PCOS (Now PMOS): Causes, Symptoms & Treatment

Update May 2026: PCOS has officially been renamed PMOS (Polyendocrine Metabolic Ovarian Syndrome). The condition, the diagnostic criteria, and the treatment options remain unchanged.^5,6

PCOS

What is the polycystic ovary syndrome (PCOS)?

Polycystic ovary syndrome (PCOS) is the most common hormonal and metabolic disorder in girls and women, affecting 1 in 8 worldwide, more than 170 million people.^5,6 It can affect fertility as well as skin, weight, hormone balance and mental well-being, and is often diagnosed late.

As of May 2026, PCOS has officially been renamed polyendocrine metabolic ovarian syndrome (PMOS) by a global scientific consensus of more than 50 professional and patient organizations, published in The Lancet.^5,6 We use both names so you can find what you need regardless of the term your doctor uses.

Typical symptoms of PCOS

The symptoms of PCOS vary greatly and can develop gradually.

The most common symptoms include:

Irregular or very long cycles (35 days or more)
Unfulfilled desire to have children due to absent or irregular ovulation
Skin blemishes, including severe acne
Hirsutism: increased facial and body hair, e.g. more hair on the chin, abdomen, or back
Hair loss or a receding hairline
Darkened patches of skin (acanthosis nigricans), especially on the neck, armpits, or groin
Elevated male hormones (androgens), which can lead to masculinization (virilization)
Psychological symptoms such as low mood, anxiety, or depression, now officially recognized as core features of the condition
Weight gain, especially around the abdomen
Sleep disturbances and fatigue

These symptoms may occur individually or in combination. PCOS is a diagnosis of exclusion, meaning that other conditions, especially thyroid and adrenal disorders, must be ruled out before the diagnosis can be confirmed.

How is PCOS diagnosed?

Doctors use the Rotterdam criteria; most women are diagnosed between the ages of 20 and 40.⁴

PCOS is usually diagnosed when other causes of the symptoms (e.g. thyroid disease) can be ruled out and two or all of the following criteria are met:

Absent or infrequent ovulation (an- or oligoovulation)
Clinical or biochemical signs of hyperandrogenism (e.g. hirsutism, acne, or elevated androgens in blood)
Polycystic ovaries on ultrasound^2,4

A blood test assesses hormone levels (LH, FSH, testosterone, SHBG, DHEA-S, insulin) plus blood sugar and cholesterol, as PCOS is often associated with insulin resistance.⁴

Note on the ultrasound criterion: the structures seen are arrested follicles, not pathological cysts, and are not more numerous than in people without the condition; many with PCOS have no cysts at all. Under the updated 2026 framework, an elevated Anti-Müllerian Hormone (AMH) level can replace the ultrasound criterion in many adult cases.^5,6

Causes and Risk Factors

The exact causes are not fully understood; genetic predisposition, hormonal imbalance and lifestyle likely act together.⁴

The following aspects are considered risk factors:

Family history of PCOS, type 2 diabetes, or metabolic disorders
Unhealthy diet, overweight, lack of physical activity
Chronic stress and sleep deprivation
Environmental factors that disrupt hormonal balance

Most people with PCOS have insulin resistance: excess insulin drives androgen production and disrupts ovulation, which is why PCOS is linked not only to irregular cycles but also to a higher risk of type 2 diabetes and cardiovascular disease.⁴

Therapeutic Approaches for PCOS

Holistic and Individualized

Treatment depends on the individual's symptoms and circumstances; the goal is to regulate hormones, restore ovulation, improve metabolic markers and well-being.⁴

Lifestyle Changes as Primary Therapy

The most important approach: even a 5–10 % weight loss can significantly improve symptoms.⁴

Recommendations include:

Balanced diet: high in fiber, low in sugar, with quality fats and plant-based proteins
Exercise: at least 150 minutes of moderate physical activity per week
Stress management through yoga, mindfulness, or meditation

Pharmacological Treatment

Depending on the symptoms, different medications are used:

Metformin to treat insulin resistance, often used when trying to conceive
Clomiphene to induce ovulation in cases of infertility
Anti-androgens or combined hormonal contraceptives to treat hirsutism, acne, and menstrual irregularities
Spironolactone for severe hirsutism (only under medical supervision)⁴

Support through cycle tracking

Women with PCOS who still ovulate can track their cycles using cycle trackers like Daysy. By measuring basal body temperature daily, it becomes evident whether ovulation has occurred. Daysy can support you if your cycles fall within the 19 to 40 day range, including occasional cycles that exceed this range. If your cycle regularly falls outside this range, Daysy is not recommended.

This not only helps with family planning but also allows tracking the effectiveness of dietary changes or medication therapies. In cycles where no ovulation occurs, Daysy will show more red and yellow days. Daysy shows green only after confirming that ovulation has taken place.

Psychological support

Many women with PCOS experience emotional distress due to infertility, physical changes, or chronic symptoms. Psychotherapy or support groups can be very beneficial in providing relief.

