NHS Urges Check for PMOS in Women with Irregular Periods

New Guidelines for Polyendocrine Metabolic Ovarian Syndrome

Up to 4 million women in the UK who have irregular periods should be checked for polyendocrine metabolic ovarian syndrome (PMOS), according to new draft guidance from the National Institute for Health and Care Excellence (Nice). Formerly known as polycystic ovary syndrome, PMOS is estimated by the World Health Organization to affect up to 13% of women of reproductive age.

Symptoms include irregular, very short, long, or absent periods, high testosterone levels, and ovaries with multiple small follicles. The condition is linked to an increased risk of type 2 diabetes, cardiovascular disease, sleep apnoea, fatty liver disease, mental health issues, and pregnancy complications.

Who Should Be Tested?

The new guidance applies to girls aged 10 and older, as well as adult women, trans men, and non-binary people not undergoing gender-affirming therapy or surgery. Patients with suspected PMOS should have blood tests for hormone levels and, in some cases, ultrasounds. The guidance stresses that PMOS should not be ruled out in women who have gone through menopause or those with eating disorders.

PMOS can be more common in black, Asian, and mixed-ethnicity women, and healthcare professionals are advised to consider this when assessing symptoms.

Annual Reviews and Treatment

Once diagnosed, individuals with PMOS should have an annual review to monitor symptoms such as menstrual irregularities and excessive hair growth. The review should cover cardiovascular health, diabetes, obesity, mental health, and other risks. IVF should be offered to eligible women with PMOS who meet standard Nice criteria. However, laser hair removal or light therapies for excess hair are not recommended due to cost, with Nice estimating these could cost the NHS up to £100 million per year in England.

Expert Responses

Marieanne Ledingham, Nice's consultant clinical advisor for women's health, said PMOS is often overlooked but can have a major impact. Dr. Rachel Reid-McCann from Oxford University stressed that irregular periods may signal long-term health issues. Wellbeing of Women CEO Janet Lindsay welcomed the guidelines, noting that women from minority communities face additional barriers to diagnosis. Consultation on the draft runs until August 11, 2026, with final guidelines expected in December 2026.