PCOS Has a New Name: Why It’s More Than an Ovarian Disorder

Transcript

Welcome back to the podcast. Today I’m doing a solo episode and I am so excited about this. I actually have some notes I’m going to be talking off of, which I don’t normally do this, but there’s so much I want to talk to you guys about that I have taken some notes. I normally just free flow this, so be a little different for me. I’m interested to see if you like this, but I want to talk about something that has been misunderstood, underdiagnosed, and mistreated for far too long. What most people know as PCOS. But in this episode I want to introduce a newer and in my opinion, more scientifically accurate way to think about it. It’s been reclassified as PMOs or Poly Endocrine Metabolic Syndrome. And I’m so excited about this. The reason the name matters is because the old name polycystic ovarian syndrome has always been incomplete. It puts the focus on the ovaries when in reality, this condition affects far more than ovaries. It affects insulin, it affects metabolism, it affects cortisol and the stress response. It affects testosterone, estrogen, and progesterone. It affects your skin, your hair, your weight, your mood, fertility, inflammation, and often the gut, which is what is left out. Another reason the old name falls short is because many women diagnosed with this condition do not actually have ovarian cysts. So many people think, well, I don’t have PCOS because I don’t have ovarian cysts, but you don’t have to.
So when we continue to use the name that centers only on the ovaries, we miss the bigger story. We delay the diagnosis in possibly millions of people, and we create a stigma. And we often fail to give women the kind of comprehensive whole body care that they actually need. So today, I want to walk you through the new classification and the new way to think about PCOS, or rather PMOs now and explain why it’s not just one disorder. We’re going to talk about why the old name is misleading. Why? This is really a whole body endocrine and metabolic issue. The different types or patterns women can fall into and why? Better classification leads to better care, which is the point of. Everything that I do on this podcast is to educate and help you be a better advocate for yourself and have better overall healthcare outcomes. If you have ever struggled with irregular periods, infertility, acne, facial hair, scalp hair loss, weight gain, belly fat, fatigue, anxiety, or feeling like something is off in your body. Even though people keep telling you your labs are normal. This episode is for you, and I am so happy because my book that was published earlier this year in 2026, there’s a whole chapter in my book about PCOS, and I actually talk about all these things, and I talk about how PCOS is actually a multisystem issue, not just a hormonal or an ovary issue. And so I’m so glad this has been reclassified and just at a perfect timing right after my book came out.
So let’s get into this episode. I want to start with why I believe this reframe matters so much to women. When people hear polycystic ovarian syndrome, they immediately think this problem is a gynecological problem and ovary problem or a fertility problem. That’s what most people think. And if you’re listening to this episode, you probably used to think that as well. But that is not the whole picture. With medicine, we are finding out with a lot of disease processes that there’s a much larger picture. When we start looking at root cause approach, because what we actually see in practice, and what I see in the women I take care of is they often also have insulin resistance. They have metabolic dysfunction, chronic inflammation, acne, excessive facial hair or body hair. They have a lot of scalp hair thinning, weight fluctuations, stubborn abdominal fat that worsens as they age, mood instability, gut dysfunction, sleep issues, and fertility challenges, which a lot of times are masked until they’re in their 30s because PCOS was typically treated with birth control, even in younger women, and then women maintained the treatment of birth control from their teens into their 20s, and then they become in their mid 30s, and they want to have a baby and they don’t realize they were having fertility challenges, which this disease was causing, but the treatment was masking. So this is not just an ovarian issue.
This is a multisystem disorder. And when we call something by too narrow of a name, it shapes how we think about it clinically. So patients and providers. So if you called an ovarian disorder, you are more likely to send the patient to a gynecologist, check a few sex hormones, maybe do an ultrasound and and then prescribe birth control. But if you understand as a poly endocrine metabolic syndrome, now you are forced to zoom out. You have to look at all of the endocrine systems and you have to ask, what is their insulin doing? What is their cortisol doing? Is their thyroid functioning? If not, why? What is causing inflammation? Are they inflamed? Is their CRP high probably driven by their high insulin? What is happening in their gut? Because our gut metabolizes our hormones and metabolizes our estrogen when our gut is off, it’s going to affect the conversion of our thyroid hormone. Is this woman even ovulating? We need to know that before we just put her on birth control. Is she metabolically healthy even if she’s thin? I’m going to teach you guys that there is a type of PCOS that is a thin PCOS type. And so this is a completely different level of care than here are a few sex hormones. Let’s check them. Oh, let me write you a prescription for birth control that will fix most of the symptoms you’re having. Come back and see me in 15 years when you want to have a baby, completely different level of care.
