PCOS, or polycystic ovarian syndrome, is a condition that affects one in ten people with female anatomy.
To the layman, PCOS is a reproductive disorder. That's how most people think of it. Treated as consequence of female anatomy. Certainly it's understudied, as most conditions that only affect females are.
But PCOS is deeply complex. What causes it? The science is still unclear, but there are some suggestions that stress, childhood trauma and ethnicity could all be factors. One of the common symptoms of PCOS is that it can slow or inhibit your ability to have biological children. Much of the discourse around PCOS is centred on this one issue, your ability to procreate. As for the other physical and mental issues it causes, they're widely under-recognised and almost brushed off.
But the reality of this condition is far different from the public perception that it just affects your ovaries. It's the most common endocrine condition affecting females.
Yes, it's considered an endocrine condition, not just a reproductive one.
To add context, one of the most common treatments for PCOS is metformin, an insulin and blood-sugar regulating drug used to control diabetes. Why? Because those with PCOS are three to five times more likely to develop type 2 diabetes, irrespective of their weight. In fact, More than half of females with PCOS will develop type 2 diabetes by the age of 40.
It's why there has been a recent groundswell within the medical community, a push to officially change the name of PCOS so it can be understood for what it truly is.
"Polycystic ovaries do not accurately reflect the multi-system disorder that is associated with PCOS. It is way more complex than that," said Dr Devini Ameratunga, a Brisbane gynaecologist and board-certified reproductive endocrinologist.
Beyond pushing women into insulin resistance and diabetes, there are almost more consequences of PCOS than you can count. PCOS can make your hair fall out. It means you're more likely to battle acne. It can cause weight gain that doesn't respond to a healthy diet and exercise. It can cause excess hair growth on the face and body.
"PCOS is a condition that is due to a disruption of hormones – the main signalling pathway for the endocrine system. There are many things that will feed into the endocrine system to change how it behaves," said Dr Dev. "So anything that affects the endocrine system can theoretically affect PCOS or how PCOS is manifested."
Beyond some of the physical manifestations, the mental ones can be even more insideous. It can increase your risk of developing depression and anxiety conditions. It can lower your ability to absorb B12, which in turn can lead to Alzheimer's disease. It makes you more sensitive to the impacts of stress, which can further blow out all the rest of your symptoms. This is a condition that affects the entire body and mind, with consequences that extend far beyond the ovaries.
"Polycystic ovarian syndrome was initially termed by a gynaecologist in the early 20th century due to the typical multicystic-appearing ovaries," says Dr Dev. "Now, most of us specialists feel this is an outdated term."
That's because Polycystic Ovarian Syndrome does not accurately represent that this is a condition of the endocrine system. In fact, many females with PCOS may not even have visible ovarian cysts at all.
"Women with multiple cysts or follicles do not necessarily have the multi-system disorder or many different physical characteristics associated with this condition. Likewise, you can have the syndrome without having visible ‘cysts’ on an ultrasound," says Dr Dev.
Keeping this condition inside its reproductive naming convention has significant repercussions for people with PCOS.
Monash University published an article in 2025 that shows how the current name of this condition is contributing to misdiagnoses, late diagnoses and many females being undiagnosed all together. The current naming convention also contributes to the perception that this condition is not as "serious" as it actually is.
Could you imagine asking your boss for a personal leave day to manage your PCOS? Now, imagine asking your boss for a personal leave day because you have a condition where excessive stress can cause you to develop diabetes and make your hair to fall out? The response would almost certainly be different.
A new name would convey the truth of the condition and potentially improve the outcomes for women with PCOS. But we're still a while away from a formalised change.
"The process to come up with a new name will be extensive and involve stakeholders from a variety of areas," said Dr Dev. "I suspect it will have a name that involves or represents the endocrine disruption that occurs in the disease."
Editor’s note: in the context of this article, we use 'female' to denote people with anatomically female sex characteristics. We use 'women' to denote gender and to refer to people who identify as women. There may be exceptions when language is taken from a direct quote.
