New draft PMOS guideline recommends annual review and could mean quicker diagnosis
People with polyendocrine metabolic ovarian syndrome (PMOS) should have their condition diagnosed sooner and be offered an annual review to monitor symptoms, treatment and long-term health risks, according to draft our guideline published for public consultation today.
People with polyendocrine metabolic ovarian syndrome (PMOS) should have their condition diagnosed sooner and be offered an annual review to monitor symptoms, treatment and long-term health risks, according to draft our guideline published for public consultation today.
PMOS was until recently known as polycystic ovary syndrome (PCOS). The new name better reflects the wide-ranging hormonal, metabolic and reproductive effects of the condition. These are comprehensively addressed in the draft guideline, the first on this condition tailored to a UK population.
PMOS is a lifelong condition characterised by irregular periods, high testosterone levels, and ovaries with multiple small follicles. Despite affecting around 1 in 8 women, PMOS is frequently under-diagnosed and inconsistently managed.
PMOS is also linked with a range of health risks, including type 2 diabetes, cardiovascular disease, sleep apnoea, fatty liver disease, mental health problems and complications in pregnancy. Despite this, awareness and diagnosis rates remain lower than expected, meaning many people do not receive timely care.
Our draft guideline says an annual review should be offered to people diagnosed with PMOS and cover symptoms and signs such as menstrual irregularities and excess hair growth, medicines use, and risk of long-term conditions such as diabetes and cardiovascular disease at a stage when lifestyle changes could help to prevent more serious illness.
To improve early diagnosis, the draft guideline makes detailed recommendations on when to suspect PMOS. It recommends that all people with irregular or absent menstrual cycles and symptoms or signs of excessive levels of male hormones should be investigated for PMOS because these are often linked to the condition.
It also says PMOS should not be discounted in women who have been through the menopause. PMOS may be more prevalent in women of Black, Asian and mixed ethnicity, and healthcare professionals should consider this when assessing symptoms.
Living with PMOS can have a significant impact on mental health and quality of life and the draft guideline highlights that depression and anxiety are common across all ages in people with the condition. Eating disorders also disproportionately affect people with PMOS and the draft guideline is clear the presence of these should not be dismissed solely on the basis of a person’s weight.
PMOS is linked with an increased risk of fertility problems and for those planning a pregnancy, advice on weight, diet, nutrition, exercise, sleep and mental health is recommended, reflecting the range of factors affecting reproductive outcomes. The draft guideline also includes comprehensive recommendations on fertility treatment, including that IVF should be offered to those who meet the relevant access criteria in line with our fertility guideline.
Because people with PMOS are also likely to be at an increased risk of developing a number of other conditions, particularly cardiovascular disease and diabetes, the draft guideline signposts to the relevant NICE guidance on these conditions. It also addresses the management of common problems associated with PMOS such as acne, hirsutism (excessive hair) and obstructive sleep apnoea.
Sharon Manship, a lay member on the guideline committee, said: “As someone who has been living with PMOS for around 30 years, I am really pleased to see the new NICE guideline come to fruition.
“I first sought support in my early 20s having realised that my irregular and painful menstrual cycle and issues with my weight and mental health were not the norm. It was so disheartening to be told, until I was finally diagnosed in my mid-30s, that my symptoms were just part of being a woman.
My hope is that with this new guideline, people with PMOS will be taken seriously, diagnosed earlier and provided with evidence-based support and care from healthcare professionals from the outset, rather than having to go what I went through.
Sharon continued: "I am positive that the whole community of individuals living with this all-encompassing and debilitating condition will similarly welcome this new guidance.”
Marie Anne Ledingham, consultant clinical advisor for women's and reproductive health at NICE, said: “PMOS is a common but often overlooked condition that can have a major impact on health and wellbeing. Recommending a simple annual review is an important step towards ensuring people get the ongoing care and monitoring they need.
“The new guideline will help improve consistency of care, increase awareness of the condition, and support earlier diagnosis and management.”
The draft guideline makes a number of recommendations for treatments to address the underlying causes of hirsutism. It does not make a recommendation about the use of mechanical laser and light therapies for hair reduction. This is because analysis suggests these are not cost-effective ways of improving overall health and wellbeing. We estimate the likely cost impact to the NHS of recommending these therapies to be up to £100 million per year in England.
The draft guideline is open for consultation from 1 July to 11 August 2026, and we are inviting feedback from healthcare professionals, patients and the public. We expect to publish our final guideline on PMOS in December 2026.