New EMAS Clinical Guide in Maturitas addresses what the proposed rename from PCOS to PMOS means for menopause care
The European Menopause and Andropause Society (EMAS) has published a Clinical Guide in Maturitas addressing the implications of a proposed global terminology change for women during the menopausal transition and after menopause. The guide provides practical recommendations on assessment, cardiometabolic risk, cancer risk, bone health, and menopausal hormone therapy in women with a history of PCOS or PMOS.
A global consensus reached in 2026 proposed renaming polycystic ovary syndrome (PCOS) as polyendocrine metabolic ovarian syndrome (PMOS), reflecting a broader understanding of the condition as a lifelong endocrine and metabolic disorder rather than a syndrome defined primarily by reproductive features and ovarian morphology. For menopause specialists, this shift has direct clinical implications. The reproductive criteria that have historically defined PCOS become progressively less useful after menopause. The cardiometabolic consequences do not.
“After menopause, the question is no longer whether a woman meets the diagnostic criteria for PCOS. The challenge is recognising that the condition still matters — and that the clinical priorities have changed.”
Assessment after menopause
After menopause, the diagnosis of PMOS cannot be established de novo. Menstrual criteria no longer apply, ovarian morphology changes with age, and androgen concentrations decline. Recognition in postmenopausal women depends primarily on a documented diagnosis before menopause or a well-characterised reproductive history. The clinical priority shifts from reproductive management to cardiometabolic risk assessment, including evaluation of weight, waist circumference, blood pressure, glycaemic status, and lipid profile.
The guide notes that PMOS is not currently included as an independent variable in commonly used cardiovascular risk calculators such as SCORE2 or QRISK3. Calculated risk estimates may therefore be conservative, and clinicians should interpret results within the broader clinical context.
Menopausal hormone therapy
PMOS alone is not a contraindication to MHT. Treatment should follow standard indications and be individualised according to the woman’s overall risk profile. Transdermal estradiol may be preferred in women with obesity, hypertriglyceridaemia, or elevated thromboembolic risk. The guide acknowledges that current recommendations for this population are largely extrapolated from evidence in the general menopausal population, as direct studies in women with PMOS remain limited.
Cancer risk and bone health
Current evidence does not support additional endometrial, breast, or ovarian cancer screening on the basis of PMOS alone. A separate osteoporosis screening strategy is similarly not indicated. Assessment in both areas should follow standard risk-based clinical guidance.
“The shift from PCOS to PMOS encourages clinicians to view the condition through a lifespan perspective. Menopause care is an opportunity to address risks that have been accumulating for decades.”
The full Clinical Guide is available open access in Maturitas.
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