Diagnosed with PMOS?

Here's what you need to know...

Polyendocrine Metabolic Ovarian Syndrome (PMOS, formerly known as PCOS) is a common hormonal condition affecting people with ovaries. It’s not just about ovarian cysts - it’s a complex metabolic and endocrine disorder that influences hormones, insulin, inflammation, and reproductive function.

Key features of PMOS →

• Irregular or absent menstrual cycles

• Elevated androgens (male hormones) → acne, excess hair growth, hair thinning

• Insulin resistance or blood sugar imbalances

• Ovarian cysts may be present, but not everyone with PMOS has cysts, and having cysts alone doesn’t mean you have PMOS

Types of PMOS →

PMOS can present in different ways, often classified by what drives the symptoms:

1. Insulin-resistant (most common)

   • Symptoms: weight gain, difficulty losing weight, fatigue, sugar cravings, acne

   • Key factor: insulin dysregulation → elevated androgens

2. Inflammatory

   • Symptoms: skin inflammation, digestive issues, fatigue, irregular cycles

   • Key factor: systemic low-grade inflammation affecting hormone signalling

3. Adrenal

   • Symptoms: stress-related acne, hair growth, irregular cycles

   • Key factor: excess androgens coming from the adrenal glands rather than the ovaries

4. Post-pill

   • Symptoms: acne, irregular cycles, sometimes hair thinning, often with normal weight

   • Key factor: hormonal rebound after stopping contraceptives + hormone sensitivity

Important nuance:

• You can have PMOS without visible ovarian cysts - diagnosis is based on hormone patterns and symptoms, not imaging alone.

• Conversely, some people may have ovarian cysts on an ultrasound but don’t meet the diagnostic criteria for PMOS.

PMOS is a spectrum, not a single presentation. Symptoms, hormone imbalances, and metabolic features can vary widely, which is why a personalised approach is best.

What to do:

1. Insulin support is of utmost importance

Insulin resistance is a major driver of androgen production and ovarian dysfunction (which is why this can lead to absent or irregular cycles). When insulin is chronically elevated (often from insulin resistance), it signals the ovaries to produce more testosterone (and this clinically presents as acne, hair growth, and weight gain).

Ways to support insulin:

• Pair carbohydrates with protein, healthy fats, and fibre to reduce spikes in blood glucose and insulin.

•  A 10–20-minute walk can improve glucose uptake and lower insulin levels.

• Weight training builds muscle, improves insulin sensitivity, and helps regulate hormones.

• Avoid long periods without eating or excessive snacking on refined carbs.

• Certain herbs can really support this too: Cinnamon, nigella, reishi, saw palmetto etc.

2. Support the HPO-axis

The HPO (hypothalamic–pituitary–ovarian) axis controls your cycle, hormone balance and fertility. In PCOS, signalling can be disrupted by insulin resistance, stress, and inflammation, leading to irregular or absent periods and elevated androgens.

Ways to support the HPO axis:

• High-protein, anti-inflammatory diet

• Prioritise nervous system regulation (stress management) and consistent sleep

• Certain herbs can really support this too: Peony + licorice combined

3. Nervous system regulation

Chronic stress increases cortisol, which can worsen insulin resistance, androgen activity, and inflammation. Supporting the nervous system helps the body “feel safe,” allowing hormones to rebalance.

Ways to regulate the nervous system:

• Daily relaxation: deep breathing, journaling, yoga, or meditation

• Consistent sleep schedule

• Adaptogenic or calming nutrients/herbs where appropriate (magnesium, L-theanine, licorice, withania, reishi, passionflower, skullcap)

• limit HIIT training → can lead to excess cortisol → androgen → sebuum production → acne + cycle irregularity

4. Reduce inflammation

Low-grade inflammation worsens insulin resistance, androgen production, and hormonal imbalance. Managing inflammation is key for metabolic and skin health.

Practical ways to reduce inflammation:

• Anti-inflammatory foods: colourful vegetables, berries, herbs, spices

• Fibre-rich foods: support gut health and hormone clearance

• Limit inflammatory triggers: ultra-processed foods, excess sugar, alcohol, and dairy if sensitive

5. Support liver detoxification + bowel clearance

The liver and gut are central to hormone balance, especially for clearing excess androgens and oestrogen. If detox pathways or bowel movements are sluggish, hormones can be reabsorbed, increasing inflammation, acne, and cycle irregularities.

Ways to support liver and gut:

• Bitter and cruciferous foods: broccoli, kale, dandelion, artichoke to support liver detox pathways

• Fibre-rich meals: whole grains, legumes, vegetables, fruit to promote regular bowel movements

• Hydration: adequate water to support digestion and elimination

• Gentle movement: walking, yoga, or stretching to stimulate bowel motility

• Certain herbs can really support this too: schisandra, rosemary, st mary’s thistle, globe, dandelion root

6. Support lipid metabolism

Impaired lipid metabolism is common in PCOS, affecting cholesterol, triglycerides, and hormone synthesis. It is common to see lower ‘good’ cholesterol, which can lead to a higher risk of heart problems. Healthy fats help stabilise blood sugar, improve insulin sensitivity, and support hormone production.

Ways to support healthy lipid metabolism:

• Include omega-3 rich foods: fatty fish, flax, chia, walnuts

• Choose monounsaturated fats: avocado, olive oil, nuts

• Avoid excessive processed seed oils and trans fats

• Support detoxification pathways

• Aerobic activity and resistance training

Ready to understand your PMOS?

The old name pointed to cysts that don't actually exist (or were rarely found on ultrasounds), while the real condition (a complex hormonal and metabolic syndrome affecting 1 in 8 women) went underdiagnosed and undertreated for decades. The new name changes the conversation, and better conversations lead to better care.