In May 2026, one of the most common hormonal conditions in the UK was given a new name. Polycystic ovary syndrome became polyendocrine metabolic ovarian syndrome, or PMOS, following a global consensus published in The Lancet and developed with more than 50 clinical and patient organisations.
The change was more than cosmetic. The old name focused on the ovaries and implied cysts that are not actually cysts. The new name reflects the condition’s hormonal and metabolic features, and its impact beyond fertility.
For HR and reward teams, that shift is important. PMOS has long been treated primarily as a fertility issue, while people living with it can experience symptoms and health risks across their reproductive, metabolic and mental health. In the UK, much of the cost of managing those impacts can also fall on the individual.
What PMOS is
PMOS affects an estimated one in eight women and people assigned female at birth in the UK, making it one of the most common hormonal conditions.
In adults, diagnosis is based on two of three features: 1. irregular or absent ovulation, 2. higher-than-typical androgen levels, and 3. polycystic ovarian morphology. Despite its name, this means a high number of immature follicles rather than cysts in the everyday sense.
Under the 2023 international guideline, an anti-Müllerian hormone (AMH) blood test can be used instead of an ultrasound scan to assess polycystic ovarian morphology in adults. Where irregular cycles and raised androgen levels are both present, neither test is needed. In adolescents, neither imaging nor AMH is used for diagnosis.
Despite its prevalence, up to 70% of people with the condition are thought to be undiagnosed. UK primary care data records PMOS in around 3-4% of women, compared with international prevalence estimates of 10-13%. The gap suggests the majority of people living with symptoms are undiagnosed.
How PMOS affects the body
The name change reflects the fact that PMOS is not simply a reproductive condition. It can affect multiple aspects of health, and symptoms vary from person to person.
Periods and fertility
Irregular or absent ovulation is one of the main features of PMOS. This can mean unpredictable cycles, heavy or absent periods, and difficulty conceiving. PMOS is one of the most common causes of fertility difficulty in the UK and is often diagnosed when someone seeks help to conceive, sometimes years after their first symptoms.
Weight and insulin resistance
Insulin resistance is a recognised feature of PMOS and can make weight harder to manage, sometimes despite considerable effort with diet and activity. In Verity’s 2025 patient consultation, 44.9% of respondents said they were badly affected by weight management. Weight can also become a particularly frustrating part of the experience when people receive advice without adequate support.
Hair and skin
Higher androgen levels can cause excess facial and body hair, acne and thinning hair on the scalp. Around 30% of respondents said they were badly affected by excess hair growth. These symptoms can be dismissed as cosmetic concerns, but patient testimony to the All-Party Parliamentary Group on PMOS describes a much deeper impact.
Mood and mental health
Depression and anxiety can also be part of living with PMOS. Around 31% of respondents said they were badly affected by depression and mood swings. Visible symptoms, stigma and years of struggling to get a diagnosis can compound the impact.
Long-term health
PMOS is associated with a higher risk of type 2 diabetes, cardiovascular disease, fatty liver disease and obstructive sleep apnoea, as well as a higher risk of some pregnancy complications. The risk of endometrial cancer is also increased, although the absolute risk remains low.
Why so much of the cost lands on the individual
The UK does not currently have a nationally commissioned care pathway for PMOS. When the APPG on PMOS sent Freedom of Information requests to all 42 Integrated Care Boards in England, only a small number reported integrated pathways or comprehensive support. Most cited general gynaecology as the main route available.
There is also no licensed medication specifically for PMOS in the UK. Metformin is widely prescribed off-label, but access can vary between regions and practices.
Access to NHS-funded laser hair removal also varies, meaning some people pay privately to manage excess hair growth. Weight management medication is available through the NHS only for people who meet specific eligibility criteria, leaving others to pay privately or go without.
The result is a gap between what people need and what is routinely available. When there is no clear route through the NHS, people may end up paying for support themselves.
What people are actually spending
The APPG inquiry, drawing on Verity patient surveys with more than 2,000 responses from across the UK, puts some numbers on that cost.
On average, patients reported spending nearly £1,500 on private treatments for excess hair growth, nearly £1,500 on fertility treatment and £2,000 on weight management across their lifetime.
That adds up to around £5,000 in reported private spending on a condition affecting one in eight women and people assigned female at birth. And it does not include appointments, travel, time off work or the cost of getting diagnosed.
Thirty-four percent of respondents to Verity’s 2025 diagnosis survey said they waited more than four years for a diagnosis. Some described having more than 10 GP appointments before their symptoms were connected.
Getting a diagnosis does not necessarily mean getting the support people need. Only 3% of patients said they felt supported and informed by the clinician who diagnosed them, while 38% were given no resources at all.
Patients rated NHS management of the condition at 1.9 out of 10, down from 2.2 in 2023. Meanwhile, 86% said they felt they knew more about PMOS than their GP, up from 75% two years earlier.
The cost is not shared evenly
The financial burden of PMOS is not distributed equally. For example, people of South Asian heritage are around 2.5 times more likely to be diagnosed with PMOS than their white counterparts, while people of African-Caribbean heritage are around 1.8 times more likely. Symptoms can be more severe, and associated risks such as type 2 diabetes can also be higher.
Income matters too. Among women with a household income below £35,000, 63% rated NHS management of the condition as absolutely poor, compared with 54% of those earning above that threshold.
Private treatment is not a realistic option for everyone. For people already facing greater health risks or more severe symptoms, the ability to pay can determine how much support they can access.
What this means for employers
If your organisation employs 1,000 people, PMOS is likely already affecting your workforce, whether or not you realise it.
Some employees will be dealing with symptoms at work. Others may be navigating fertility treatment, managing appointments or paying privately for care. Many may not have a diagnosis yet.
There are three practical implications:
- Fertility-only benefits reach PMOS at the latest possible point. Fertility difficulties can be one consequence of PMOS, but they are only part of the picture.
- Employees are already spending significant sums privately. The question is not whether PMOS costs money. It is who absorbs that cost, and what support is available.
- PMOS belongs in a broader hormonal health conversation. Like menopause, it can affect physical and mental health across a person’s working life. Treating it solely as a fertility issue misses much of the employee experience.
What is changing
For the first time, there will be national guidance on PMOS. NICE published draft guidance on PMOS on 1 July 2026, the first of its kind for the UK. It covers management of the condition and associated problems including acne, excess hair growth and obstructive sleep apnoea. Consultation closed on 11 August, with final guidance expected in December 2026.
That gives employers a window to prepare. National guidance is likely to increase awareness, and greater awareness may mean more employees recognising symptoms and seeking support. Organisations that understand PMOS before the guidance lands will be better placed to respond when the conversation becomes more prominent.
If this sounds familiar from your own experience rather than your workforce, speaking to a GP is a good place to start. Verity, the UK charity supporting people with PMOS, provides free guidance to help you prepare for that conversation.
How Carrot can help
Carrot supports employees across fertility, family-forming and hormonal health, with personalised care plans, access to a vetted network of specialists and expert guidance.
For a condition where people can wait years for a diagnosis and spend thousands privately along the way, having access to support matters.
To learn how Carrot can support your organisation, get in touch. If you’re a Carrot member, sign in to your Carrot account and explore your resources.
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