PCOS is Now PMOS: Why the Name Change Matters – And What It Means for Women’s Health

In this blog Surrey’s leading Naturopathic Nutritional Therapist and Functional Medicine Test expert Natalie founder @natnuthc explores the importance of changing the name of PCOS to PMOS; why the name change matters and what this means for women’s health.  Natalie explores the metabolic role of PMOS (formerly PCOS), including the role of inflammation, gut health and stress and how different women are affected from acne, to facial hair growth, to infertility, weight gain, menstrual dysregulation, to poor gut health and stress.

 

Introduction:

For many years, PCOS (Polycystic Ovary Syndrome) was the name used to describe one of the most common hormonal conditions affecting women of reproductive age.  The condition has now been renamed PMOS (Polymetabolic Ovary Syndrome), and in my opinion, this is a hugely positive step forward.

As a Naturopathic Nutritional Therapist, I wholeheartedly welcome the change.  For too long, the name Polycystic Ovarian Syndrome has been misleading, causing confusion for women and, in many cases, delaying a deeper understanding of what is really happening within the body.

The new name, Polymetabolic Ovarian Syndrome (PMOS), better reflects the complexity of the condition.  It shifts the focus away from the ovaries alone and towards the wider metabolic, hormonal and inflammatory processes at the heart of the condition.

 

Why the Name Change Was Needed:

One of the biggest misconceptions about PCOS was that ovarian cysts were essential for diagnosis.

In reality, many women diagnosed with what is now known as PMOS have never had ovarian cysts visible on an ultrasound scan.  Equally, many women have polycystic appearing ovaries but do not have PMOS, formerly PCOS.  Then there are the women who have struggled to get a PCOS diagnosis until they ran a DUTCH test, or were diagnosed with PCOS when really all they had was insulin resistance and blood sugar management issues; however that’s another conversation!  Learn more about the DUTCH test here.

PCOS, the previous name understandably led many women to believe that cysts were the cause of their symptoms, when in fact they were simply one possible feature of the condition.

The renaming to Polymetabolic Ovary Syndrome (PMOS) acknowledges what many practitioners have recognised for years: this is primarily a metabolic disorder with hormonal consequences, rather than simply a condition affecting the ovaries.

That may sound like a small change in terminology, but it represents a significant shift in how we understand women’s health.

 

PMOS Is About Much More Than Your Ovaries:

PMOS is a complex condition involving multiple systems throughout the body.

These commonly include:

• Blood sugar regulation
• Insulin resistance
• Chronic inflammation
• Gut health
• Stress physiology
• Hormone production and metabolism
• Nutrient status
• Liver detoxification pathways
• Sleep and circadian rhythm

When one of these systems becomes dysregulated, it can have a knock-on effect on the others.  This is why PMOS presents differently in every woman:

• Some struggle with weight gain
• Others experience acne
• Some develop unwanted facial or body hair
• Others notice thinning hair on their scalp
• Some have absent, irregular periods and/or extensively long cycles
• Others experience fertility challenges
• and others struggle with anxiety, fatigue, sugar cravings and digestive problems

The symptoms may look different in each individual, but they are often connected by the same underlying metabolic dysfunction, and often driven by different mediators that are personal to each  individual.

Weight gain in particular, or difficulty losing weight, and it’s connection to PCOS/PMOS is the one most commonly missed clinical signs and is only fully understood when a DUTCH test is run.  This is where functional testing can really add additional clinical insight – learn more about DUTCH testing here.

 

Blood Sugar Balance – One of the Biggest Drivers of PMOS:

One of the most significant contributors to PMOS is poor blood sugar regulation and insulin resistance, and this is pretty much consistent in all patients, and is the one thing rarely addressed by conventional medicine unless they prescribe metformin, yet it is so easy to fix with simple dietary and supplemental modifications.

Every time we eat carbohydrates or a sugar based food, our blood sugar increases.  This causes insulin to be released so that glucose can be moved into our cells, but when this is continuously happening it can lead to insulin resistance; meaning our cells cannot read the insulin and the glucose cannot enter the cell leading to said glucose hanging around in the blood stream driving inflammation, disrupting hormone signals, damaging the Gut lining and more.

