Goodbye PCOS. Hello PMOS.

A name change in medicine is never just semantics. It’s a shift in how we understand a condition, how we talk about it, and ultimately how we care for the women who live with it. That’s exactly why the proposed transition from Polycystic Ovarian Syndrome (PCOS) to Polyendocrine Metabolic Ovarian Syndrome (PMOS) matters. It reflects 10+ years of research with 22,000 participants showing that this condition is far more than ovarian cysts—and that the old name has been holding both clinicians and patients back.

If we've worked together on your diagnosis of PCOS, you know that I rarely go straight for balancing your hormones. Are you tired of me talking about optimizing liver health, balancing gut health, and restoring the nervous system? I hate to say it but you might need to take a nap - cause I'll never end this conversation.

PCOS in medicine was never a singular focus on ovarian cysts. To be diagnosed with PCOS, you need to meet two of the three criteria: 1) an ultrasound revealing ovarian cysts, 2) elevated testosterone, 3) cycles >35 days or <8 cycles/year. PCOS is no longer an accurate diagnosis because it implies dysfunctional ovaries are the problem but what's causing the ovaries to be dysfunctional?

Women with PCOS have an increased risk of developing other health conditions including:

• gestational diabetes or high blood pressure in pregnancy

• weight gain, especially around the belly

• type 2 diabetes

• hypertension (high blood pressure)

• high cholesterol

• cardiovascular disease

• obesity

• sleep apnea

• metabolic steatohepatitis

• endometrial hyperplasia or endometrial cancer

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Can dysfunctional ovaries alone cause all of this? Absolutely not.

Can abnormal blood sugar regulation, an imbalance in gut bacteria, stagnated liver detox pathways, and a sedendtary lifestyle cause all of this? Absolutely.

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Here's where Polyendocrine Metabolic Ovarian Syndrome (PMOS) makes it's debut.

“Polyendocrine” acknowledges that multiple hormone systems are involved

PMOS affects far more than ovarian hormones. Research consistently shows dysregulation in:

• Insulin and glucose metabolism

• Adrenal androgen production

• Thyroid function

• Gonadotropin signaling (LH/FSH ratio)

• Appetite and satiety hormones

• Stress physiology (HPA axis)

Calling it polyendocrine validates what patients experience.

This is a whole-body endocrine condition, not an ovarian malfunction.

“Metabolic” centers the metabolic dysfunction that drives symptoms

Up to 75% of patients with PMOS have measurable metabolic abnormalities, including:

• Insulin resistance

• Abnormal cholesterol

• Chronic low-grade inflammation

• Altered fatty tissue cell signaling

• Increased heart disease risk

Even patients who are not overweight can have significant metabolic disruption.

By naming this explicitly, PMOS shifts the clinical conversation from:

“Let’s fix your ovaries”

to

“Let’s address the metabolic and endocrine roots of your symptoms.”

“Ovarian” remains because the ovaries are still affected, but not blamed.

The ovaries are part of the syndrome, but they are responders, not the primary cause.

The new name keeps them in the picture without centering them incorrectly.

This helps patients understand:

• Their ovaries are not “broken”

• The follicles are responding to upstream metabolic and endocrine signals

• Restoring hormonal and metabolic balance can restore ovulation

Here's where it gets really good! It guides clinicians toward root-cause treatment.

Instead of focusing on:

• Birth control to regulate cycles

• Fertility meds to force ovulation

• Ultrasounds to “monitor cysts”

PMOS encourages clinicians to prioritize:

• Insulin sensitivity

• Adrenal and thyroid balance

• Anti-inflammatory nutrition

• Stress physiology

• Sleep and circadian rhythm

• Cardiometabolic risk reduction

This leads to more effective, individualized care by all clinicians. Can I get an amen?!

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"Naturopathic medicine is harder for you than it is for me." You've likely heard this in a visit or three. From my heart to yours, naturopathic medicine is hard. It takes faith, focus, courage, trust, and grit - a lot of grit. Reversing PMOS isn't easy but it also isn't impossible - and you can do hard things.

If we've been working through this diagnosis together, I see you. I see your hard work. I see your struggle. I see your victories. I see your frustrations. I see you wanting to give up and jumping back in with two feet. I'm proud of you and I hope the reframing of this diagnosis sheds light to why this feels so hard. Keep fighting, dear one.