And this is why the language matters. It is so important. It improves scientific accuracy. This new name, because many women don’t actually have ovarian cysts. So that’s another issue. It also acknowledges the systemic impact because this affects the whole body and it opens the door to better care because it moves us away from a one size fits all label and towards individualized treatment, which is what we need in medicine. This is why so many people are so darn sick, because we have all of these treatment protocols instead of individualized treatment. So let’s talk about what the old model missed, right? Traditionally, PCOS has been diagnosed using the Rotterdam criteria. This means a woman needs two out of the three following things. She needs to have irregular cycles or irregular ovulation, typically meaning less than nine cycles per year. But they’re very irregular. And a lot of women with PCOS have cycles every 36 days or every 42 days, and then they have one every 28 days, but they have irregular cycles. So that’s one. The second one is signs of hyperandrogenism. So like acne, hair growth on their face or on their abdomen, hair thinning on their head or elevated testosterone levels. And the third is polycystic appearing ovaries on ultrasound. And while these criteria can help identify the condition, they don’t tell us why the woman has this. And that’s really important, right? They don’t tell us what system is driving this.
Is it their gut? Do they have a metabolic insulin issue? And it doesn’t tell us whether it is primarily coming from high insulin, from stress and cortisol from inflammation, whether that be unresolved trauma or gut issues, whether it’s a post pill issue, like they were on birth control, and now that’s actually caused their symptoms and their metabolic issues to be worse, whether it’s postpartum or whether it’s part of a broader metabolic collapse. And that is one of the biggest problems is that women get grouped together under one label, but they don’t always have the same biology. And that’s why so many people are misdiagnosed, misclassified, mistreated. Some are lean, but very highly insulin resistant. And so people miss that because they’re lean and they don’t even check their insulin levels. And then this person will end up in their 30s, gaining weight rapidly, cortisol levels increasing. And that’s because this insulin resistance was missed for years and it gets really bad. Some of these women are highly inflamed and stressed. Some are coming off birth control or some sort of birth control pill, and their body never properly restarted or reregulated. Some women with PCOS are postpartum or POS now or postpartum, and their hormones never fully recover from being postpartum. Some have adrenal issues primarily, and so that’s their big issue. And many are a combination or of 2 or 3 of these patterns.
And I talk a lot about this in my book of the seven different types that I picked out and how a lot of women are a combination of these, and God forbid you be a combination, you’re definitely going to be mistreated because most people are just looking at your sex hormones and writing you a prescription for birth control. So the old model gave us a label. It did not give us a framework for precision, and that is why so many women are either missed, dismissed or poorly managed for years with this condition. So if we’re going to think about PMOs, what are we really saying? Right. What we’re saying that this disorder involves multiple endocrine systems and metabolic dysfunction at the same time. So we’re saying that the ovaries are not acting alone, which is what I’ve said for years. We’re saying that insulin, cortisol, thyroid hormones, estrogen, progesterone, testosterone, adrenal hormones, inflammatory signaling, and often gut function and maybe even our immune system are all involved in this process. And the word metabolic matters because in the majority of women with this condition, there is some degree of impaired metabolic signaling, especially around insulin. And if this is not addressed, if people don’t know this, then they will never heal from this disorder and it will actually get worse over time because insulin is so powerful and how the rest of our body and hormones are regulated. So insulin is one of the most missed parts of this entire conversation.
