NICE updates PCOS clinical guidelines: new diagnostic thresholds and treatment pathways
Source: NICE Guideline NG245, May 10, 2026
Summary
The UK National Institute for Health and Care Excellence (NICE) published its updated PCOS clinical guideline (NG245) on May 10, 2026 — the first major revision since 2014. Key changes: (1) AMH threshold for polycystic ovarian morphology updated to >= 25 pmol/L at referral, aligned with ESHRE 2023. (2) GLP-1 receptor agonists (liraglutide, semaglutide, tirzepatide) formally included as second-line treatment for metabolic symptoms when metformin is insufficient or not tolerated. (3) Mental health assessment mandated at diagnosis and annually — depression and anxiety screening now a quality standard. (4) Testosterone testing updated to include calculated free testosterone or FAI, not just total testosterone. (5) PCOS terminology note: the guideline acknowledges the international PMOS renaming but retains PCOS as the UK clinical term pending formal adoption. (6) Inositol supplements: evidence rated as moderate; NICE states they 'may be considered' as adjunct therapy but not as replacement for evidence-based treatments. This guideline update impacts all NHS PCOS care pathways.
Why it matters for you
If you're in the UK, this guideline update should directly improve your care: your GP can now formally refer you for GLP-1 therapy and is required to screen for mental health impacts. Print the guideline summary for your next appointment at nice.org.uk/guidance/ng245.