PCOS to PMOS | Here’s What You Need to Know
In this post I will go over everything from what PCOS + PMOS mean, to PCOS symptoms, to effective and holistic PCOS treatment. But the thing I want you to hold onto right now is that this new metabolic perspective on PCOS is not new information. And more importantly, the rename from PCOS to PMOS does not mean your medical providers instantly know how to address the root causes of your PCOS symptoms.
I’ve been helping females with PCOS symptoms by addressing their gut health, metabolic health, and endocrine health, for as long as I’ve been in practice - including my own PCOS!
I’ve Been Saying it for Years…
Your PCOS diagnosis has been rightfully renamed to PMOS - a win for female-bodied folx everywhere!
In this post I will go over everything from what PCOS + PMOS mean, to PCOS symptoms, to effective and holistic PCOS treatment. But the thing I want you to hold onto right now is that this new metabolic perspective on PCOS is not new information. And more importantly, the rename from PCOS to PMOS does not mean your medical providers instantly know how to address the root causes of your PCOS symptoms.
I’ve been helping females with PCOS symptoms by addressing their gut health, metabolic health, and endocrine health, for as long as I’ve been in practice - including my own PCOS!
Hello, my muffin tops. I’m Hilary Beckwith, ex-dieter and functional health expert. Women with PCOS/PMOS, IBS, and autoimmune conditions 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:
Differences between PCOS diagnosis and PMOS
Why the rename is so important
PCOS treatment with functional nutrition
Ways you can start advocating for your health in more meaningful ways
the name PCOS has always been a problem
And this is a huge disservice to female-bodied folx everywhere. When I got my PCOS diagnosis nearly 20 years ago, I was told, “you will probably become diabetic” and that I would not be able to get pregnant without expensive medical intervention. That was the only guidance I received from my gynecologist.
I didn’t know then how to advocate for my health, ask questions, or seek out a second opinion, or even holistic support. But I know now, and that’s why my ongoing mission is to educate and empower a new generation of women to do the same by holding their practitioners accountable, asking questions, and getting heard, no matter what it takes.
The first step is to educate yourself.
WHAT DOES PCOS STAND FOR?
PCOS stands for PolyCystic Ovarian Syndrome. Getting a PCOS diagnosis primarily requires a female to meet at least two of these measures:
elevated androgen levels
irregular or absent ovulation
an ultrasound confirming multiple “cysts” on the ovaries
more recently, low egg count was added to this list
You can see, these criteria largely point to a gynecological focus - here’s why that’s a problem:
Elevated androgens and sex hormone imbalances don’t just happen. In general, are often caused by a disruption in the HPA axis (brain and adrenal glands), blood sugar instability (also tied to HPA axis), prolonged chronic stress (oh hey, that’s HPA axis, too!), and liver functionality.
Ovulation issues stem from these same hormonal imbalances, caused largely by - yep! - HPA axis dysfunction and blood sugar instability or insulin resistance. While it’s true that the ovaries themselves can contribute to the problem, the root cause is often in communication between the brain and ovaries, not the ovaries themselves. Chronic stress, insulin resistance, and liver health can all be supported to improve ovarian function.
PCOS ovaries are not covered in “cysts”: The classic visual of PCOS is this picture of an ovary covered in what looks like a string of pearls - these are not cysts - they are follicles that were not able to release an egg into the fallopian tube, and thus became stuck. Your ovaries can develop cysts, but what is seen in PCOS is not cysts.
What’s more, the cause of these stunted follicles is commonly caused by an increase in androgens (testosterone, DHEA) produced by the ovaries in response to elevated insulin levels, caused by insulin resistance - again, not a gynecological issue.
Egg Count: The quality of eggs is vastly more important than the number of eggs. Think about it - does it do you any good to have a drawer full of dead batteries, if only 2-3 of them have any juice left?
WHAT DOES PMOS STAND FOR?
PMOS stands for Polyendocrine Metabolic Ovarian Syndrome. Polyendocrine, meaning it involves many factors in the endocrine system, including metabolic, or blood-sugar-regulating endocrine glands such as the adrenal glands and pancreas.
Take a close look at the diagram below to see the differences between a PCOS diagnosis and PMOS.
renaming PCOS to PMOS does not mean your doctors instantly know how to support you
Whether we call it PCOS, PMOS, or the acne-bloat-crazy-bananas-plague - PCOS is a complex interplay of dysfunction in metabolic health, hormones, liver, gut, and brain.
The renaming of PCOS to PMOS is a step in the right direction, but the medical community still has a long way to go when it comes to understanding how to treat PMOS effectively. This rename will bring more awareness to the medical community, leading to better research and education for medical providers, but that is YEARS down the road.
After all, it took decades before medical doctors even started to become aware (awareness does not equate to action) that more nutrition education would be helpful to their patients. The minuscule amount currently required for medical licensing is largely focused on biochemistry, not patient care.
And while it would be a dream come true to find that one-stop shop for full-body PCOS and PMOS treatment, it simply does not exist, and probably won’t for some time.
That’s why practitioners like me exist - I am in practice to help female-bodied folx uncover hidden causes of their dysfunction that are keeping them stuck in their PCOS symptoms.
