Britain’s National Institute for Health and Care Excellence (NICE) has published new draft guidelines for women with polyendocrine metabolic ovarian syndrome (PMOS), recommending they have their condition diagnosed sooner and be offered an annual review to monitor symptoms, treatment and long-term health risks.
The guideline is open for public consultation until 11 August, and NICE is inviting feedback from healthcare professionals, patients and the public, with plans to publish the final guideline on PMOS in December 2026.
Until recently, PMOS was known as polycystic ovary syndrome (PCOS), but experts believe 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 one in eight women, PMOS is frequently under-diagnosed and inconsistently managed.
It’s also linked with various 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.
The draft guideline recommends that an annual review be offered to people diagnosed with PMOS, covering symptoms and signs like 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 guideline makes detailed recommendations on when to suspect PMOS. It recommends that all women 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.
PMOS is linked to 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.
Because women with PMOS are also likely have a greater risk of developing various other conditions, particularly CVD and diabetes, the draft guideline signposts to the relevant NICE guidance on these conditions, and additionally, addresses the management of common problems associated with PMOS, like acne, hirsutism and obstructive sleep apnoea.
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Why rebranding PCOS as PMOS is not ideal