PCOS is here to stay: does 'PMOS' truly reflect biological reality?

The recent proposal to rename 'polycystic ovary syndrome' (PCOS) as 'polyendocrine metabolic ovarian syndrome' (PMOS) reflects an important attempt to reconsider disease nomenclature in light of contemporary understanding of the syndrome. However, although the limitations of the term 'PCOS' are well recognized, the proposed terminology raises conceptual, biological and clinical concerns. 'PMOS' appears to redefine the syndrome through an expansive multisystem framework in which endocrine and metabolic associations become defining nomenclature elements, potentially underestimating the biological centrality of ovarian dysfunction. Moreover, the rationale supporting the new terminology relies heavily on consensus methodology and stakeholder engagement. While patient involvement and multidisciplinary consensus are essential components of modern medicine, consensus alone does not necessarily establish biological validity. Syndromic nomenclature has functioned historically as a clinical identifier rather than an exhaustive summary of pathophysiology. The transition from 'PCOS' to 'PMOS' may represent not merely a terminological refinement, but a broader conceptual reframing of the syndrome itself. Whether this shift truly reflects biological reality and improves clinical utility remains open to debate.