And it’s not just about diabetes. It is a hormone. And when insulin is elevated, it drives ovarian testosterone production. So when we have high insulin, it makes our testosterone higher, which is why a lot of women with PCOS have high testosterone levels. You don’t have to, but a lot of them do it also insulin when it’s high, it will lower sex hormone binding globulin, which means you will have more free androgens circulating in your body. This contributes to abdominal fat gain, so it is not good. It also worsens inflammation and disrupts ovulation in women. And it creates the exact hormonal chaos that women are living in. It also can be one of the drivers of acne. So a lot of women and providers know this by way of symptoms and by way of lab tests, but they don’t understand what’s actually causing it. So a lot of the symptoms and the lab tests that you see in PCOS are driven by a high insulin level. So it’s important that we understand that and we go to the root cause of that, and we fix that so that we’re not masking symptoms or treating parts of this disease without treating the root cause. So when I think about PMOs, I want women to understand this. It’s not simply my ovaries are acting up. This is my whole endocrine and metabolic system is out of rhythm. That is so important. Let me repeat that.
My whole endocrine and metabolic system is out of rhythm. And when you understand that, you stop asking narrow questions like, do I have cysts? Am I overweight enough to even have this disorder? Should I just go on birth control? Those are all very narrow questions. Instead, I want you to start asking better questions. What is driving this in my body? What pattern am I living in? Do I have a certain pattern of PMOs and how do I address fixing this pattern? What hormones are involved in my specific diagnosis or condition? What is my insulin doing? What is my stress response doing? What is my gut doing? Why is my body not ovulating? Normally, this is the shift that I need you to make in your mind, and I need providers to make so that we can properly address and treat this. So although this disease has been newly classified, I listed seven patterns of PCOS that I saw in my practice prior to writing my book for years. And I want to just go into this part because I want women to understand this is not one disorder. But let me talk to you about the different patterns that I saw and still see as a board certified endocrinologist, helping thousands of women with hormonal issues in my practice so that you understand you may have one of these, you may have two of these, you may have a combination of four of these, but there are multiple recognized patterns or subtypes, and it’s important to understand that.
And so the first one is insulin resistant or the typical used to be PCOS. I’m going to call it PMOS. And this is the most recognized pattern, right? This is the one that women often think that they have. They have high insulin, weight gain, belly fat, irregular periods, higher testosterone levels, acne, facial hair, and sometimes darkened skin, especially around the neck or underarms. So this is the pattern most people commonly think of, but it’s only one version. Know that there are other types, and I talk about all these extensively in my book, what they are, how you treat them, etc. the second type is lean. I’m going to call it PMOS now used to be PCOS. This is one of the most important patterns to understand because it breaks one of the biggest myths in PCOS and now PMS. You do not have to be overweight to have this condition. And I’m going to tell you guys about my story. But I was not overweight whenever I was diagnosed with this. Finally, after being misdiagnosed forever, Lean women can still have high insulin. I did. They can still have irregular cycles. I did. They can still have infertility, I did. They can still have cystic acne, facial hair, hair thinning, poor muscle tone, and major hormonal disruptions. They are often dismissed because they look healthy on the outside. That was me, dismissed by three endocrinologists as a board certified endocrinologist.
But thin does not equal metabolically healthy, so keep that in mind so you can have the insulin resistant or typical PMS type, or you can have the lean PMS type. The third type that I see in practice is inflammatory PMS. And this is when women have chronic low grade inflammation. It is a major driver. And so they have typically gut issues. A lot of these people will have eczema or psoriasis or skin issues because when we have gut issues, that causes skin issues, a lot of fatigue, a lot of joint pain, because again, we’ll get a lot of inflammation when you have gut issues, which cause fatigue, because when your gut is overactive, it steals a lot of the energy that your brain needs. So you get fatigued, and then you get joint pain from the inflammation and the bad bacteria in your gut. A lot of these people have food reactions, post-viral symptoms, poor sleep, and irregular cycles. And in these women, inflammation is feeding their hormone dysfunction on labs. A lot of times you’ll see very high CRP levels. They also have high insulin levels. And so that is another very important inflammatory piece. Because if they have high inflammation, we need to figure out why. And we need to lower the inflammation, if not when we’re trying to treat the PCOS for whatever reason, they’re going to continue to have issues because their gut will stay inflamed when their guts inflamed, it will drive their cortisol to be high.
