Women with irregular periods should be investigated for polyendocrine metabolic ovarian syndrome (PMOS), according to new guidance from UK’s National Health Service (NHS), the country’s publicly-funded healthcare system.
Previously known as polycystic ovarian syndrome (PCOS), PMOS is believed to affect up to 13% of reproductive age women, based on the World Health Organization (WHO) estimates. Symptoms include irregular periods, excess levels of testosterone, and ovaries with multiple small follicles. This condition is associated with greater risk of developing Type 2 diabetes, cardiovascular disease, sleep apnea, fatty liver disease, mental health issues and complications in pregnancy.
Sadly, according to the National Institute for Health and Care Excellence (Nice), PMOS is “frequently underdiagnosed and inconsistenly managed”.
And so its Nice’s draft guidance for NHS was developed, based on the evidence-based guideline produced by Monash University and used by more than 100 countries.
The draft guidance – which covers girls aged over 10, adult women, trans men and non-binary people who are not receiving gender reassignment therapy or surgery – push for patients with suspected PMOS to be offered blood tests, including male and female hormone levels and ultrasounds.
The guideline also states that:
- PMOS should not be discounted in women who have been through the menopause, or those with eating disorders.
- PMOS can be more prevalent among Black, Asian and mixed ethnicity women, so they should be given attention.
- Once diagnosed, those with PMOS should have an annual review to monitor symptoms, as well as discuss risks associated with PMOS (e.g. cardiovascular health, diabetes, obesity, mental health care).
- Only offer IVF to women with PMOS who meet the standard Nice criteria for IVF.
Consultation on the draft guidelines remains open until 11 August 2026, with final guidelines due in December 2026.
