Mental Health in Polyendocrine Metabolic Ovarian Syndrome (PMOS): Prevalence, Aetiology and Management Across the Lifespan

Polyendocrine metabolic ovarian syndrome (PMOS), formerly known as polycystic ovary syndrome (PCOS), affects approximately 8%–13% of reproductive-aged women worldwide and is one of the most common endocrine disorders in women. Psychiatric comorbidities represent a substantial but often underrecognised component of this multisystem condition. This narrative review summarises current evidence on the prevalence, mechanisms and management of psychiatric disorders in PMOS across the lifespan. Women with PMOS have significantly higher rates of depression, anxiety, eating disorders, ADHD, bipolar disorder and OCD than women without PMOS. Reduced quality of life, body image distress and emerging evidence of increased suicidal ideation further contribute to the disease burden. Psychiatric morbidity persists beyond the reproductive years and appears to be amplified by obesity and metabolic dysfunction. Proposed mechanisms include hyperandrogenism, insulin resistance, neuroinflammation, hypothalamic–pituitary–adrenal axis dysregulation, sleep disturbance and psychosocial stressors. Evidence-based management includes routine screening, psychological interventions, pharmacotherapy when indicated, lifestyle modification and coordinated endocrine, metabolic and mental health care. Psychiatric comorbidity is a core clinical feature of PMOS and warrants routine screening, longitudinal surveillance and integrated management across the lifespan.