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A Short History of How PCOS Got its Name

— and why every name has been incomplete

From Hippocrates to The Lancet 2026. A history of one of the most common endocrine conditions affecting women — and of how medicine has tried, over and over, to give it the right name.

A Short History of How PCOS Got its Name

By Dr Gautam V. DaftaryDirector, Aksigen IVF

Last reviewed June 20268-minute read1,600 words

The condition now called polyendocrine metabolic ovarian syndrome — PMOS — has had several names over the past century. Each name was the best description medicine could offer at the time. Each one turned out to be incomplete.

This article tells the story of how PCOS got its name, what names came before, and why the 2026 rename is the latest step in a long pattern of trying to describe what we do not yet fully understand. The story has a moral: medical naming is provisional. What looks like an explanation in one decade often turns out to be one feature among many in the next.

For a condition that affects approximately 170 million women worldwide, the history of how it has been named is also the history of how it has been understood — and how it has been misunderstood.

Hippocrates to Achard–Thiers — the Condition Before it had a Name

The condition we now call PMOS has been with women for as long as there have been women. Hippocrates, writing in the fifth century BC, described women “whose menstruation is less than three days or is meagre, are robust, with a healthy complexion and a masculine appearance” — a description that maps recognisably onto what would be diagnosed today as PMOS.

Across the centuries, scattered medical descriptions captured pieces of the syndrome without naming it as a single entity. Nineteenth-century anatomists described enlarged ovaries with multiple small follicles. Gynaecological texts noted associations between hirsutism, irregular menstruation, and infertility. But no one had put the picture together.

The first integration came in 1921, when two French physicians, Émile Charles Achard and Joseph Thiers, published a paper in the Bulletin of the National Academy of Medicine in Paris titled — translated from the French — Pilar virilism and its association with glycolytic insufficiency: diabetes of bearded women¹. Achard and Thiers had described, in essence, the metabolic and androgenic dimensions of PMOS. They identified the link between androgen excess and insulin resistance — what we now call hyperandrogenism and metabolic dysfunction — sixty years before that link was reconfirmed by modern endocrinology.

What they could not see was the ovarian morphology. Imaging the ovary required a procedure that did not exist in 1921. The metabolic-and-hormonal half of the syndrome was named; the ovarian half remained hidden.

Stein and Leventhal, 1935

In 1935, at the meeting of the Central Association of Obstetricians and Gynecologists in Chicago, two American gynaecologists — Irving Freiler Stein and Michael Leo Leventhal — described seven patients in whom they had observed a consistent pattern: amenorrhea or oligomenorrhea, hirsutism, infertility, and bilaterally enlarged ovaries containing multiple small follicles. Their paper, Amenorrhea Associated with Bilateral Polycystic Ovaries, was published in theAmerican Journal of Obstetrics and Gynecology that year².

Three things made the Stein and Leventhal paper the foundational reference in the field for the next half-century. It was the first report to describe a series of patients rather than isolated case reports — connecting what had previously been separate clinical observations into a unified syndrome. It offered a treatment: bilateral ovarian wedge resection, a surgical procedure that removed a wedge of ovarian tissue.

In a follow-up series of seventy-five women, Stein and Leventhal reported restoration of menstrual cycles in 90 percent and restored fertility in 65 percent. And the authors were consistent, clear writers who continued to publish on the topic for years afterward.

For these reasons, the condition came to be known as Stein-Leventhal syndrome for the next several decades. It was a name based on what could be seen at surgery — the enlarged, polycystic appearance of the ovaries on direct macroscopic inspection.

The metabolic and androgenic dimensions that Achard and Thiers had identified fourteen years earlier were known but were not central to the Stein-Leventhal framing. The name described what the surgeon could see.

This is the first major incompleteness in the modern naming story: the metabolic dimension was identified before the ovarian feature became the defining one, and was then partly forgotten.

The PCOS Era — What Biochemistry Revealed

The next major shift came from the development of biochemistry. Through the 1960s and 1970s, radioimmunoassay techniques made it possible to measure individual hormones in blood — testosterone, androstenedione, luteinising hormone, follicle-stimulating hormone, insulin. For the first time, the syndrome could be characterised by what was happening hormonally, not just by what could be seen surgically.

Two findings reshaped the understanding of the condition. The first was the recognition that the hypothalamic-pituitary-ovarian axis was disturbed — that the brain's release of GnRH was abnormal in the syndrome, biasing the pituitary toward producing more LH than FSH.

The second, published in 1980 by Burghen, Givens, and Kitabchi, was the demonstration that insulin resistance was a central feature of the condition, present in the majority of affected women³ — confirming what Achard and Thiers had described six decades earlier.

In parallel, the introduction of ultrasound imaging in the 1980s made it possible to see the ovaries without surgery. The polycystic appearance that Stein and Leventhal had identified at laparotomy was now visible on a non-invasive scan. The condition could be diagnosed without going to the operating theatre.

By the 1990s, the name Stein-Leventhal syndrome had gradually been replaced by the more descriptive polycystic ovary syndrome — PCOS. The metabolic dimension was acknowledged in the literature but was not central to the name.

The Criteria Era

As the field matured, the question shifted from what the condition was called to how it was diagnosed. The terminology was being used inconsistently across centres and countries. Clear diagnostic criteria were needed.

In 1990, a National Institutes of Health conference in the United States produced the first formal diagnostic criteria. The NIH criteria required clinical or biochemical hyperandrogenism plus ovulatory dysfunction, with other causes excluded. Ovarian imaging was not a criterion at this stage.

