Update: PCOS is Now PMOS!

Polycystic Ovary Syndrome (PCOS), a condition that affects over 10% of women, just got a new name. This formal name change has been in the works for many years, as patients and providers have realized that this condition affects far more than the ovaries, as its previous name implied. Under its new name, Polyendocrine Metabolic Ovarian Syndrome, PMOS is now being fully recognized as a complex hormonal and metabolic condition. We know that there are significant connections between our reproductive hormones, our ovaries, and our metabolic hormones (like insulin), and this new name reflects those connections! 

What is PMOS?

PMOS is one of the most common women’s health concerns affecting hormonal balance. The syndrome involves an excess of androgens (what we know as male hormones: testosterone, DHEA), menstrual irregularity, and may also include cystic ovaries. You can still be diagnosed with PMOS without cystic ovaries; this is just one piece of the puzzle.

PMOS affects a little over 10% of women aged 18-44 years old. But, it is suspected that there are likely many women who meet the criteria that have not been formally diagnosed, which could mean that the number of affected women exceeds 10%. 

What are the signs and symptoms of PMOS? 

• Menstrual Irregularity: 
  • Delayed onset of the first menstrual cycle
  • Infrequent or absent menstrual cycles
  • Infertility (lack of ovulation)
• Hyperandrogenism:
  • Acne
  • Hirsutism (excess coarse male pattern body hair growth – common on the upper lip, chin, chest, and below the belly button)
  • Thinning hair 
  • Skin tags
  • Patches of skin that appear dark brown/black (especially in the neck, armpits, or groin)
  • Elevated testosterone and DHEA
• Metabolic Issues:
  • Weight gain 
  • Sleep Apnea (short periods where breathing stops while sleeping)
  • Insulin resistance (blood sugar imbalance)
• Mood dysregulation:
  • Depression
  • Anxiety
  • Eating disorders

Women with PMOS are at Increased Risk for: 

• Metabolic Syndrome, Obesity
• Type II Diabetes, Insulin Resistance
• Heart Disease and High Blood Pressure
• High cholesterol
• Mood disorders
• Infertility
• Endometrial Hyperplasia and Endometrial Cancer
• Obstructive sleep apnea

What causes PMOS? 

Currently, the exact cause of PMOS is unknown; this is due to the fact that there are a number of factors that contribute to the development of PMOS.  Genetics does play a role; you have a greater chance of developing PMOS if your mother or sister has it. Excess inflammation, body weight, and insulin/blood sugar imbalances also contribute to PMOS.  

How is PMOS treated?

Doctors may prescribe a number of medications to treat the symptoms of PMOS. These may include birth control pills to regulate your menstrual cycle, spironolactone for the excess hair growth, metformin for blood sugar balance, and/or clomid to induce ovulation. 

The naturopathic approach to PMOS is quite different. We will review what lifestyle factors and stressors may be obstacles to your healing. Lab work and imaging will also be reviewed to guide our support of the endocrine system. Support will include education on lifestyle and dietary changes to support your body.  And we may use tools such as herbs, homeopathy, vitamins, and supplements to naturally support your hormones, blood sugar, and mood.

Types of support may include:

• Diet and Lifestyle Support:
  • Dietary assessment and adjustment to focus on a whole food diet with adequate protein, vegetables, fiber, and healthy fats to balance blood sugars, lower cholesterol, and modulate weight.

• Herbal Support:
  • Liver-supporting herbs such as milk thistle, white peony, or dandelion root may be used to aid the liver in metabolizing and regulating hormone balance.
  • Hormone modulators like chaste tree or saw palmetto may be used to decrease testosterone and balance female hormones.
  • Adaptogens like eleutherococcus and licorice may help buffer your body’s stress response and reduce the impact of extra cortisol (the stress hormone) on blood sugar.

• Vitamin, Mineral, & Nutrient Support:
  • B vitamins are important in all biochemical reactions in the body. They are active in hormone metabolism and support adrenal gland function (the stress-management glands).
  • Mineral support, including magnesium, zinc, chromium, and other trace minerals. These minerals play a number of roles in the body, from blood sugar and hormone balance to proper heart and brain function.
  • Omega-3 Essential Fatty Acids are anti-inflammatory and play an important role in hormone production and the modulation of cholesterol.

These are just some of the many options your naturopathic doctor may suggest for someone living with PMOS.  Naturopathic care plans are extremely specific and unique to each patient.  Reminder: we are supporting the person, not the disease! 

References:

• Shukla A, Rasquin LI, Anastasopoulou C. Polyendocrine Metabolic Ovarian Syndrome. [Updated 2025 Jul 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459251/
• Teede H, Khomami M, Morman R et al.
  Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: a multistep global consensus process
  The Lancet, 2026; 407, 2329-2339