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CHICAGO — More than 1 in 4 adolescent girls and young women have at least one risk factor for polyendocrine metabolic ovarian syndrome (PMOS), new research suggested.
Recent international guidelines highlighted an “at risk” category for PMOS, defined by the presence of either menstrual irregularity or hyperandrogenism, to guide clinical surveillance, Varun Lingadal, BA, a research assistant at Boston Children’s Hospital, said at ENDO 2026: The Endocrine Society Annual Meeting.
The population-based analysis of female participants in the Avon Longitudinal Study of Parents and Children (ALSPAC) also revealed that genetic risk for PMOS (previously termed polycystic ovary syndrome), was associated with hyperandrogenism but not irregular menses, suggesting that “androgen excess is a more specific early manifestation of inherited PMOS liability,” Lingadal said.
“Hyperandrogenism is something to pay attention to, because it might indicate that this individual could be at risk of PMOS in the future. So, it’s worth monitoring them more closely,” he told Medscape Medical News.
Based at the University of Bristol in the United Kingdom, ALSPAC recruited more than 14,000 pregnant women between April 1991 and December 1992 and continues to follow them and their children. A total of 1533 women had complete reproductive questionnaire data.
Hyperandrogenism was defined by elevated testosterone and/or free androgen indices (≥ 2 standard deviations of the cohort mean) and/or a modified Ferriman-Gallwey score (hirsutism) ≥ 4. Menstrual irregularity was defined using age- and menarche-specific guideline criteria for cycle length.
Of the 1533 women, 3.2% (49) had both irregular menses and hyperandrogenism and were diagnosed with PMOS. Another 18% (276) had just hyperandrogenism and 9.2% (141) had just irregular menses, together comprising the “at risk” group of 27%. The rest, 69.6% (1067), had neither condition and were considered controls.
Individual PMOS polygenic scores were calculated for 1371 participants based on the largest genome-wide association study of European women to date. In those individuals, a higher PMOS polygenic score was significantly associated with increased odds of the group at risk via hyperandrogenism (odds ratio [OR], 1.22, P = 4x103), but not those at risk due to irregular menses (OR, 0.98, P = .8). The association with PMOS was positive but not significant (OR, 1.28, P = .2), likely reflecting low statistical power due to the small number, Lingadal noted.
Asked to comment, session moderator Andrea E. Dunaif, MD, professor of molecular medicine at the Icahn School of Medicine at Mount Sinai, New York City, noted that “in adolescent girls after menarche, 2 years of irregular cycles is physiologic, so that may be confounding. What was their age at menarche, and is this just in the physiologic transition period?”
Nonetheless, Dunaif said, the concept that young females can be risk-stratified is important. “If we knew when a girl was 14 or 15 that she was at risk for [PMOS], we could start to look at diabetes risk, liver disease risk, and cardiovascular disease risk and potentially intervene.”
Lingadal and Dunaif reported no relevant financial relationships.
Miriam E. Tucker is a freelance journalist based in the Washington, DC area. She is a regular contributor to Medscape, with other work appearing in the Washington Post, NPR’s Shots blog, and Diatribe. She is on X (formerly Twitter) @MiriamETucker and BlueSky @miriametucker.bsky.social
