POLYENDOCRINE METABOLIC OVARIAN SYNDROME (PMOS), FORMERLY POLYCYSTIC OVARY SYNDROME (PCOS): SOUTH ASIAN AND GLOBAL BURDEN – A REVIEW

Abstract

Polyendocrine metabolic ovarian syndrome (PMOS) is a relatively prevalent and heterogeneous endocrine-metabolic condition which occurs predominantly in the reproductive age of the female population and was formerly classified as polycystic ovary syndrome (PCOS). In 2026, following an international global consensus process, PMOS was renamed, becoming the new name and reflecting the multisystem nature of the condition rather than the ovarian cysts, which are not the only components involved in PMOS [1]. The current epidemiological evidence indicates that prevalence estimates can differ dramatically, depending on the diagnostic criteria and the population. According to a global systematic review and meta-analysis in 2026, the prevalence of PCOS among women in adulthood was 12.1% by Rotterdam criteria, 7.9% by original NIH criteria and 12.7% by AE-PCOS criteria [2]. South Asia is a major region of interest in the area of PMOS/PCOS studies. According to GBD 2021 analyses, there is a considerable population burden in South Asia, with an estimated 10.75 million prevalent cases by 2021 and a trend of increasing prevalence between 1990 and 2021 [3,4]. The 2025 GBD analysis [3] indicated that India had the highest age-standardized prevalence rate amongst South Asian countries. There are a number of clinically significant studies in Pakistan, however, often samples are selected from hospital settings or other settings. So individual estimates of prevalence for Pakistan should not be considered as national prevalence estimates [5,6,9].This overview highlights the evidence regarding terminology, prevalence, regional differences, clinical presentation, metabolic and psychological burden, reproductive outcomes, diagnosis, management and the research gaps, especially in South Asian context and in Pakistan. It also makes a key methodological observation: that a modelled GBD case count is a type of evidence different from a community prevalence estimate and the proportion of features found in a sample of cases already diagnosed in the clinical setting.