UK — The National Institute for Health and Care Excellence (NICE) issued draft guidance recommending annual reviews and standardized investigation procedures for polyendocrine metabolic ovarian syndrome (PMOS). The guidance recommends that women with irregular periods be investigated for PMOS, a condition previously known as polycystic ovarian syndrome.

NICE stated that PMOS is frequently underdiagnosed and inconsistently managed. The guidance covers girls aged over 10, adult women, trans men not receiving gender reassignment therapy or surgery, and non-binary people also not undergoing such therapy or surgery. Patients with suspected PMOS should be offered blood tests, including male and female hormone levels, and ultrasounds in some instances. Healthcare professionals should consider ethnicity when assessing PMOS symptoms, as the condition can be more prevalent among Black, Asian, and mixed ethnicity women. PMOS should not be discounted in women who have been through menopause or in those with eating disorders.

Those diagnosed with PMOS should have an annual review to monitor symptoms such as menstrual irregularities and excess hair growth. This review should also discuss cardiovascular health, diabetes, obesity, and mental health care. For individuals planning a pregnancy, advice on weight, diet, nutrition, exercise, sleep, and mental health is recommended. In vitro fertilization should be offered to women with PMOS who meet standard NICE criteria.

NICE recommends against offering laser hair removal or light therapies to PMOS patients for excess hair growth. Analysis suggests these treatments are not cost-effective for improving overall health and wellbeing for these patients. NICE estimates it would cost the National Health Service (NHS) up to £100 million annually in England to offer these therapies to PMOS patients. The draft guidance is based on an international evidence-based guideline produced by Monash University, which is used by more than 100 countries.

Marieanne Ledingham, a consultant clinical advisor for women's and reproductive health at NICE, stated that PMOS is often overlooked. "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. This new guideline will help improve consistency of care, increase awareness of the condition, and support earlier diagnosis and management," Ledingham said. Dr. Rachel Reid-McCann, a researcher at Oxford University, commented on the guidance. "Not only can irregular periods be burdensome in the short term, but they have also been associated with longer-term chronic health and reproductive outcomes, making prompt investigation important. A PMOS diagnosis in those with irregular periods can open up access to treatment, support and advice that can help improve symptoms and may also reduce longer-term health risks. The key challenge will be ensuring NHS services have the resources needed to implement these recommendations and doing so consistently across the UK," Reid-McCann said.

Janet Lindsay, chief executive of Wellbeing of Women, welcomed the draft guidelines. "For too long, women with [PMOS] have faced delays in diagnosis and inconsistent care. Too often, symptoms such as irregular periods, fertility difficulties or concerns about weight have been dismissed as something they must simply live with. Wellbeing of Women welcomes these draft Nice guidelines, recognising [PMOS] as a complex, lifelong condition that can affect reproductive health, mental wellbeing and long-term health outcomes. The recommendation for regular review is an important step towards ensuring women receive the ongoing support, monitoring and information they need throughout their lives. It is particularly encouraging to see the guideline acknowledge the inequalities that persist in diagnosis and care. Women from black, Asian and other minoritised communities can face additional barriers to investigation and diagnosis, and tackling these disparities is essential if everyone is to receive timely, evidence-based care," Lindsay said.

Consultation on the draft guidelines is open from July 1 to August 11, 2026. Final guidelines are due for publication in December 2026.

Why It Matters

Up to 4 million women in the UK are estimated to have PMOS. The World Health Organization estimates that PMOS affects up to 13% of reproductive-age women globally. The condition is a major cause of female infertility and is associated with a greater risk of developing type 2 diabetes, cardiovascular disease, sleep apnea, fatty liver disease, and mental health issues such as depression and anxiety. These new guidelines aim to address the current underdiagnosis and inconsistent management of PMOS by standardizing investigation procedures and ensuring ongoing care through annual reviews.