When their cortisol is high, it’s going to jack up their insulin. Both things are going to affect their sleep, going to affect their weight. When they have more adipose tissue, their hormones are metabolizing incorrectly in their gut. That’s going to affect their estrogen, in their testosterone levels, their ovulation. So it’s a big deal. The fourth type is post pill PMS. This is a huge one and it is so commonly missed. These are the women who had regular cycles before birth control. They went on the pill for acne, for painful periods, for irregular periods, and then came off the pill years later. Or maybe they even went on it for actual true birth control. But they go on the pill, they come off of it years later and their body never fully restarts. That’s a danger with a medication like birth control, your birth control. So what it does is it’s going to trick your brain into thinking that it doesn’t need to make hormones. So it will affect your FSH and your LH levels. A lot of times it makes women’s FSH very low, meaning your brain stops giving a signal to your body to make estrogen. And, you know, LH isn’t made or produced. And so you’re not making progesterone. And then when your body shuts itself off like that over time, because you’re taking a synthetic hormone, which does have side effects. See my podcast episode with Doctor Pete, where we talked about all of those recently.
Then you’re gonna have issues long term if your body shuts itself off from being able to make a hormone, sometimes it just, it won’t make it again. And so that’s what happens in these Post-pill PMS people. And so they never fully restart making hormones. So now they have absent or irregular cycles. They get a lot of acne mood changes. Some of them get facial hair and their provider tells them, oh, just wait, you’ve been on birth control to take 6 to 12 months to get your period back. But this is real and it deserves real attention. And if you wait a year, especially when you’re in your mid 30s and you’re trying to have a baby, we may be in some serious issues. And if we’re not addressing the fact that now you have no hormones, no synthetic, and your body’s not making them, that further worsens your gut, it further worsens your thyroid hormone conversion, further worsens your cortisol and your sleep and your insulin and your weight. And it’s just a big, big hormonal mess. Now the fourth type is what we call adrenal PCOS. In these women, stress and adrenal output are major players, so they’ll have very high DHEA or DHEA S levels because that is made in your adrenal high cortisol, a lot of anxiety, poor sleep, irregular menstrual cycles. Because when their cortisol is off, it’s going to affect their progesterone and make their cycles irregular.
They get a lot of acne from the high cortisol, the lack of sleep, the gut dysregulation. They have hair issues and a body that feels stuck in survival mode. So they are so anxious. And these are the people who are wired but tired. They lay down, they can’t fall asleep, things like that. They’re often very driven, high achieving women who have
been under chronic stress for years. This was part of my problem. I had part of the lean PCOS, so was lean and adrenal, but I’d also been on birth control because I was told to take birth control when I was younger, like everyone else. So this is a big problem as well. The sixth type is the hidden cause PMS. And so this is the woman who clearly has symptoms, but the root driver is not immediately obvious. So a lot of times when I see women, I know, I know what’s driving their issue. But sometimes this, you know, women can have genetic issues. They can have environmental issues like mold or, you know, heavy metals they’re not aware of. Their toxic burden is high depending on maybe they’re putting something on their skin or they’re using a lot of chemicals or have chemicals in their clothes. They’re not aware of a lot of gut related issues, thyroid related issues, or a mixed picture. And these women need a broader workup and a provider willing to think deeper or they will never get better.
But if you have PMOs, the true cause of it, root cause needs to be found and addressed, or you won’t get better. And then there’s a postpartum or post-pregnancy PMOs where pregnancy reveals or worsens an underlying hormonal or metabolic issue. So some women notice after having a baby that they suddenly have cycle irregularity, weight changes, insulin resistance, hair loss, mood changes, fatigue, hormonal dysfunction that never quite resets and is worse than prior to them getting pregnant. And sometimes that can be a combination of they gained weight during pregnancy and that changed their adipose tissue, or they had some gut issues. And so that happens that postpartum transition can be the trigger that exposes the underlying pattern. And here is the key takeaway for this. Many women are not just one type. Like I said, they are a blend and they may be lean and adrenal or insulin resistant and inflammatory, post-pill and gut driven, postpartum and thyroid driven. But once you understand that and the one size fits all model does not work and completely falls apart, then you will understand why this disease process needed better classification and why you need a provider that understands this, so they can really help you work through this and figure out how to truly treat this disease, not just keep covering it up. And I feel so strongly about this because like I told you, I lived it. I know what it feels like to know something is wrong and still be dismissed, even as a doctor, even as a board certified endocrinologist or hormone doctor, I knew something wasn’t right and I was dismissed by multiple people because I was thin.
