PMOS (PCOS) Symptoms: Signs, Diagnosis and When to See Your GP

The most common PCOS symptoms are irregular or missing periods, extra hair on the face or body, acne, thinning hair on the scalp, and trouble getting pregnant. Many people also notice weight changes, low mood or anxiety, and tiredness. Symptoms vary a lot: some people have several, others have very few, and you do not need cysts on your ovaries to have it. PCOS is diagnosed when at least two of three features are present and other causes have been ruled out. In May 2026 the condition was renamed polyendocrine metabolic ovarian syndrome (PMOS), but the symptoms and the way it is diagnosed have not changed.

What is PMOS (PCOS)?

PMOS is a common, lifelong hormonal condition. It affects how the ovaries work, and also how the body handles insulin, so it reaches well beyond the reproductive system. The 2023 International Evidence-based PCOS Guideline, led from Monash University, puts the global prevalence at 10 to 13% of women. Jean Hailes says it may be more common in Aboriginal and Torres Strait Islander women.

The old name was misleading. People with PCOS do not have harmful cysts on their ovaries. What shows up on an ultrasound is a larger number of small, partly developed follicles (eggs that have not been released). In May 2026, a global consensus published in The Lancet renamed the condition polyendocrine metabolic ovarian syndrome, or PMOS. Jean Hailes and Better Health Channel now use the new name, Healthdirect notes the change, and a transition period is under way, so you will see both names for a while. Read more in our article on the PCOS name change to PMOS. We use “PCOS” in this article because that is still what most people search for.

PMOS (PCOS) symptoms at a glance

This table sets out the main symptoms, what you might notice, and how each one is used in diagnosis. Not everyone has every symptom, and many of them also happen in other conditions.

The main symptoms explained

Irregular periods

Irregular cycles are a common sign. The 2023 guideline defines them by how long it has been since your first period. Irregular cycles are normal in the first year. From 1 to 3 years after your first period, cycles shorter than 21 days or longer than 45 days count as irregular. After that, irregular means cycles shorter than 21 or longer than 35 days, or fewer than 8 periods a year. Any single cycle longer than 90 days, or no period at all by age 15, is also worth checking. Ovulation problems can still happen with regular cycles, so a blood test for progesterone is sometimes used to check.

Androgen signs: hair and skin

Androgens are hormones such as testosterone. Everyone has them, but levels or their effects are often higher in PMOS. Unwanted hair growth on the face or body is the strongest sign. The guideline treats hirsutism on its own as a reliable pointer to high androgens in adults. Acne and scalp hair thinning on their own are weaker signs, because they have many other causes. The guideline also says your own report of unwanted hair counts, even if you remove it so your doctor cannot see it. For more on hair changes, see our guide to PMOS (PCOS) and hair.

Insulin resistance

Insulin resistance means the body needs more insulin to keep blood glucose steady. The guideline calls it a key feature of PMOS, but says the insulin blood tests available in routine care are not accurate enough to be useful, so they are not recommended. Instead, your GP checks your blood glucose. Our article What is insulin resistance? explains it in more detail.

Mood, body image and eating

Depression and anxiety are much more common with PMOS. The guideline recommends that all adults with PMOS are screened for both, and adolescents for depression. Hair, skin and weight changes can affect body image. The guideline also says eating disorders and disordered eating should be considered in PMOS, regardless of weight. If food or your body is causing you distress, our eating disorder dietitian page explains how we can help.

Sleep

Obstructive sleep apnoea is significantly more common in women with PMOS, and this is independent of body weight. Signs are snoring together with waking unrefreshed, daytime sleepiness or fatigue. If that sounds familiar, mention it to your GP.

How PMOS (PCOS) is diagnosed in 2026

Doctors use the 2023 International Evidence-based Guideline, which builds on the older Rotterdam criteria. You need at least two of these three features:

1. Irregular cycles or ovulation problems, using the cycle definitions above.
2. High androgens, seen as symptoms (mainly excess hair) or on a blood test for total and free testosterone.
3. Polycystic ovaries, seen on ultrasound (20 or more follicles in at least one ovary, best measured with a transvaginal scan if you are comfortable with it) or, new in 2023, a high anti-Müllerian hormone (AMH) blood test.

Other conditions that can look similar must be ruled out first. Your GP may check thyroid function, and if androgen levels are very high, look for rarer causes such as adrenal conditions or a hormone-producing tumour.

A few details matter for testing:

• Ultrasound is not always needed. If you have irregular cycles and signs of high androgens, the diagnosis can be made without an ultrasound or AMH test.
• AMH or ultrasound, not both. Either can be used in adults, but the guideline advises against doing both, to avoid over-diagnosis. AMH should not be used as a test for PMOS on its own, and it is affected by your age and by recent use of the contraceptive pill.
• The pill makes androgen tests hard to read. If a blood test for androgens is essential and you take the combined pill, the guideline suggests stopping it for at least three months first, with other contraception during that time.

PMOS (PCOS) in teenagers

Diagnosis in adolescents is harder because irregular cycles and acne are common during normal puberty. For teenagers, both irregular cycles and high androgens are needed. Ultrasound and AMH are not recommended in adolescents (within about 8 years of the first period) because they cannot reliably tell PMOS apart from normal development. If a teenager has some features but does not meet the criteria, the guideline suggests treating them as at “increased risk” and reassessing by 8 years after their first period.

Which symptoms are linked with weight?

PMOS happens across all body sizes, and none of the diagnostic criteria involve weight. Women with PMOS are more likely to have higher weight, according to a meta-analysis of 35 studies, although the studies varied a lot. Higher weight can make some features stronger. A review of 30 studies found higher weight was linked with higher testosterone, glucose and insulin, and less healthy blood fats, in women with PMOS.

Other risks are there at any size. The guideline says women with PMOS have a higher risk of type 2 diabetes regardless of age and BMI, and sleep apnoea is more common independent of weight. Many women with PMOS experience weight stigma in health care, which the guideline asks health professionals to recognise. Importantly, it also says a healthy lifestyle brings benefits even without weight loss. So the focus is on health behaviours, not a number on the scales.

Long-term health links

PMOS is lifelong. Androgen-related symptoms can continue after menopause, so these checks stay relevant as you age.

Where diet and a dietitian fit

The guideline recommends healthy eating and physical activity for everyone with PMOS, at any weight. It also says there is no evidence that any one type of diet is better than another. That means no single “PCOS diet” is required: any eating pattern consistent with healthy eating guidelines has benefits, as long as it suits you and is not unduly restrictive.

A dietitian can help you turn that into something that fits your life, your symptoms, your relationship with food and your goals, whether those are energy, cycles, fertility or long-term health. Our PMOS (PCOS) diet guide covers the eating patterns with the best evidence, and our inositol and metformin article looks at supplements. If you are planning a pregnancy, see fertility and diet.

When to see your GP

See your GP if you have any of the symptoms in this article, if they are getting worse, or if you are planning a pregnancy. Go sooner if:

• your cycles are often longer than 35 days, you have fewer than 8 periods a year, or you have gone 3 months or more without a period
• you have new, unwanted hair growth, especially if it appeared quickly or is getting worse fast (this needs checking for other causes)
• you are having trouble getting pregnant
• you snore and wake unrefreshed, or feel very sleepy during the day
• you are struggling with low mood, anxiety, or your eating

Your GP can arrange blood tests and, if needed, an ultrasound, and can refer you to a dietitian. If you have a GP Chronic Condition Management Plan, you may be able to claim a Medicare rebate for dietitian visits. This article is general information and cannot diagnose PMOS.