Women with irregular periods should be checked for PMOS, NHS says

Symptoms for PMOS, previously known as polycystic ovarian syndrome, include irregular, very short, long or absent periods. Photograph: Science Photo Library/Alamy View image in fullscreen Symptoms for PMOS, previously known as polycystic ovarian syndrome, include irregular, very short, long or absent periods. Photograph: Science Photo Library/Alamy Women with irregular periods should be checked for PMOS, NHS says Polyendocrine metabolic ovarian syndrome is underdiagnosed and inconsistenly managed, according to Nice Up to 4 million women with irregular periods should be investigated for polyendocrine metabolic ovarian syndrome, according to new NHS guidance . PMOS, previously known as polycystic ovarian syndrome, is believed to affect up to 13% of reproductive age women , the World Health Organization estimates. Symptoms include irregular, very short, long or absent periods, excess levels of testosterone, and ovaries with multiple small follicles. The condition is associated with greater risk of developing type 2 diabetes, cardiovascular disease, sleep apnoea, fatty liver disease, mental health issues and complications in pregnancy. But the National Institute for Health and Care Excellence (Nice) says that, despite affecting 3- to 4-million women in the UK, PMOS is “frequently underdiagnosed and inconsistenly managed”. Nice’s new draft guidance covers girls aged over 10, as well as adult women, trans men and non-binary people who are not receiving gender reassignment therapy or surgery. Patients with suspected PMOS should be offered blood tests including male and female hormone levels and in some cases ultrasounds. PMOS should not be discounted in women who have been through the menopause, or those with eating disorders, which disproportionately affect people with PMOS, the guidance states. PMOS can be more prevalent among black, Asian and mixed ethnicity women, and the guidance also says healthcare professionals should consider this when assessing symptoms. Once diagnosed, those with PMOS should have an annual review to monitor symptoms such as menstrual irregularities and excess hair growth. The annual review should discuss cardiovascular health, diabetes, obesity, mental health care and other risks associated with PMOS. The guidance also states that IVF should be offered for women with PMOS who meet the standard Nice criteria for IVF. But they should not be offered laser hair removal or light therapies for excess hair growth “because analysis suggests these are not cost-effective ways of improving overall health and wellbeing”, Nice said. It would cost the NHS up to £100m a year in England to offer those treatments to PMOS patients, Nice estimates. The draft guidance is based on the international evidence-based guideline produced by Monash University and used by more than 100 countries. Marieanne Ledingham, consultant clinical advisor for women’s and reproductive health at Nice, said: “PMOS is a common but often overlooked condition that can ha