PCOS/PMOS Treatment with Functional Nutrition - Seattle Nutrition Expert
Successful PCOS/PMOS Treatment Starts with Repairing the Gut
You’ve probably heard all kinds of advice about PMOS (formerly known as PCOS) — things like “just lose weight,”“eat less and move more,” or “cut out gluten.” None of that feels helpful when you’re already dealing with the frustration and grief of feeling like your body is fighting against you.
PCOS/PMOS doesn’t exist on its own. It’s a condition caused by mix of deeper imbalances — digestion, gut health, liver function, inflammation, and insulin regulation all play a role. When those systems aren’t supported, it can snowball into issues like thyroid slowdown, adrenal fatigue, and weight changes.
The good news? When you address those root causes, your symptoms can shift in a meaningful way. I’ve experienced that firsthand, and in this post I’m sharing what truly made a difference for me.
Hi lovelies. I’m Hilary Beckwith, ex-dieter and functional nutrition expert. Women with PCOS/PMOS or who are in perimenopause come to see me with signs of adrenal stress, insulin resistance, and inflammatory conditions, and my job is to find the root causes so we can address their symptoms more effectively and fill in the gaps between their lab values and how their body actually feels. Before you continue, click here to read my Medical Disclaimer.
In this article, you’ll learn:
my PCOS/PMOS story
types of PCOS/PMOS
PCOS/PMOS and leaky gut
PCOS/PMOS and insulin resistance
why repairing the gut should be your first step in PCOS/PMOS treatment
my PCOS/PMOS story
Like many women with PCOS/PMOS, I had many of the classic PCOS/PMOS symptoms.
Got my first period later than most females I knew (age 17)
Periods were highly irregular and unpredictable (1-2 periods per year)
Severe cystic acne from adolescence and into my late 20s (when I finally decided to go on Accutane)
Belly weight (referred to as "PCOS belly”) that simply would not budge
Migraines (that I now know, for me, are caused by low estrogen)
Blood sugar symptoms - I was hungry All. The. Time. and my hunger was paired with irritability, shakiness, and brain fog - classic symptoms of blood sugar dysregulation.
Nearly zero libido
I was under-tested and over-medicated
I was put on the pill at 17 to regulate my periods. I was put on loads of antibiotics and topical meds for acne for many years before opting for Accutane.
No provider ever tested my hormones. No provider ever tested my blood sugar levels. Despite my symptoms of dysfunction in both. I didn’t know what I didn’t know, so I didn’t know how to advocate for myself, or that I even needed to.
I only knew I was miserable and felt broken and totally alone.
My PCOS Diagnosis
I was diagnosed with PCOS (now more accurately called PMOS - Polyendocrine Metabolic Ovarian Syndrome) in my late 20s, right after my spouse and I decided to start trying for a baby. I stopped the pill and waited for my cycle to return… but it never did. After months of nothing, my provider put me on two rounds of Clomid to try and stimulate ovulation.
Looking back, it’s pretty clear that if they’d checked my hormones first, they probably would not have given me a medication that inhibits estrogen production — but here we are.
When Clomid didn’t work, my GYN finally ordered a pelvic ultrasound, and that’s when we got the classic PCOS/PMOS image: enlarged ovaries, lots of follicles, no ovulation. We were told our chances of conceiving naturally were low and that our only “real” option was expensive fertility treatment — something we absolutely couldn’t afford at the time.
We were devastated and felt hopeless.
But here’s the part they got wrong: not the PCOS diagnosis, but the idea that nothing could be done.
Addressing the root causes of PCOS/PMOS can shift symptoms in huge ways — and you don’t always need medication or costly fertility interventions to see real progress. I know because that’s exactly what happened for me.
types of PCOS + PMOS
Depending on who you talk to, there are four main types of PCOS. It may not always be useful to classify your PCOS/PMOS symptoms, since the starting point should be to uncover the hidden dysfunctions behind those symptoms.
But for the sake of understanding and information, here are the three main types of PCOS/PMOS:
#1: Classic PCOS/PMOS characteristics:
high androgen levels
visible polycystic ovaries on ultrasound OR normal-looking ovaries on ultrasound
anovulation (does not ovulate, or rarely ovulates), irregular cycles
insulin resistance
high insulin levels
high triglycerides or other out-of-range cholesterol levels
weight gain, difficulty losing weight
#2: Ovulatory PCOS/PMOS characteristics:
high androgen levels
regular cycles
visible polycystic ovaries on ultrasound
higher insulin levels
elevated lipids (cholesterol, triglycerides)
belly weight gain (PCOS belly)
elevated androgens
#3: Non-Hyperandrogenic PCOS/PMOS characteristics:
androgen levels within range
mostly regular cycles, although without ovulation (all or most cycles)
visible polycystic ovaries on ultrasound
fewer cases of insulin resistance
PCOS, PMOS, and leaky gut syndrome
When I see clients with digestive symptoms such as chronic constipation or diarrhea (or both), bloating, sensitivities to foods, especially wheat or dairy, or who have adult cystic acne, eczema, or blood sugar regulation issues - all of which are common with PCOS/PMOS - I look to the gut for answers.
If you take anything from this post - take this:
Inflammation of the digestive tract tissue, whether due to poor digestion, pathogenic overgrowth, or both, will cause the symptoms I just listed. Additional stress caused by pathogenic overgrowth will also disrupt sex hormone production and balance, and cause insulin resistance.
