Prevalence, Incidence, Clinical Presentation, and Treatment of Polyendocrine Metabolic Ovarian Syndrome in Primary Care in the United Kingdom Between 1998 and 2025

OBJECTIVE: Polyendocrine metabolic ovarian syndrome (PMOS) is a multisystemic disorder with a wide range of health consequences. We sought to describe temporal trends in the prevalence and incidence of PMOS and to characterize its clinical presentation, comorbidity burden, and pharmacological management in primary care in the United Kingdom (UK) between 1998 and 2025. DESIGN: Population-based matched cohort study using primary care records from the UK Clinical Practice Research Datalink. PATIENTS: Females newly diagnosed with PMOS between the ages of 15 and 49 matched on age, general practice, calendar year of cohort entry, and duration of medical history to population controls without PMOS. MEASUREMENTS: Annual prevalence and incidence of diagnosed PMOS; baseline prevalence and incidence of cardinal PMOS features and various comorbidities; and pre- and post-cohort entry prevalence of hormonal contraceptive, anti-androgen, ovulation-inducing drug, and metformin use. RESULTS: The prevalence of diagnosed PMOS increased from < 0.1% in 1998 to 2.0% in 2025, with incidence rising from 0.1 to 3.6 per 1,000 person-years over the same period. Among 125,482 patients with newly diagnosed PMOS matched with an equal number of controls, patients with PMOS had higher baseline prevalence and incidence of cardinal features of PMOS, as well as diabetes, dyslipidemia, hypertension, cardiovascular and cerebrovascular disease, sleep apnea, thyroid disorders, endometriosis, uterine fibroids, chronic pain, depression, and anxiety. Use of anti-androgens, ovulation-inducing drugs, and metformin was substantially higher in patients with PMOS, especially in the year following diagnosis. CONCLUSIONS: PMOS is increasingly diagnosed in UK primary care and is associated with substantial multimorbidity and pharmacotherapy.