However, it is important to note that not all carbohydrates are equal, some have different effects than others, and it is important to understand the difference between processed/refined carbohydrates and those that have a high glycaemic load (e.g. they quickly spike your blood sugar) versus the slow release carbohydrates with a low glycaemic load, which have much more of a sustained affect without any major spikes.   In other cases certain foods may not contain sugar but contain other ingredients that spike our blood sugar including fructose, sucralose, aspartame and acesulfame potassium for example, so watch out for these hidden gremlins in food ingredients.

Blood sugar can also be constantly spiking when we are frequently snacking, eating lots of refined carbohydrates such as crisps, white bread, cakes, chocolate bars, drinking squash and juice, but also due to poor sleep or chronic stress, and in some cases, although this is genetic, even coffee can spike the blood sugar, hence why I do not recommend coffee during a fast unless I have run a few tests first.

But here’s the thing; high insulin and insulin resistance doesn’t just affect blood sugar.  It also stimulates the ovaries to produce more androgens (male hormones), particularly testosterone.  It also damages our arteries, drives inflammation and destroys our GUT lining.  This can contribute to many of the symptoms women experience with PCOS/PMOS, including:

• Acne
• Oily skin
• Weight gain
• Difficulty losing weight
• Facial hair growth (hirsutism)
• Hair growth on the chest, stomach or back
• Male pattern hair thinning
• Irregular or absent periods
• Ovulation problems
• Fertility challenges

Supporting blood sugar balance is therefore one of the foundations of improving hormonal health, and this applies not just in PCOS/PMOS but also in PMDD, Perimenopause, gestational diabetes and during fertility struggles.

 

Inflammation – The Hidden Driver:

Another major feature of PMOS is chronic low-grade inflammation.

Unlike acute inflammation, which is necessary to help us heal after injury, chronic inflammation quietly disrupts hormone signalling throughout the body, and can worsen insulin resistance, impair ovulation, increase oxidative stress, contribute to hormone imbalance, and also make it much harder to lose weight.

Unfortunately, inflammation often develops silently over many years, but what causes inflammation?  There are lots of drivers of inflammation from insulin resistance and poor blood sugar management; to inflammatory processed foods; to poor GUT health and stress.

 

Your Gut Could Be Contributing More Than You Think:

One of the areas I believe deserves far more attention is the role of gut health.

Our gut microbiome influences everything from immunity and inflammation to hormone metabolism and nutrient absorption.

When the gut becomes imbalanced through poor diet, antibiotics, chronic stress, infections or food sensitivities, inflammation can increase throughout the body.

Poor gut health may contribute to:

• Increased intestinal permeability (“leaky gut”)
• Chronic immune activation
• Poor oestrogen metabolism including oestrogen dominance linked to breast cancer and endometriosis for example
• Reduced nutrient absorption
• Increased inflammation
• Blood sugar dysregulation

All of these can worsen PMOS symptoms!

Looking after the gut is therefore about far more than just improving digestion; the microbiome needs to be balanced, we need to ensure we do not have an overgrowth of yeasts or pathogens and we need to ensure the lining of the GUT it healthy and intact and not ‘leaky’ as leaky GUT is a major driver of inflammation, so GUT health is a key part of restoring hormonal balance and addressing inflammation.

To assess your GUT health and to understand exactly what needs to be addressed rather than throwing a random probiotic at it (which incidentally can worsen issues) we recommend a comprehensive stool analysis – learn more here about stool testing via the GI360 by Drs Data.

 

Stress, Cortisol and Adrenal Health:

Stress is another factor that is frequently underestimated.

Whether it’s work pressures, lack of sleep, over-exercising, emotional stress, caring responsibilities or constantly feeling overwhelmed, your body responds in exactly the same way – it produces cortisol.

While cortisol is essential for survival, chronically elevated cortisol can increase blood sugar, worsen insulin resistance, promote abdominal fat storage and interfere with healthy hormone production.

From a naturopathic perspective, prolonged stress can also contribute to what we often refer to as adrenal depletion.  Although “adrenal fatigue” is not recognised as a medical diagnosis (they prefer the term Hypothalamus-Pituitary-Adrenal-Axis dysfunction or HPA-A dysfunction), long-term stress can alter cortisol patterns and leave women and men feeling exhausted, anxious, unable to cope and struggling to recover their energy, but stress doesn’t simply affect your mind; it also affects your:

• metabolism
• hormone balance
• digestive function
• immune function and resilience
• fertility and everything else that is connected.

