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PMOS Screener

PMOS Screener

Polyendocrine Metabolic Ovarian Syndrome — formerly PCOS — Rotterdam diagnostic criteria

🆕 Name Change — May 2026

Polycystic Ovary Syndrome (PCOS) has been officially renamed
Polyendocrine Metabolic Ovarian Syndrome (PMOS)

A landmark international consensus published in The Lancet on May 12, 2026 — the result of a 14-year, 22,000-person global process — formally retired the term PCOS. The old name was judged "inaccurate, implying pathological ovarian cysts, obscuring diverse endocrine and metabolic features, and contributing to delayed diagnosis, fragmented care, and stigma."

What each word means

Polyendocrine — multiple interacting hormonal disturbances: insulin, androgens, neuroendocrine
Metabolic — inherent metabolic dysregulation, insulin signaling, cardiovascular risk
Ovarian — ovarian involvement retained
Syndrome — complex multisystem condition

Why it matters

~70% of those affected were undiagnosed. The old name led many patients and clinicians to focus only on ovaries and reproduction — missing the metabolic, cardiovascular, dermatological, and psychological dimensions. PMOS is not "just a period problem."

⚠️ The diagnostic criteria (Rotterdam 2 of 3) are unchanged. The renaming reframes the condition — it does not alter how it is diagnosed.

Evidence Base

Based on 5 source publications — Teede et al. Lancet 2026 (PMOS renaming), Rotterdam ESHRE/ASRM 2004 criteria, ACOG PB 194 (2018), and others.

PMOS is the most common endocrine disorder in women of reproductive age, affecting approximately 1 in 8 women (more than 170 million worldwide) — though up to 70% remain undiagnosed. Diagnosis requires 2 of the 3 Rotterdam criteria after excluding other conditions that cause similar symptoms (thyroid disease, congenital adrenal hyperplasia, hyperprolactinemia, androgen-secreting tumors).

The Rotterdam Criteria — 2 of 3 required (unchanged):

① Irregular or absent periods (oligo/anovulation)

② Signs of excess androgens (hyperandrogenism)

③ Polycystic-appearing ovaries on ultrasound

Important: This screener is for educational purposes and to guide conversations with a healthcare provider. PMOS is a diagnosis of exclusion — other conditions must be ruled out first. Diagnosis requires clinical evaluation.

PMOS Criteria Assessment

Select all criteria that apply. Rotterdam requires 2 of 3 for diagnosis.

0 of 3 criteria selected

Criterion 1
✓
Irregular or Absent Periods
Oligomenorrhea (<8 cycles/year or cycles >35 days) or amenorrhea (no period for ≥3 months). Reflects anovulation or irregular ovulation.
Fewer than 8 periods per year
Cycles consistently longer than 35 days
No period for 3 or more months
Criterion 2
✓
Signs of Excess Androgens
Clinical hyperandrogenism (unwanted hair growth, acne, hair thinning) OR elevated androgen levels on blood tests (testosterone, DHEAS, free androgen index).
Unwanted hair growth (face, chest, abdomen)
Persistent acne
Scalp hair thinning (androgenic alopecia)
Elevated androgens on blood test
Criterion 3
✓
Polycystic-Appearing Ovaries on Ultrasound
12 or more follicles measuring 2–9 mm in diameter in one or both ovaries, OR ovarian volume >10 mL on transvaginal ultrasound (ESHRE/ASRM 2003 criteria; updated threshold ≥20 follicles per ovary with newer ultrasound technology).
≥12 small follicles per ovary on ultrasound
Ovarian volume >10 mL
Both increased follicle count and volume

Assessment Result

Based on Rotterdam 2003 consensus criteria · PMOS (formerly PCOS)

What This Means
Diagnosis of exclusion: Before confirming PMOS, a clinician should rule out: thyroid dysfunction (TSH), hyperprolactinemia (prolactin), non-classical congenital adrenal hyperplasia (17-OH progesterone), and androgen-secreting tumors (very elevated testosterone/DHEAS). Pregnancy must also be excluded.

Evidence Base

Source publications and what each contributes to this tool

The Name Change — Primary Source
1

Teede HJ, Gibson-Helm M, Dokras A, et al. Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: a multistep global consensus process. Lancet. 2026. doi:10.1016/S0140-6736(26)00717-8

Landmark Lancet consensus published May 12, 2026. Led by Helena Teede at Monash University, Australia. A 14-year process involving 56 academic, clinical, and patient organizations and iterative global surveys of over 22,000 stakeholders across all world regions. Used modified Delphi methods, nominal group technique workshops, and systematic literature review. Formally retires "PCOS" and introduces "PMOS" with an implementation roadmap for clinical guidelines, medical education, ICD coding, and public communication.

Global consensus PMOS renaming May 2026
Diagnostic Criteria
2

Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81(1):19–25. doi:10.1016/j.fertnstert.2003.10.004

Defines the three Rotterdam diagnostic criteria used in this tool. Established the requirement of 2 of 3 criteria for diagnosis. These criteria are unchanged by the PMOS renaming — the Lancet 2026 consensus explicitly states that diagnostic thresholds remain in effect pending updated international guideline revisions.

Diagnostic standard
3

ACOG Practice Bulletin No. 194. Polycystic Ovary Syndrome. Obstet Gynecol. 2018;131(6):e157–e171. doi:10.1097/AOG.0000000000002656

Current ACOG guidelines on PMOS (formerly PCOS) diagnosis and management. Covers differential diagnosis, evaluation, and treatment including letrozole for ovulation induction. An ACOG update is expected to adopt the PMOS terminology following the Lancet 2026 consensus. Used in this tool for management recommendations, differential diagnosis, and evaluation guidance.

ACOG guideline · Update expected
4

Teede HJ, Misso ML, Costello MF, et al. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Fertil Steril. 2018;110(3):364–379. doi:10.1016/j.fertnstert.2018.05.004

International evidence-based guideline co-developed by ESHRE and ASRM. Covers diagnosis, lifestyle, infertility treatment, metabolic and psychological features. Letrozole is recommended as first-line for ovulation induction. This guideline is expected to be updated to incorporate the PMOS nomenclature and implementation guidance from the Lancet 2026 consensus.

International guideline · Update expected
Prevalence
5

Bozdag G, Mumusoglu S, Zengin D, Karabulut E, Yildiz BO. The prevalence and phenotypic features of polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod. 2016;31(12):2841–2855. doi:10.1093/humrep/dew218

Systematic review and meta-analysis establishing prevalence across diagnostic criteria. Historically cited as ~10% of reproductive-age women. The Lancet 2026 consensus [1] updates this figure to 1 in 8 women (more than 170 million worldwide), reflecting broader application of diagnostic criteria and improved ascertainment.

Prevalence · Meta-analysis
Guideline update status (May 2026): The PMOS renaming was published May 12, 2026. ACOG Practice Bulletin 194 and the ESHRE/ASRM 2018 international guideline have not yet been formally updated to reflect the new terminology. The Lancet consensus includes a transition roadmap for adoption across clinical practice, education, and ICD coding. Until updated guidelines are issued, diagnostic criteria and management recommendations are unchanged.