This is why so many women find relief from their PCOS/PMOS symptoms when they do the work to repair the gut lining and digestion first.
I’m going to say that again…
When addressing PCOS/PMOS symptoms, it is essential to address gut health and digestion as the first step.
This step is largely overlooked by Western medicine practitioners, and because of it, women with PCOS/PMOS are dismissed from clinics, having been told to “eat less, move more,”“cut out gluten,” or “reduce your stress”.
And if these women also happen to be trying to get pregnant, they are additionally sent to expensive infertility clinics and given medications they may not need.
There is another way, friend. You can treat PCOS/PMOS symptoms and get pregnant without expensive infertility treatments, harsh diets or food restrictions, and medications.
PCOS/PMOS and insulin resistance
Here’s the part that really sucks for females with PCOS/PMOS - most females with PCOS/PMOS have a predisposition to having insulin resistance. They’re born with it.
What does that mean?
It means that women with PCOS/PMOS have a higher propensity for cells to block out insulin, rather than allowing insulin to shuttle in glucose for energy production like they are supposed to. Click here for a more detailed look at insulin resistance.
Insulin resistance is a big driver of hormone imbalance, weight gain, fatigue, and that jittery, irritable, want-to-punch-someone-in-the-throat feeling you get between meals.
And because insulin resistance leads to higher insulin levels in the blood, this increase in insulin stimulates the ovaries to pump out androgens (testosterone and all its variants).
And remember that elevated androgens are a common characteristic in two of the three main PCOS/PMOS types.
This feels so unfair for women with PCOS/PMOS.
But at the end of the day, all it means is that we have to work a bit harder - and have a lot more self-grace - to keep insulin in check. But it is possible with the right support.
PCOS/PMOS treatment with functional nutrition
I had PCOS/PMOS - and now I don’t. I was told by my doctors that I would likely become diabetic, that the only option for pregnancy was expensive fertility treatment, and aside from that, was given zero direction.
So I figured it out for myself - but you don’t have to.
Initially, it was just me doing research and trying different methods to improve weight loss and blood sugar. What I didn’t know at the time is that my efforts were also addressing gut health and adrenal health, and ultimately hormone balance. All of which improved my PCOS/PMOS symptoms immensely.
It wasn’t until I decided to get a degree in holistic nutrition that I connected the pieces - the reason why my methods had worked is because they addressed gut health and insulin resistance.
HERE’S HOW MY SYMPTOMS HAVE CHANGED SINCE WORKING ON MY GUT AND INSULIN:
My hormones are all testing at optimal levels, with the occasional minor imbalance.
My periods went from 1-2 per year, to 30-34-day cycles.
My anxiety has greatly decreased.
Insulin sensitivity has greatly improved, and I am more tuned in to my body when blood sugar symptoms start to show again.
Lab hormone levels and cycle tracking confirm that I now ovulate on my own - While I no longer want to have children, I’m confident that I could successfully conceive.
My skin remains clear, save for the occasional PMS breakout (which I’m quite happy to have - feels like a sign of normalcy after decades of feeling broken!)
I have far more consistent energy every day than I used to.
taking probiotic supplements is not gut repair
Healing the gut involves functional support - supporting healthy digestive enzymes, stomach acid, motility, and bowel movements - and tissue repair - signs of inflammation, food sensitivities, bloat, acne, bad breath, persistent pain, and anxiety are all signs of inflammation - especially in the gut.
WHY IT’S IMPORTANT TO TREAT PCOS/PMOS HOLISTICALLY:
Common PCOS/PMOS symptoms, such as bloat, weight gain, feeling hangry between meals, fatigue, acne, and irregular periods, are all signs of dysfunction and imbalance in multiple body systems. Treating or masking the symptom is profoundly different than addressing the root cause.
Poor digestion can lead to tissue damage and inflammation - addressing the inflammation and symptoms is pointless without addressing what caused it to become dysfunctional in the first place.
Poor digestion also increases susceptibility to pathogenic infection, including SIBO (small intestinal bacterial overgrowth), h. pylori, parasites, and especially candida (yeast) overgrowth. A healthy digestive system should be able to kill off and eliminate pathogens before they become a problem. It is very common with my PCOS/PMOS clients to find such infections.
Unaddressed gut infections put stress on the adrenal glands and thyroid, leading to increased inflammation due to a constant state of fight-or-flight response. Eventually, we see this show up as abnormal thyroid levels on labwork, chronic fatigue, anxiety, and a suppressed immune system.
Stress on the adrenal glands interferes with hormone production and balance. Stress is modulated by the HPA axis (hypothalamus, pituitary, adrenal). Female sex hormones are modulated by the HPO(vary) axis. Human bodies prioritize stress over most other functions in the body - including hormone balance. Constant activation of the HPA axis in response to an unaddressed stressor (such as a pathogenic infection) will cause disruption in hormones.
Hopefully you are beginning to see how addressing gut health is essential to PCOS/PMOS treatment and finding relief for your PCOS/PMOS symptoms. Addressing gut health reduces inflammation and opens up the necessary pathways for optimal hormone function.
This is where I come in. When clients come to me with a PCOS/PMOS diagnosis, the first thing I do is look into the gut. Here are some of the tools I use to assess gut health:
Functional lab testing and food journals to evaluate digestive function.
Subjective intake to get a clear picture of the client’s health history and patterns that might be relevant.
Questionnaires designed to narrow down what type of lab testing would be most helpful.
Dietary analysis to see how certain foods are affecting mood, energy, and sleep.