 

There Is No Single Root Cause of PMOS (formerly PCOS):

One of the reasons PMOS can be so frustrating is because there isn’t one single cause.  Every woman is different:

• For one woman, insulin resistance may be the biggest driver
• For another, chronic stress may be the underlying issue
• Someone else may have significant gut dysbiosis, nutrient deficiencies or chronic inflammation
• Although, many women have a combination of several factors working together

This is why generic advice rarely works.  This is certainly one condition where a one-size fits all approach will not work and requires personalised tailored support and likely some functional testing.  Learn more about our functional testing services here.

You cannot treat every woman with PMOS in the same way because every woman has a different story!

 

Where Conventional Medicine Often Falls Short

Conventional medicine has undoubtedly improved awareness of PCOS, changing the name to PMOS is a good start, but there are still significant limitations in the way it is diagnosed and managed.

In fact, I often see woman for fertility or irregular menstrual cycles who have been told they by their GP they have PCOS and that they will never have children, yet when I run my naturopathic assessment and run some functional tests, what I find in a lot of cases is that they do not really have PCOS.  Instead they have an inflammatory diet, poor GUT health, poor blood sugar management and/or high levels of stress and when we start to unpick and address these matters their menstrual cycles return to normal and they fall pregnant.

Unfortunately, diagnosis with conventional medicine often relies on a collection of symptoms rather than identifying why those symptoms developed.  As a naturopathic nutritional therapist I always assess my patients holistically understanding their diet, their lifestyle, looking for clinical signs of HPA-A dysfunctional (adrenal dysfunction), cortisol dysregulation, sleep issues, GUT dysbiosis, inflammation, increased intestinal permeability (leaky gut) and understanding the drivers behind their symptoms in order to ask the why question!

Further frustration steps in with conventional medicine, because their treatment options rarely extend beyond the contraceptive pill, metformin, acne medications and fertility drugs when all the patient really needed was some tweaks here and there to address stress, diet, inflammation and Gut health.  Conventional medicines treatment options can be absolutely incredible for some woman and they certainly have their place but they rarely address the underlying root causes and thus only really mask the real issues.

In other cases, many women are simply advised to lose weight without receiving the support needed to understand why losing weight may feel almost impossible and as a result, women can spend years managing symptoms while the underlying drivers remain unaddressed.

 

A Naturopathic Nutritional Therapy Approach

This is where Naturopathic Nutritional Therapy takes a very different approach.  Rather than asking, “How do we suppress this symptom?”, we ask:  “Why has your body developed this symptom in the first place?”

Every one of my Health Reset Plans @natnuthc starts with a comprehensive Naturopathic Health Assessment.  Learn more about our health reset plans here.

A naturopathic health assessment @natnuthc isn’t simply a questionnaire.  It is a detailed face to face (either in person on via video call) investigation into your unique health history and physiology.  We look for clinical signs while using intuition and years of experience to explore:

• Hormonal health
• Blood sugar balance
• Digestive function
• Gut health
• Stress levels
• Energy
• Sleep
• Nutrition
• Lifestyle
• Medical history
• Environmental influences
• Family history

Only by understanding the bigger picture can we begin addressing the true root causes, because symptoms are not random.  They are your body’s way of communicating that something deeper needs attention.

My aim is never simply to put a plaster over your symptoms!  It is always to address the underlying root case.  Now don’t get me wrong, I have some tools up my sleeve where I can temporarily put some sticky plasters over your symptoms.  This is sometimes necessary, because while I am addressing the root, you may just need the edge taken off things so you have the capacity to work with me to make the lifestyle and dietary modifications I recommend, but my aim is always to help you uncover what is driving your issues so we can support your body in restoring balance naturally.

 

Why I Often Recommend DUTCH Hormone Testing

One of the most useful tools available for understanding complex hormonal conditions like PMOS (formerly PCOS) is the DUTCH Test (Dried Urine Test for Comprehensive Hormones).

Unlike standard blood tests, the DUTCH Test provides a far more comprehensive picture of how your hormones are actually behaving.