Because I didn’t look like anything was wrong with me. Because, you know, it was just you’re just stressed. It’s all in your head. I know what it feels like to not fit the stereotype of PMS or PCOS, and I know what it feels like to be told, you don’t look like somebody who has this. And that is exactly why I’m so passionate about changing the way that we talk about this, and why I wrote about it in my book, because there are so many women who are living in that exact same experience right now, and it’s terrible. I lived in it for too long, unfortunately, and I had issues with infertility and multiple miscarriages and ultimately ended up not being able to have a baby. And now I’m 40. And so I know what it’s like to live in that situation. And a lot of people who are living in this situation are smart, and they’re trying and they’re paying attention, and they’re still being told that they’re fine and they’re not fine. They are being under evaluated. And until we stop thinking about this as one ovarian diagnosis and start thinking about it as a broader endocrine metabolic syndrome, we are going to keep failing women, unfortunately, and I’m not okay with it, like we need to demand better.
So why does this new classification actually matter? Because better classification changes. Who gets diagnosed. Better classification will change what providers learn about and are expected to know, and how they’re expected to treat people under the old framework. Too many women got missed because they were not overweight. They didn’t have obvious cysts on their ovaries, their glucose and a1c’s still looked normal, but nobody was checking their insulin. No one was checking the right labs. And so this led to delayed diagnoses. And then years later, those same women show up and now they’re having infertility issues. They have type two diabetes or they’re severely insulin resistant. They have fatty liver disease because they’ve been insulin resistant for so long, worsening thyroid dysfunction, chronic inflammation, or a body that feels like it’s falling apart. And no one can explain to them why. So this is not just schematics and cinnamons, and this is not me just throwing random information at you. Right. This is about preventing women from slipping through the cracks. It’s also about reducing stigma. Like, I don’t want people to think, oh, I have PCOS. This is a terrible diagnosis. Or because I have PCOS, I’m going to have all this facial hair. I’m going to have all these cysts on my ovaries. It’s not about that. When we talk about this through the lens of weight or fertility. A lot of times we blame women or we feel blamed as women, but that’s not what should happen.
And a lot of times, unfortunately, women with PCOS have been told to eat less, exercise more, try harder, stop being so stressed out, just go back on the pill. And none of those are good explanations. If we frame this correctly as a poly endocrine metabolic syndrome, we stop blaming the woman and we start evaluating the symptoms. And as a provider, you’re going to have to do that as a patient. You’re going to have to demand that. Like, you can’t just blame me. You can’t tell me to just try harder. Like I need to understand what poly endocrine, what multiple endocrine metabolic symptoms are not working. And how do we fix this? That’s just better medicine. And so I’m so happy that this has been reclassified. So I want to talk now about something that I believe is still missing from most conversations around this condition. And that’s the gut. I believe there’s a gut hormone metabolic connection here. Obviously, again, my book fixture, gut fixture hormones, everything starts in the gut. Many women with PMS have dysbiosis of the gut, leaky gut, poor estrogen metabolism in their gut, chronic inflammation of the gut, and poor nutrient absorption. And when the gut is inflamed, everything is harder. Your gut is actually what I believe is a endocrine system that was never classified correctly. Like we don’t learn about this, but we should start teaching providers, patients, people that your gut is a system.
You know, just like the rest of your body, like in itself, just like your cardiovascular system. We talk about the GI tract, but your gut is an important hormonal system, as are your fat cells. And so nobody talks about adipose tissue or fat cells as an endocrine organ, but they are. They release very toxic and potent chemicals that also change the way our body metabolizes certain hormones and how it stores fat and how we metabolize food. So all of this, it’s really, really important, right? And so the immune system also, I’m going to tell you, in people with PMS, when your gut’s inflamed and everything gets harder, your immune system gets activated, your cortisol rises, your inflammation signals rise, your blood sugar becomes harder to regulate. Hormone clearance is less efficient because your gut is not working as well, and the body stays stuck in this loop of inflammation, metabolic dysfunction, and hormonal chaos. So for many women, if you ignore the gut, you will never fully fix the actual problems that are driving this poly endocrine metabolic syndrome. And that is one of the reasons I believe the older way of thinking about PCOS has been so incomplete. It left out one of the biggest drivers. This is not just an ovarian story. This is a gut story, a metabolism story, a stress story, a hormone story, multiple hormones. And that is exactly why PMS is a better framework than PCOS.