In 2003, a joint consensus meeting of the European Society of Human Reproduction and Embryology and the American Society for Reproductive Medicine, held in Rotterdam⁴, produced what became the most widely used diagnostic framework. The Rotterdam criteria required any two of three features — hyperandrogenism, ovulatory dysfunction, or polycystic ovarian morphology on ultrasound.

The Rotterdam criteria introduced ultrasound morphology into formal diagnosis for the first time. This was controversial: critics argued that allowing diagnosis without hyperandrogenism diluted the condition. Defenders argued that it captured a broader and more accurate clinical population.

In 2006, the Androgen Excess and PCOS Society proposed more conservative criteria that required hyperandrogenism plus at least one other feature.

The 2018 International Evidence-Based Guideline, led by Helena Teede of Monash University and developed jointly with ASRM, the Endocrine Society, and similar bodies, unified the field around a single evidence-based framework. The 2023 update of that guideline⁵ added explicit recommendations on metabolic and mental-health screening — anticipating what would soon become the formal rename.

2026 — PMOS

In May 2026, after a fourteen-year consensus process led by Monash University and involving fifty-six leading academic, clinical, and patient organisations⁶6, the name was changed again. Polycystic ovary syndrome — PCOS — became polyendocrine metabolic ovarian syndrome — PMOS. The decision was published in The Lancet and formally endorsed by the American Society for Reproductive Medicine, the Endocrine Society, the International Androgen Excess and Polycystic Ovary Syndrome Society, and similar bodies worldwide.

The new name corrects two of the incompletenesses of the old. First, it acknowledges that the condition involves multiple hormonal systems — polyendocrine — rather than the ovary in isolation. Second, it names the metabolic dimension that Achard and Thiers identified in 1921 and that Stein and Leventhal omitted in 1935. The metabolic dimension is no longer downstream of the diagnosis; it is part of the diagnosis itself.

The retention of ovarian in the name acknowledges that ovulatory disturbance remains the most acute and most fertility-relevant feature of the condition. But it is the third word in the new name, not the first.

It took ninety-one years — from Stein and Leventhal in 1935 to The Lancet in 2026 — to integrate the metabolic and ovarian observations into a single name. The integration was overdue.

Why Every Name has been Incomplete

The history is a story of incomplete observation made into definition. Hippocrates saw the clinical pattern but had no mechanism. Achard and Thiers saw the metabolic and androgenic connection but had no ovarian imaging.

Stein and Leventhal saw the ovarian morphology but did not centre the metabolism. The PCOS era saw the hormones but kept the ovarian feature in the name. PMOS now integrates the polyendocrine, metabolic, and ovarian dimensions — but PMOS too will likely be refined further.

This is not a criticism of any of the observers. Each of them named what they could see, with the tools they had. Medical naming is provisional by nature. A name describes the current best understanding; understanding deepens; the name evolves. The pattern is normal and ongoing.

There are dimensions of PMOS we still do not fully understand. The role of the gut microbiome. The genomic and epigenetic architecture. The early-life developmental origins of the metabolic abnormalities. The interaction with environmental and dietary factors. Each of these may eventually require the framing of PMOS to be revised.

The patient lesson from this history is that medical names are useful but not final. The body has been doing the same thing throughout — what has changed is what we have been able to see, measure, and interpret. PMOS is the best name available in 2026. It is likely not the last.

For the clinical picture under the current name, see the pillar article Understanding PMOS

About the Author

Dr Gautam V. Daftary is Director of Aksigen IVF and a senior consultant in reproductive medicine. He is a senior author on the 2026 review of PCOS / PMOS in the Indian context published inInsights in Reproductive Medicine.

This article is part of the Bharat Daftary Knowledge Centre, the patient-education programme of Aksigen IVF. It is intended for general information and does not replace consultation with a qualified clinician.

References

Achard EC, Thiers J. Le virilisme pilaire et son association à l'insuffisance glycolytique (diabète des femmes à barbe). Bulletin de l'Académie Nationale de Médecine (Paris). 1921;86:51–56.
Stein IF, Leventhal ML. Amenorrhea associated with bilateral polycystic ovaries. American Journal of Obstetrics and Gynecology.1935;29:181–191.
Burghen GA, Givens JR, Kitabchi AE. Correlation of hyperandrogenism with hyperinsulinism in polycystic ovarian disease. Journal of Clinical Endocrinology & Metabolism. 1980;50(1):113–116.
The Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertility and Sterility.2004;81(1):19–25. (Rotterdam consensus, 2003.)
Teede HJ, Tay CT, Laven J, Dokras A, Moran LJ, Piltonen TT, et al., on behalf of the International PCOS Network. Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. Human Reproduction.2023;38(9):1655–1679.
Teede HJ, Bahri Khomami M, Morman R, et al. Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: a multistep global consensus process. The Lancet. Published online May 12, 2026.
Ganie MA, Chowdhury S, Suri V, Joshi B, Bhattacharya PK, Agrawal S, et al.Prevalence, phenotypes, and comorbidities of polycystic ovary syndrome among Indian women.JAMA Network Open.ICMR-PCOS National Task Force, n = 9,824.
Teede HJ, Tay CT, Laven J, Dokras A, Moran LJ, Piltonen TT, et al., on behalf of the International PCOS Network.Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome.Human Reproduction.2023;38(9):1655–1679. DOI: 10.1093/humrep/dead156.
Cree M, Piltonen TT, Dokras A, et al.From PCOS to PMOS: inclusion of the adolescent voice in setting clinical and research priorities.The Lancet.Companion comment to the rename paper, 2026.

Aksigen IVF•Bharat Daftary Knowledge Centre•A Short History of How PCOS Got its Name•June 2026

The History of How PCOS Got Its Name