Breaking the cycle: Addressing systemic failures in PCOS diagnosis and management (APPG on PCOS, 8 September 2025)

Summary

Polycystic Ovary Syndrome (PCOS) affects an estimated one in eight women and those assigned female at birth, making it one of the most common hormonal conditions. Yet it remains poorly understood, underdiagnosed, and inconsistently managed across the health system.

In response to widespread concern among patients, clinicians and advocates, the All-Party Parliamentary Group (APPG) on PCOS launched a formal inquiry to examine the state of diagnosis, management and long-term care across the UK. The inquiry drew on oral evidence sessions focused on diagnosis and treatment/management, Freedom of Information (FOI) responses from all 42 Integrated Care Boards (ICBs) in England, and insights from patient surveys from PCOS charity Verity (PCOS UK), with over 2000 responses from across the UK.

Together, these sources paint a clear picture: PCOS services are fragmented, access is unequal, and both patients and clinicians are often left navigating a complex condition without adequate guidance or support, particularly during the early stages of the diagnostic journey, where repeated GP visits and a lack of consistent pathways can delay intervention for years.

Content

Recommendations

Delayed diagnosis and fragmented care

• The Government should commit to reducing the time to PCOS diagnosis by embedding the forthcoming NICE guidelines into a nationally commissioned diagnostic pathway. This should be embedded within primary care services to support the hospital to community shift and reduce unnecessary GP appointments and referrals.
• The Government should prioritise the integration of PCOS care into Women’s Health Hubs (WHHs), including the commissioning of holistic, joined-up PCOS services across all Integrated Care Systems (ICSs) for all ages. This would reduce delays in diagnosis, relieve GP workloads, and contribute to the Government’s goal of reducing NHS waiting lists and improve patient experiences.
• The Government should ensure that forthcoming updates to the Women’s Health Strategy and digital transformation plans across the UK recognise PCOS as a chronic, multisystem condition, accurately coded, enabling it to be commissioned and funded on par with other long-term conditions such as diabetes. Clinical societies and Royal Colleges should also reflect this understanding by classifying PCOS as a complex endocrine condition, with links to gynaecological, reproductive, cardiovascular, metabolic, and psychological health. This reclassification will help drive improvements in clinical education, national data collection, guideline development, and integrated care delivery across the NHS.

Health inequalities and cultural barriers

• The Government should work to address ethnic and socioeconomic disparities in PCOS care and outcomes, through targeted health equity audits, culturally appropriate integrated care models, and improved access to services across the country reducing the postcode lottery.
• The Government should ensure that commonly prescribed medications, such as Metformin and GLP-1 receptor agonists, are licensed for PCOS management and made accessible regardless of diabetes diagnosis.
• The Government should reinstate NHS funding for laser hair removal as a clinically justified treatment for PCOS-related hirsutism. In line with international, evidence-based recommendations.

Psychological impact and insufficient support

• The Government should expand investment in mental health support within primary care, ensuring mental health screening and emotional wellbeing support are routinely included in PCOS treatment plans and provided by professional with PCOS expertise. Improving

Education, research, and access

• The Government should support the development and roll-out of mandatory PCOS-specific training for all healthcare professionals, including GPs, nurses, and allied health professionals. This training should be embedded in undergraduate curricula and incentivised via CPD programmes and schemes such as the Quality and Outcomes Framework (QOF).
• The Government should ensure menstrual health, including PCOS, is included within public and school�based health education, aligned with the Women’s Health Strategy for England and equivalent strategies in Scotland and Wales. Early education and public awareness will support earlier recognition, reduce stigma, and promote timely access to care.
• The Government should mandate a women’s health rotation including gynaecology and reproductive health as part of GP training programmes, in recognition that over 50% of a GP’s patient base will experience disorders that uniquely, disproportionately or differently affect girls, women and people assigned female at birth across their life course. Ensuring that all GPs enter practice with foundational experience in menstrual health, including conditions such as PCOS, is essential to delivering equitable and high-quality care in primary settings.