If you’re going to think about this correctly, you also need the right labs. And so I want to talk to you now about what labs actually matter. If you think that you have this syndrome, right. This is another place where women are so often failed. And this is just generally in medicine. We are failing in medicine with lab work and interpreting lab work optimally and correctly in patients. A basic lab panel with some basic hormone levels is not enough. I honestly don’t think that’s enough in anyone. Like I don’t know in what disease process you’re trying to treat, even if you’re trying to keep someone metabolically healthy, looking at their electrolytes. Not helpful. Like you have to be pretty dang sick, y’all, for your electrolytes and kidney function and liver enzymes to be out of whack. We want to catch it way before then. Right. So if you really want to understand PMS, you need a broader view. And I list in my book in the chapter on PCOS, every lab that you need as a patient with PCOS or PMOS now, and the lab ranges that I’m looking for. And if they’re abnormal, what does that mean? And that would take a long time to go through. But in general, what you need to know if you think you have PMS is what is your fasting insulin? It should be less than five. What is your fasting glucose? Ideally, I like it 75 to 85.
What is your a one C? It should not be higher than 5.65.75.8. We’re getting to abnormal numbers here. Okay. You don’t have to be all the way at 6.5 and be diabetic before you know something’s wrong and your insulin is going to be higher way before your A one C. You want to know what your total and free testosterone levels are. Is your total high? Is your free high? Maybe your total is normal, but your free is high. Why? In addition to that, you want to know what your sex hormone binding globulin is. Because if your sex hormone binding globulin is low, that gives you a worse prognosis long term than if it’s normal or high. What is your DHEA and DHEA S levels? Right. Is your adrenal involved or not? We want to know what’s your LH and FSH. Is your brain actually giving the signal to your body to make hormones? Typically in people with PCOS, their LH is going to be higher than their FSH. So that’s a good signal and diagnostic clue as well, because typically our LH is not higher than FSH. What is your estradiol level? Are you making estradiol correctly as your level too low? Are you not metabolizing your estrogen correctly as your level too high? What is your progesterone? Your prolactin level, your thyroid labs? And when I say thyroid labs, I mean a full panel, your TSH, your free T4, your free T3, your TPO antibodies, your reverse T3, your free T3 level.
And a lot of people with PMS is going to be low because they have gut issues, because they have inflammation issues. And when your free T3 is low, that’s a problem. And if extra weight, it affects your metabolism. And that conversion from T4 to T3 happens in your gut. So if you have a lot of gut dysfunction, we’re going to have an issue there. So you need to know those levels. You need to know do you have high inflammatory markers like CRP levels. What are your liver enzymes. Are they high. And I consider anything high in the you know, if your alt and AST are above 16, 17, that’s high. But the lab will tell you it can be all the way up to 30 or 32. And that’s just not optimal. And then I want to know what are your key micronutrients like your ferritin, your vitamin D, your B12, your folate, your iodine. All these numbers are very important because if you don’t have micronutrients, your thyroid hormone can’t convert. A lot of times your sex hormones won’t work as well. And you’ll start to develop symptoms because all these micronutrients are important. And a lot of times when they’re low, it’s because you have a gut issue. And so that helps me determine is your gut playing a role here? And again, I go through all these labs in my book in detail. I also have a lab guide that you can request from my website where I go over all this in detail.