Long-term consequences and monitoring

Untreated PCOS can increase the risk of the following conditions in the long run:

Type 2 diabetes
Cardiovascular diseases
High blood pressure
Sleep apnea
Endometrial cancer⁴

Regular monitoring of hormone levels, weight, blood pressure, blood sugar, and cholesterol is strongly recommended.

PCOS and fertility

Chances of getting pregnant

Although PCOS is a common cause of infertility, pregnancy is often possible. Lifestyle changes, hormone therapy, ovulation induction or assisted reproduction help many women conceive; early diagnosis and personalized treatment improve the chances.⁴

PCOS is manageable in most cases

Polycystic ovary syndrome is a complex condition, but in most cases it is very manageable, especially when diagnosed early. A combination of healthy lifestyle choices, targeted medical treatment, and regular medical monitoring forms the foundation of successful care. Women with PCOS should not be discouraged: with knowledge, self-awareness, and medical support, it is possible to live well with the condition.

FAQs

Can I get pregnant despite having PCOS?

Yes, many women with PCOS can become pregnant—either naturally or with medical support. Even if ovulation is irregular or absent, successful pregnancies are possible through lifestyle changes, hormonal treatments (such as clomiphene or letrozole), or assisted reproduction (e.g. IVF).

What can I do myself to manage PCOS?

A healthy lifestyle is essential. Weight loss, a low-sugar diet, regular exercise, and stress reduction can significantly improve symptoms such as irregular cycles, acne, or insulin resistance. Losing just 5–10% of body weight can already make a noticeable difference.

Why is cycle tracking especially important with PCOS?

Cycle tracking is particularly valuable for women with PCOS, as it helps to better understand hormonal patterns and detect irregular or absent ovulation. By observing your menstrual cycle—via basal body temperature, cervical mucus, or digital cycle tracking tools like Daysy—you can monitor and document changes in your body early on.

Benefits of cycle tracking with PCOS:

Detecting ovulation: Even with PCOS, ovulation can occur—tracking helps identify it.
Recognizing cycle patterns: Even with long or irregular cycles, consistent tracking can reveal individual patterns.
Supporting fertility treatment: Cycle data provides a helpful basis for medical decisions when trying to conceive.
Monitoring lifestyle changes: Improvements through diet, exercise, or medication become visible through tracking.
Early detection of problems: Sudden changes in your cycle can be identified early and discussed with a doctor.

Especially with PCOS—where the body often doesn’t follow a “standard” 28-day cycle—cycle tracking offers valuable insights into your health and supports greater body awareness and self-empowerment.

What is the difference between PCOS and PMOS?

PMOS is the new official name for PCOS, adopted in May 2026 by a global scientific consensus published in The Lancet. The condition, the diagnosis criteria, and the treatments remain the same. The new name better reflects the hormonal and metabolic nature of the condition.

Learn more

PCOS Is Now Called PMOS: What It Means for Your Cycle

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Cycle Disorders

Sources

1)

Deutsche Gesellschaft für Endokrinologie (DGE), mit Unterstützung des BDI (Sektion Endokrinologie/Diabetologie); Koordination: Jaursch-Hancke, C.; Reger-Tan, S. S2k-Leitlinie Diagnostik und Therapie des polyzystischen Ovarsyndroms (PCOS), AWMF-Registriernummer 089-004. AWMF (federführend: Deutsche Gesellschaft für Endokrinologie, DGE). Version 1.1. (2025).

Available at: www.awmf.org .

2)

Lerchbaum, E.; Rabe, T. Kurzfassung der Endocrine Society Practice Guidelines: Diagnosis and Treatment of Polycystic Ovary Syndrome. Journal für Klinische Endokrinologie und Stoffwechsel (Austrian Journal of Clinical Endocrinology and Metabolism). 7 (1), 33–36 (2014).

Available at: www.kup.at .

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Weiss, J. Das polyzystische Ovarsyndrom (PCOS): Neues zu Pathogenese, Definition und Therapie. GYNÄKOLOGIE (Rosenfluh Publikationen). 2019 (2). (2019).

Available at: www.rosenfluh.ch .

4)

Teede, H. J.; Misso, M. L.; Costello, M. F.; et al. (Monash University / CREPCOS). International evidence-based guideline for the assessment and management of polycystic ovary syndrome 2018. Monash University, Melbourne. (2018).

Available at: www.monash.edu .

5)

Teede, H. J.; et al. Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: a multistep global consensus process. The Lancet. (2026).

DOI: 10.1016/S0140-6736(26)00717-8. Available at: www.thelancet.com .

6)

Endocrine Society. Polyendocrine Metabolic Ovarian Syndrome: New name to improve diagnosis and care of condition affecting 170 million women worldwide. Endocrine Society. (2026).

Available at: www.endocrine.org .

Polycystic Ovary Syndrome PCOS Causes Symptoms and Treatments