Polycystic ovary syndrome has been renamed polyendocrine metabolic ovarian syndrome following an international consensus process endorsed by 56 professional and patient organisations. The rationale is that the old name was wrong twice over: the ovarian appearance reflects numerous arrested antral follicles rather than pathological cysts, and the term itself pushed a lifelong endocrine-metabolic condition into an ovarian and fertility-centred frame.
Diagnostic criteria are unchanged — two of three: irregular cycles with ovulatory dysfunction, clinical or biochemical hyperandrogenism, and raised anti-Müllerian hormone or multiple follicles on ultrasound in adults.
The reason this belongs in a briefing rather than a terminology note is the obstetric risk profile the report assembles. The condition affects around 10 to 13% of reproductive-age women. In pregnancy it is associated with higher risks of miscarriage, gestational diabetes, hypertensive disorders, caesarean delivery, preterm birth, fetal growth restriction, low birthweight and small-for-gestational-age infants — with many associations persisting after adjustment for age and body mass index, which is the point most often missed. It is not simply a proxy for obesity.
And it is not routinely captured as a risk modifier at the first antenatal visit, nor embedded in antenatal decision pathways.
That is the actionable gap. Asking about it at booking costs one question — irregular cycles before conception, hirsutism or acne, previous fertility treatment — and it changes the antenatal plan: earlier glucose testing, blood pressure vigilance, growth surveillance.
- Ask about pre-pregnancy cycle irregularity, hyperandrogenism and fertility treatment at the booking visit
- Record the diagnosis as an obstetric risk modifier, not just in the gynaecological history
- Bring forward glucose testing and maintain blood pressure and growth surveillance in affected pregnancies
- Note that risk persists after adjustment for body mass index — this is not simply obesity by another name
- Diagnostic criteria are unchanged; only the name and the clinical framing have changed
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