And so this is important because this condition does not live in one lab value. If you get a basic BMP and a testosterone and say someone’s fine, you’re not looking at the full picture, right? You’ve been under evaluated and that’s a problem. Like typically this condition will show up as a pattern. And one of the biggest things I want women to understand is this you can have a normal ANC and still have significant insulin resistance. You can look thin and still have major metabolic dysfunction. You can have normal basic labs and still not be ovulating. So if no one has checked your insulin, if no one has looked at your DHEA s, if no one has looked at the broader hormone and metabolic picture, then you may not have had a real evaluation yet. And that’s really important because you don’t want to wait until you have so much dysfunction that then we check, right? So ask yourself, have you had all those labs that we’ve talked about? So let’s talk about what better care should look like. Now that we know that this condition is a poly endocrine metabolic syndrome condition. If PMO s is the more accurate way to think about this, then what does actual better care look like? Right. It means we have to stop asking what prescription do I give every woman with PCOS? And we need to start asking what is driving this woman’s pattern so that we can actually fix this condition.
Better care means identifying the subtype or the combination of subtypes addressing insulin resistance, early improving diet quality, supporting sleep, calming the stress response, healing the gut, correcting nutrient deficiencies, evaluating thyroid dysfunction, and helping the body restore ovulation and metabolic flexibility. To me, that’s what better care means. It means whole body care. It means personalized care, and it means not waiting until the woman is infertile, diabetic, exhausted, inflamed, overweight, and miserable before we finally take them seriously. That is what this reframing of this disease process is all about. In my opinion. It’s about accuracy. It’s about earlier diagnosis. It’s about reducing stigma, and it’s about giving women the kind of comprehensive care they should have had from the beginning. So if you take nothing else from this episode, take this. What has traditionally been called PCOS is not just one disorder. It’s better understood as ppmos poly endocrine metabolic syndrome, because many women do not actually have ovarian cysts, and it requires a whole body approach to diagnose and treat. This is not just about periods. It’s not just about fertility. It is not just about weight. This is about the intersection of hormones, metabolism, insulin stress, inflammation, and gut health. And when we classify this better, we care for women better. That is the shift I hope starts happening more and more in healthcare. So one of the things I want to do is recap the big ideas that we talked about in this episode.
Pcos is too narrow of a name. Keep that in mind. So polycystic ovarian syndrome too narrow poly, endocrine, metabolic ovarian syndrome, better PMS. It’s a whole body framework. So important. Not every woman is going to have an ovarian cyst, so keep that in mind. Just because you don’t have an ovarian cyst does not mean that you don’t meet the criteria or possibly have PMS. This condition is systemic. Insulin matters. Cortisol matters. Your thyroid matters. Your gut health matters astronomically. If you don’t start there, you can’t fix your thyroid or your cortisol or your insulin or your sex hormones or your weight or your sleep. Weight is not the whole story. You can be thin and have this disease process and classification matters because treatment should match the pattern. Now also, when we’re talking about treatment, your treatment is going to depend on what is causing your disease process. And I write a lot about that in my book. You need to know what type of PCOS or PMOS you have, and all the different avenues that are driving the inflammation in the lab abnormalities before you really dive into treatment, because you want to make sure that you’re treating all of the avenues at the same time, we don’t want to just treat one of them and then shunt, you know, hormones down a different pathway and make something worse. The other thing that I really want you to take away from this birth control is not the answer for PCOS.
It is not. I did a reel on this in March of 2024 that went viral. You can find it on TikTok where I said the treatment for PCOS is not birth control. And I talked about why and it went so viral. I had a bunch of people who hated on it. I had some people who liked it, but it’s true. Birth control, again, will just mask the symptoms. It does not treat the disorder. I was talking about how PCOS at the time was a metabolic systemic illness and a disease that could potentially be worsened by gut health. And I mean it like if you are a prescriber listening to this and you give everyone birth control for PCOS, please buy my book and read it and figure out another way to treat this disease process. Metformin. Same way a lot of people just give women metformin. Tell them to eat less, exercise more, and write them a script for birth control. And all you are doing is making this entire disease process worse. As a patient, if you’re like, man, I’m pretty much giving up. I love my birth control. It makes my skin complexion better. I don’t know what else to do. I feel terrible when I’m not on it. That’s a problem because the longer you stay on it, the more your body is going to become dependent on it.
