Daijiworld Media Netwok - New Delhi

New Delhi, Jun 21: India is facing a dual challenge of declining fertility rates and rising infertility, while millions of women continue to deal with a hormonal condition that experts say is often misunderstood as only a reproductive disorder.

The recent renaming of Polycystic Ovary Syndrome (PCOS) as Polyendocrine Metabolic Ovarian Syndrome (PMOS) aims to shift the focus towards its broader impact on women’s overall health, said leading gynaecologist Dr Rishma Pai.

"PMOS causes prediabetes, diabetes, high blood pressure, metabolic problems and even heart disease. It affects the entire body and the way its metabolism behaves," said Dr Pai, consultant gynaecologist and infertility specialist at Lilavati and Reliance Hospitals.

Dr Pai explained that the change in terminology followed a global consensus involving medical organisations and patient groups, stressing that it was not just a name change but a shift in understanding the condition.

"For more than 35 years, the focus was on cysts in the ovary. But a large number of women don't have cysts at all. Patients would tell us, 'I don't have PCOS because there are no cysts in my ovary'," she said.

The new term highlights hormonal and metabolic abnormalities associated with the condition, which affects around one in eight women globally.

According to Dr Pai, women with PMOS are at higher risk of insulin resistance, obesity, abnormal cholesterol levels, high blood pressure, diabetes and heart disease. She said the condition should be treated as a lifelong metabolic and endocrine disorder rather than only a fertility-related issue.

She added that managing PMOS requires a holistic approach involving specialists including endocrinologists, dermatologists, cardiologists and mental health professionals.

Dr Pai also linked the discussion around PMOS with India’s falling fertility rate, saying delayed marriages, late pregnancies, rising living costs and changing social priorities are contributing to the demographic shift.

"India has to look strongly at this issue before we go the China way," she said, adding that the country is facing both a fertility and infertility crisis.

She pointed out that infertility is rising due to factors such as obesity, hormonal disorders, infections, tuberculosis and increasing male-factor infertility. While advanced fertility treatments are available, access and affordability remain major challenges.

On the use of GLP-1 drugs such as semaglutide for eligible women with obesity and metabolic complications, Dr Pai said they could be useful tools but are not a cure for PMOS, which requires lifelong care and management.

Emphasising preventive healthcare, she said women should address hormonal and metabolic issues before pregnancy rather than seeking medical help only after complications arise.

"The condition should not be viewed only as a fertility disorder. It affects women from adolescence to old age and needs comprehensive care," Dr Pai said.