It measures:

• Oestrogen and it’s metabolites
• Progesterone and it’s metabolites
• Testosterone
• Androgen pathways
• DHEA
• Cortisol patterns throughout the day
• Cortisone
• Melatonin markers
• Organic acid markers linked to stress and nutrient status, as well as B12 and Biotin

This helps us understand not only how much hormones your body is producing but also how it is metabolising and clearing those hormones.  The DUTCH also helps us understand whether you are metabolising to potent damaging versions of certain hormones like 4-OH oestrogens of Dihydrotestosterone.  Once we know exactly how your body is metabolising your hormones we can precisely advise on supplements and foods to modify and shift these metabolites to healthier versions.  We can even write referrals letters to get your medications reviewed in light of the results we see on your DUTCH.

Combined with a detailed naturopathic health assessment, the DUTCH allows us to create a highly personalised plan that is based on your biology and not assumptions.

 

The Future of Women’s Hormonal Health

The renaming from PCOS to PMOS is much more than a change in terminology, it reflects a growing understanding that this condition is about far more than the ovaries.

• It is about metabolism
• Blood sugar balance
• Gut health
• Inflammation
• The entire body!

As our understanding of PMOS continues to evolve, I hope we also move towards healthcare that focuses less on managing symptoms and more on understanding the underlying root causes.

Every woman deserves to know why she is experiencing acne, weight gain, unwanted facial hair, irregular periods, fertility struggles, fatigue or mood changes; instead of simply being given a medication without exploring the bigger picture.  This is exactly what naturopathic nutritional therapy does and has been doing for many years.

 

Ready to Get to the Root Cause of Your PMOS?

If you’re struggling with symptoms such as:

• Acne
• Weight gain
• Difficulty losing weight
• Facial hair growth (hirsutism)
• Male pattern hair thinning
• Irregular or absent periods
• Fertility challenges
• Fatigue
• Sugar cravings
• Mood swings
• Bloating
• Digestive problems
• Insulin resistance

you don’t have to keep guessing.

Through my personalised Health Reset Plans, we begin with a comprehensive Naturopathic Health Assessment to uncover the underlying factors contributing to your symptoms and create a tailored nutrition and lifestyle plan that works with your body; not against it.

For women wanting an even deeper understanding of their hormonal health, I also offer DUTCH Hormone Testing, providing valuable insight into hormone metabolism, stress response and adrenal function to help guide truly personalised recommendations.

If you’re ready to move beyond symptom management and start addressing the root causes of PMOS, I’d love to support you.

Visit www.natnutc.co.uk to learn more about my Health Reset Plans, book a consultation or order a DUTCH Hormone Test here.

You can also book a FREE discovery call to learn more here and find out if this is the right approach for you.

 

Ready to Transform Your Health?

We cater to both men’s health and women’s health, offering support for individuals struggling with Post-Viral Fatigue, Burnout, Chronic Low Energy, hormone imbalance from perimenopause to PCOS and infertility and beyond.  We also support many people with hormone based cancers such as breast and prostate cancer.

We cater for individuals who want to support their health using a natural medicine approach that is safe and evidence based, and where necessary combined with their existing pharmaceutical medication or treatment plan.   Whether you’re dealing with chronic fatigue, digestive issues, perimenopause, irregular menstruation, facial hair growth, struggling with your weight, suffering from difficult PMS or PCOS symptoms our naturopathic nutrition health reset plans can help.

If you’re looking for a naturopathic nutritionist who can offer holistic, and evidence-based care, book a free call to discuss your needs to day.  We run our clinics online or from Epsom or Worcester Park in Surrey, and work with other complimentary practitioners in Sussex and Hampshire.  See our other practitioners here.

At NatNutHC we have supported numerous clients throughout London and the South of England especially those living in Epsom and Worcester Park, Surrey, as well as Petersfield in Hampshire, and Brighton and Hove in Sussex, UK.  We have helped them to achieve many health benefits including increased energy, reduced fatigue, better mental clarity and focus, less aches and pains, increased vitality and overall wellness, improved sleep, weight reduction, improved mood, fertility and more.

If you would like more information on the best diet and supplements for your particular needs, or want to find out more about naturopathic nutrition and functional medicine, get in touch today via:  info@natnuthc.co.uk, or visit our website: www.natnuthc.co.uk and book your free 15-minute no obligation discovery call.

Alternatively, please follow us on Instagram or facebook @natnuthc for more tips and advice on how naturopathic and nutritional health care can support you and your family.

 

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The Misunderstood Gut: Dysbiosis, SIBO and Food Intolerances

The Gut Hormone Axis: Chronic Hormonal Dysfunction Starts in the Gut