But it is going to continue to mess up other hormones in your body and other systemic symptoms in your body, right? So that systemic birth control will affect your cortisol, it will affect your insulin, it will affect your thyroid hormone conversion. It’s going to affect your gut. And I talk a lot about that in my book, too. There’s a whole chapter on how medications affect our gut and what they do to our hormones. And so take away from this, please, That birth control is not the end all, be all. It’s not the answer. I actually try to get all my patients off of birth control. If they’re starting on birth control just for this condition. And the other scary thing is if you’re in your 40s and you’re on a birth control, a synthetic birth control, terrifying 50s. Oh my gosh. Causes blood clots. I mean, again, I talked about this in my episode with Doctor Johnny Peat recently. And so birth control is we’ve got to stop using it as the crutch and the cover up of just like, oh, you have PCOS here is a drug because that is a cop out. It’s just an easy way to get somebody out of your office. And ultimately you’re causing them more harm than good. In my professional opinion. So I hope this episode helped you better understand why this condition needs a new lens. And I wanted to give you a more complete framework, and I hope it gave you language for what you may have been feeling in your own body for a long time, and then some ammunition or firepower to go back to your provider and say, hey, I think something’s wrong.
And maybe it could be this new classification system. You know, I’m sure you’ve heard of PCOS. Now it’s been classified differently. And maybe I have PMS and I would, you know, like to have additional lab workup or a further lab workup so I can try to really figure out from a root cause approach what is going on with this. If you want to go deeper in this topic, especially the lab breakdown of PCOS and now PMO s insulin resistance, gut dysfunction labs and treatment strategies, that’s exactly what I wrote chapter eight of my book, Fix Your Gut Hormones About. And I would love for you to get that. I would love for you to, to check it out and let me know. And if you liked this style of podcast, me just kind of teaching you about a topic and you found this very helpful and relatable, then let me know that as well on social or in the review. I’m happy to do more of these. Whatever helps you become more educated and better your health journey. And please, please, please, if you found this helpful or you know somebody who’s struggling with this, send them this episode because I think this is very powerful.
We need to get this information out there. And I’m so excited that this disease process finally got a reclassification. Thanks so much for listening to today’s episode. I hope this conversation gave you a clearer understanding of how complex this condition really is, and more importantly, why it needed to be looked at through a much broader lens than most women have been taught. If there’s one thing I want you to take away from today, it’s this what has
traditionally been called PCOS is now better understood as poly endocrine metabolic syndrome, or PMS. And that matters because this is not just one diagnosis, and it is not just an ovarian issue or even just a hormonal issue. It’s often a combination of insulin resistance, inflammation, gut dysfunction, stress physiology, nutrient depletion, and hormonal imbalance all happening at the same time. And until you identify the pattern driving your symptoms. It’s very hard to truly heal if you want to go deeper into everything we talked about today, I would love for you to check out my book Fix Your Gut, Fix Your Hormones on Amazon. Chapter eight is entirely about PCOS or PMOs, as it’s now better understood and classified and goes in depth into gut hormone metabolism and the connection between that and this disorder. The different subtypes of PMOs, the lab work that is often missed, and what it really takes to begin reversing this condition from a root cause approach. And if you’re looking for a more personalized support in your health journey, I’d also love for you to consider becoming a patient at Modern Endocrine.
You can visit www.endocrine.com to book a discovery call and see if we are the right fit for you. We’re licensed to provide telehealth in 46 states, and we also have a state of the art clinic in Oklahoma City. If you prefer in-person care. If this episode taught you something, helped you connect dots in your own health, or made you think of someone in your life who has been struggling with symptoms of PMS. Formally known as PCOS. Please share this episode with a friend or someone who needs to hear it. And if you’re enjoying the podcast, it would mean so much if you would follow the show and leave a review that really helps more people find these conversations and helps get this valuable information into the hands of women who are looking for real answers. As a special gift for listening to this episode, I also invite you to check out our website shop Modern endocrine.com. I have several supplements that are targeted for PMOs and nMOS Atoll and Insulin impact are great, and if you use code listen ten, you can get 10% off for listening to this episode. Thank you again for being here. Thank you for spending this time with me. And as always, I hope this episode helped you better understand your body, your hormones, and your health. I’ll see you in the next episode.