PMOS: Why the New Name for PCOS is Renewing Interest in Inositol

For decades, polycystic ovary syndrome, better known as PCOS, has been defined by a name that captures only one part of a complex condition. That is beginning to change.

In May 2026, an international coalition of researchers, clinicians, professional organizations and patients proposed a new name: polyendocrine metabolic ovarian syndrome, or PMOS. Published in The Lancet, the proposed terminology is intended to move beyond the misleading focus on ovarian “cysts” and to better reflect the condition’s reproductive, endocrine and metabolic dimensions.

Although the diagnostic criteria have not changed and transitioning to the new terminology will take time to work its way through medical and regulatory systems, the shift signals a broader evolution in women’s health. Rather than treating reproductive symptoms, insulin sensitivity, hormonal signaling, weight and skin concerns as unrelated issues, the PMOS framework encourages a more integrated view of the pathways connecting them.

The scale of the condition adds urgency to that shift. PMOS is estimated to affect more than 170 million women worldwide, including approximately 24 million women of childbearing age in China alone and, according to 2024 survey data, an estimated 6% of women ages 18 to 44 in the United States. Its global burden has reportedly increased by nearly 87% over the past three decades, underscoring the need for approaches that reflect the condition’s full systemic impact.

Such approaches are seeing strong commercial momentum in the form of health and nutrition products. Grand View Research estimates that the global women’s wellness products market will grow from $289.8 billion in 2025 to $549.3 billion by 2033, an 8.4% compound annual growth rate. Within women’s wellness products, reproductive and hormonal health in particular represented 24.07% of 2025 revenue. Meanwhile, HTF Market Intelligence forecasts the metabolic health supplements segment to grow at a 19.3% compound annual rate from 2025 to 2033. Together, these trends align closely with the PCOS-to-PMOS reframing: consumers and brands are already moving toward solutions that address interconnected endocrine and metabolic pathways rather than isolating ovarian symptoms.

For supplement manufacturers and formulators, the rollout of the new name creates a timely opportunity to reconsider the role of inositols — particularly D-chiro-inositol (DCI) — in next-generation women’s health products.

A foundation of metabolic and hormonal support

PCOS had often been discussed primarily in the context of fertility, menstrual irregularity or ovarian function. Yet the condition can also involve insulin dysregulation, elevated androgen levels, weight concerns, acne and other metabolic or hormonal effects. These concerns are not always independent of one another. Elevated insulin levels, for example, can influence ovarian androgen production, potentially contributing to downstream effects such as irregular menstrual cycles, unwanted hair growth and impaired ovulation.

As formulators better understand the interconnected biology of PMOS, they are evolving women’s health product development away from a symptom-by-symptom model. Instead of offering one formulation for reproductive health, another for weight management and another for skin, brands are increasingly exploring ingredients that support foundational metabolic and hormonal pathways.

D-chiro-inositol is particularly relevant to this approach because of its role in cellular signaling associated with insulin action and glucose metabolism. By supporting the body’s response to insulin, DCI may help address an underlying pathway connected to several areas of women’s wellness.

“The shift to PMOS reflects a broader understanding of the condition, and it’s opening some exciting opportunities to drive innovation in women’s health formulations. We believe it starts with ingredients like D-chiro-inositol that address metabolic and hormonal health at its foundation,” says Fiona Liu, Marketing Manager at HOWTIAN, which produces high-purity D-chiro-inositol through a proprietary enzymatic process.

DCI’s role in women’s health formulations

Inositols are naturally occurring compounds involved in numerous cellular signaling processes. Of the nine recognized inositol stereoisomers, myo-inositol (MI), and D-chiro-inositol have received the greatest attention in women’s health research.

Although closely related, MI and DCI perform distinct biological functions.

MI is more commonly associated with follicular signaling and ovulatory function, while DCI is more closely linked with insulin-mediated metabolic activity and androgen-related processes. This distinction is important for formulators because the two ingredients should not be treated as interchangeable forms of “inositol.” Depending on the intended product positioning, they can serve different but complementary roles.

Compared to MI, DCI’s more direct relationship with insulin signaling gives it potential relevance across several interconnected areas of women’s health.

The opportunity for supplement brands is not to position DCI as a solution for every women’s health concern, but to recognize how one foundational pathway can influence multiple downstream areas.

Strengthening Myo-inositol formulations with D-chiro-inositol

The evolving PMOS conversation is especially relevant for brands that already offer standalone myo-inositol products. By placing metabolic health more visibly within the discussion, the new terminology creates an opportunity for these companies to evaluate whether adding DCI could support a more comprehensive and differentiated product proposition.

A clearly defined MI-and-DCI formulation can help a brand move beyond generic “inositol” positioning. It also creates an opportunity to educate consumers, health professionals and retail partners about the distinct roles of each isomer and the importance of thoughtful formulation balance.

For brands considering a combined formulation, the opportunity is not simply to add DCI to an existing myo-inositol product or default automatically to the widely cited 40:1 ratio. Alternatively, a 3.6:1 ratio of MI to DCI is one option supported by preliminary clinical research, and formulators may want to evaluate whether it is relevant to their intended application.

That ratio has been evaluated in a randomized, open-label study of young women with PCOS in India, published in the International Journal of Gynecology & Obstetrics, in which a myo-inositol and D-chiro-inositol combination close to a 3.6:1 ratio was compared with a combined hormonal contraceptive, and it was associated with improved menstrual-cycle regularity and insulin resistance over six months. Separately, a randomized controlled trial in women with PCOS undergoing the fertility treatment ICSI, published in Gynecological Endocrinology, compared a similar 3.6:1 formulation with a roughly 40:1 formulation. It reported higher pregnancy and live-birth rates, and a lower risk of ovarian hyperstimulation syndrome, in the 3.6:1 formulation.

These are preliminary, individual studies rather than a settled evidence base. The most recent international evidence-based PCOS guideline, developed by a global coalition of medical societies, calls for additional well-controlled research. The evidence behind a 3.6:1 MI:DCI ratio should be read in that light: promising, but limited and not definitive.

As such, the appropriate formulation needs to be guided by the product’s intended use, the distinct role of each inositol form, and the strength of the evidence supporting the proposed dose and claims. For formulators, the most credible opportunity is to develop scientifically reasoned products with transparent ingredient identities, clearly defined ratios and responsible claims.

Building the next generation of inositol products

The transition from PCOS to PMOS places endocrine and metabolic health front-and-center in women’s health and creates both a scientific and commercial mandate to move beyond generic inositol positioning. HOWTIAN’s high-purity DCI, produced through a proprietary enzymatic process and supported by the company’s established myo-inositol platform, gives manufacturers an emerging and essential building block for clinically informed MI-and-DCI products.

As the science and language of women’s health continue to evolve, successful product development will require more than simply responding to a new name. It will require formulations that reflect a more complete understanding of the interconnected pathways underlying women’s wellness, and the distinct role each ingredient can play within them.