PCOS has been renamed. After apparent years of global consultation, The Lancet published a paper officially renaming polycystic ovary syndrome to PMOS - polyendocrine metabolic ovarian syndrome. A full-body syndrome. Not just something happening to the ovaries - yay!
It even prompted me to post my first reel in months - and loved all the feedback it got! Because I am genuinely excited about it. What this name finally acknowledges is something many of us have known clinically for a long time. PMOS has multiple hormones involved, a significant metabolic picture, cardiovascular and insulin implications. The old name sent everyone down the wrong path. It implied the cysts were the problem, so cutting off communication to the ovaries with the pill was the solution. For a lot of women, that was the beginning and the end of the conversation.
But here's where I’m left feeling a bit deflated, and quite frankly wanting more.
A better name is a better starting point. It isn't the answer.
And I think this matters enormously for those of you working with acne clients who carry a PCOS - now PMOS - diagnosis. Because in my experience, the diagnosis is often where the clinical thinking stops. She has PCOS. She has acne. That's her why. I understand why that happens. It's a tidy explanation. There’s a list of medical treatments to try. But it isn't connected thinking.
Let me show you what I mean...
I have two clients I’ve supported this past year, both with a PMOS diagnosis. Their skin timelines look nothing alike.
The first has lived with this diagnosis for years. She presents with hormonal breakouts and weight gain. Her picture is classic - insulin resistance is part of her story, androgens are elevated, the pathways driving her acne are all turned up. When I map her skin timeline alongside her full health history, the picture makes sense. But even here, the diagnosis isn't her why. It's the door. What's behind it - her genetic SNP’s around insulin sensitivity, antioxidant capacity and hormone balance, her relationship with stress and sugar - that's where the real work is.
The second is 21. She went to her GP with acne and irregular periods in her late teens. An ultrasound found cysts on her ovaries and she walked out with a PCOS diagnosis. (Worth noting: this is also outdated diagnostic criteria, but that's a story for another day.) She was offered the pill which she's been on since to 'manage' her skin and periods.
I've lost count of how many clients have walked through my door with exactly this picture. I bet you have too.
Here's what often gets missed and where our women deserve so much more.
Irregular cycles and acne are not automatically a sign of a hormonal condition. They can be. But they can also be the body doing what bodies do - responding to stress, sleep, blood sugar, a diet that isn't quite supporting her. Jumping straight to a diagnosis and a prescription closes down the very questions that would actually help her.
Same label. Completely different plotline. Completely different intervention.
This is the cost of stopping at the diagnosis. For the client who spends years being managed rather than understood, and for you, sitting across from her, trying to make sense of a skin picture that doesn't quite fit.
Connected thinking isn't about ignoring the diagnosis. It's about using it as a starting point, not a destination. What is the skin timeline telling me? What was happening in this woman's life in the months before this presentation? Which systems are involved, and how are they talking to each other?
That is exactly how we think inside the Skin Barrier Solution. If you want more of this kind of education - that changes how you see skin in clinic - SBS is opening in september. Join the waitlist here.
Chloe x
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