SRINAGAR,MAY ,20:
Polyendocrine Metabolic Ovarian Syndrome (PMOS): A New Diagnostic Anomaly
ICMR-PCOS Task Force Chief Cautions Global Rename of PCOS, Citing Exclusion of World’s Largest Datasets
Professor (Dr.) Mohd Ashraf Ganie, the National Chief Coordinator of the Indian Council of Medical Research (ICMR) PCOS Task Force and Director of the Sher-i-Kashmir Institute of Medical Sciences (SKIMS), alongside National Principal Investigators Prof. Neena Malhotra, AIIMS New Delhi and Prof. Rakesh K. Sahay, Osmania Medical College Hyderabad, have issued a collective formal and rigorous objection to the recently proposed renaming of Polycystic Ovary Syndrome (PCOS) to Polyendocrine Metabolic Ovarian Syndrome (PMOS). While the change was recently published in The Lancet and announced at the European Congress of Endocrinology in Prague, the leadership of the ICMR-PCOS National Task Force argues that the move is a premature anomaly. They contend it lacks a truly global evidence base and multidisciplinary consensus required to reflect the clinical reality of the world’s most affected populations.
Prof. Ganie, who is currently leading a landmark multicentric research project across 18 specialized centers in India, noted that while the medical community has long agitated for a revision of the 1935 Stein-Leventhal nomenclature, the transition to PMOS appears to be a regional perspective attempting to impose itself as a global standard. Prof. Ganie, Prof. Malhotra, and Prof. Sahay maintain that any shift in nomenclature must be led by countries like India and China the “PCOS capitals” of the world, where the largest and most well-designed studies on the condition have actually been conducted.
The core of the objection lies in a staggering disconnect between the global consensus and the statistical reality of the world’s most affected populations. Prof. Ganie highlighted that the consensus group, largely led by researchers from regions like Australia, which manages a patient footprint of approximately 1.5 million women, notably excluded data from India and China, who together represent a combined burden of nearly 75 million patients. A decade of study that ignores the data of 44 million women in India and 31 million in China is not a global consensus, Prof. Ganie stated that the exclusion of our multicenter, 9,000 subject cohort, the largest of its kind rendered the exercise bereft of the geographic diversity needed for scientific accuracy.
Beyond geographic bias, Prof. Ganie leveled critiques against the Ovarian and Polyendocrine terms of the new name. Despite the attempt to modernize, the new label remains organ oriented that ICMR data reveals is clinically inconsistent with the systemic phenotype. In a community-based cohort of 8,993 Indian women, a staggering percentage exhibited normal ovarian morphology. By re-centering the ovary in the title, we are merely polishing a 1935 morphological bias, the explained. They say ovarian abnormalities are associated with it, but in the vast majority of our patients, the ovary is a silent bystander to a much larger metabolic derangement.
Furthermore, the insertion of the term Polyendocrine has raised significant alarms regarding diagnostic clarity. The National Task Force investigators warns that this terminology risks immediate confusion in primary care settings with distinct multi-glandular disorders, such as Multiple Endocrine Neoplasia (MEN) or Autoimmune Polyglandular Syndrome (APS). This confusion stems from the non-involvement of global endocrine bodies and endocrinologists in the consensus process. Notably, hyperandrogenism, the dominant clinical signature of the syndrome is entirely absent from the new nomenclature, leading to what Prof. Ganie describes as diagnostic dilution.
The ICMR study has also identified an urgent public health concern by identifying the Pre-PCOS phenotype. The investigators with decades of research and clinical experiences in the area of PCOS revealed that every fourth woman in India is affected by metabolic irregula