Sometimes a change in medical terminology reflects something much bigger: a shift in how we understand disease itself.

Recently, two important conditions have undergone significant name changes – and both changes reflect a growing understanding of the central role of metabolism and insulin resistance in modern chronic disease.

From PCOS to PMOS

A condition long known as PCOS (Polycystic Ovary Syndrome) is increasingly being reframed as Polyendocrine Metabolic Ovarian Syndrome (PMOS).

At first glance, this may seem like a simple rebranding exercise. It is not.

The older terminology focused attention on the ovaries and the presence of ovarian cysts. The newer understanding recognises that this is a broader hormonal and metabolic condition affecting the entire body.

Women with PMOS commonly experience elevated male-type hormones such as testosterone, contributing to:

– Acne

– Excess facial or body hair

– Thinning hair on the scalp

– Irregular menstrual cycles

– Fertility challenges

Importantly, insulin resistance appears to play a major role in many women with the condition. This can contribute to:

– Weight gain

– Central abdominal fat accumulation

– Increased risk of type 2 diabetes

– Elevated blood pressure

– Cardiovascular disease

Mood symptoms including anxiety and depression are also more common.

There is also encouraging news emerging from newer research. Women with PMOS often appear to have a higher ovarian egg reserve and may experience menopause later than average. Although conception may be delayed earlier in life, studies suggest that around 8 in 10 women may ultimately conceive naturally.

Fatty Liver Disease Has Also Been Renamed

Another important terminology shift is the move from “fatty liver disease” to:

MASLD – Metabolic dysfunction-associated steatotic liver disease

This change reflects a major shift in understanding.

For many years, fatty liver disease was commonly associated primarily with alcohol excess. We now understand that the majority of cases are strongly linked to:

– Insulin resistance

– Excess visceral (organ) fat

– Metabolic dysfunction

– Chronic overnutrition

Current estimates suggest that around 3 in 10 Australian adults may have some degree of MASLD.

Why MASLD Matters

– Driven largely by insulin resistance

  Excess energy storage, hepatic insulin resistance, chronic inflammation, and altered lipid metabolism contribute to fat accumulation and liver injury.

– Linked to progressive liver disease

  MASLD is linked to metabolic dysfunction-associated steatohepatitis (MASH), liver fibrosis, cirrhosis, and liver cancer.

– Cardiovascular disease is the major cause of death

  People with MASLD are more likely to die from cardiovascular disease than liver failure itself.

– Potentially reversible early

  Weight loss, exercise, improved metabolic health, reduced visceral fat, and treatment of insulin resistance can significantly improve or even reverse early disease.

The Bigger Picture

Modern medicine is increasingly recognising that many seemingly separate diseases share common underlying biological drivers:

– Insulin resistance

– Chronic inflammation

– Visceral fat accumulation

– Hormonal dysregulation

– Metabolic dysfunction

Understanding these upstream processes may help us intervene earlier — often long before serious disease develops.

At The Possibility Coach, our focus is on helping people better understand these links through education, metabolic health assessment, lifestyle interventions, and evidence-informed strategies aimed at improving long-term health and healthy ageing.

Dr Julian Fox

The Possibility Coach