GLP-1, semaglutide, for PMOS treatment.

Eli Lilly, which makes Zepbound, did not respond for comment but its website indicates the company has not sponsored clinical studies to evaluate tirzepatide's safety or efficacy in PMOS patients.

While pharma companies may not be moving forward with studies, researchers are conducting their own.

Melanie Cree, a pediatric endocrinologist at the University of Colorado Anschutz, conducted a study in which she gave women with PMOS between the ages of 12 and 35 doses of injectable semaglutide with and without metformin over the course of 10 months. She measured ovulation rates four months before treatment and during months six through 10. The combined medications improved menstrual regularity and decreased testosterone by 52 percent, but Cree is still waiting to see if ovulation rates improved.

"It's exciting because it is another potential option for women with PMOS," Cree says. "We've had birth control or metformin for over 40 years. We've had nothing new. Now we really need more research."

Changing a name is merely the start, Cree says. The real work lies in setting the standard for what cured or managed PMOS actually looks like.

"There is nothing for the pharma companies to design around because we don't have an endpoint. We don't know what to fix because the FDA didn't set the standards for a PMOS treatment goal,” Cree says. "Everyone blames the pharma company, but if you don't have a goal post to meet, you can't do anything.”

Vaideh Mehta, a 31-year-old from Tuscaloosa, Alabama, went 20 years between her first period until her PMOS diagnosis this past June. When she was 23, a doctor offered her birth control without running further tests; she declined it. And it wasn't until she asked her own OB/GYN for a full fertility panel this year that a fertility clinic finally confirmed her diagnosis.

"It's a very isolating process," says Mehta. "I really dealt with a sense of shame, knowing that there was something wrong with my body.”

Until the FDA and the medical community define those goal posts, PMOS patients like Mehta will still be in limbo.