Through a focus on gut health, digestion, inflammation, stress, and blood sugar stability, I have helped my female-bodied clients (myself included) break free from PCOS symptoms such as:
painful and embarrassing adult acne
“PCOS belly” - weight in the belly and hips that came out of nowhere
thinning hair
irregular and unpredictable periods
PMS or PMDD (despite what you might have learned, PMS is a sign of hormone imbalances, and is not normal to experience)
hormone imbalances reflected on labs
fatigue + energy crashes
2am wake-ups
increased body or facial hair (hirsutism)
“hangry” between meals
poor mood - feeling unstable, depressed, or anxious
whole-body PCOS treatment
Most females who seek my help present with some form of hormonal imbalance, signs of prolonged chronic stress, and systemic inflammation. So, PCOS diagnosis or not, the main goal is to assess and pinpoint what the root causes of dysfunction are, so that we can create a care plan that is targeted to their specific needs.
After years of throwing spaghetti at the wall, the women who work with me walk away feeling seen, heard, and revitalized - a stark contrast from the providers’ offices that, in the past, left them feeling dismissed, ignored, and alone.
TARGETED, WHOLE-BODY PCOS TREATMENT THAT GETS RESULTS:
LIFESTYLE + DIETARY ANALYSIS:
I’m not interested in how many calories you eat per day, nor will I ever ask you to step on a scale. However, day-to-day stress levels, food quality, meal timing and atmosphere, sleep, bowel movements, body movements - all of it matters.
Chronic stress disrupts the brain’s communication with endocrine glands. This is because your brain’s priority in stress response is protection - or better yet, survival. Nothing else is important until that threat (stress) is successfully dealt with. And when the stress keeps coming, you stay stuck in survival mode, and this plays havoc on your hormones. The first thing I do is gather information so that I can meet you where you’re at.
ASSESS DIGESTIVE HEALTH:
This is a big one with PCOS. Digestive dysfunction is more than just gassy evenings, heartburn, and constipation. When your body does not produce enough stomach acid, digestive enzymes, or cannot efficiently move food through your intestines and eliminate waste - intestinal tissues become damaged and inflamed, toxic burden builds due to waste that is not eliminated, and your susceptibility to opportunistic bacterial overgrowth, candida, and even parasites, increases significantly.
Your digestive system is wired to kill off harmful pathogens and prevent their proliferation - and the biggest inhibitor of digestion is stress.
FUNCTIONAL LAB TESTING:
For cycling females, getting a one-time blood panel is not enough information to understand the big picture, and quite frankly, if you are a cycling female, it is a huge disservice to use hormone levels on a single blood panel as a starting point. Chances are that provider is simply just ticking off the boxes required by insurance to diagnose you (Click HERE to learn more about how this impacts your access to quality health care).
Working with quality functional labs, we can create a plan that is fine-tuned to your body’s specific needs, as opposed to suppressing symptoms alone. Here are the labs I most commonly recommend with PCOS symptoms:
GI-MAP (Diagnostic Solutions) - measures microbial balance, pathogens, inflammatory markers, and digestive markers.
Organic Acids Test (Mosaic) - measures for yeast and mold, neurotransmitter dysfunction, mitochondrial health, and nutrient deficiencies.
Expanded Female Hormone Panel (eFHP - Diagnostechs) - Spanning across your entire cycle, this test measures FSH, LH, Estrogen, Progesterone, Testosterone, and DHEA, and helps us locate patterns and sources of dysfunction (e.g. is the source of the problem brain-ovary communication, or is it in the gland itself?)
DUTCH Adrenal (Precision Analytics) - Measures daily cortisol rhythms, DHEA-S, and your body’s cortisol clearance and detoxification ability.
DUTCH Complete (Precision Analytics) - Measures multiple reproductive hormones as well as their metabolites and your body’s ability to detoxify each of them. It does not measure FSH or LH but is a powerhouse of information for males and females alike.
You can see that the focus with functional nutrition is not calories, diet, or weight loss - or even the lab values themselves - the focus is function.
Uncovering the root causes of dysfunction that are keeping you stuck in your inflammatory state, your constant bloat and discomfort, your debilitating fatigue, sugar cravings, and overall well-being.
ways to advocate for your own health right now
The PCOS-to-PMOS change only happened recently. It is highly unlikely that you will walk into your OBGYN tomorrow and get whole-body, root-cause support for your PCOS diagnosis. It may take years or even decades for medical providers to start receiving training that will help you the most.
The medical system trains doctors to know what to do when your health fails. It’s not their fault, but “conventional” medicine does very little to help connect your symptoms to your data.
You are among a generation of cycle-breakers, friend. The ripples have to start somewhere - let it be with you!
HERE ARE SOME WAYS TO START ADVOCATING FOR YOUR HEALTH STARTING TODAY:
Stop waiting until self-care “fits”: Now is when your body needs help. And now is when you’re worthy enough to receive it.
Stay curious. Your healthcare providers, including me, are humans just like you. We each have our own set of knowledge, skills, and biases that influence how we show up in the world and with our patients/clients. HEALTHCARE PRACTITIONERS ARE NOT ALWAYS RIGHT. Ask questions and don’t believe everything you hear (including from me!). Ask for evidence and make your own interpretations.
Stop scrolling TikTok. Stop falling for bio-hacks, supplement packs, expensive wearables, and cleanses that were not recommended based on a personalized assessment of your body’s needs.
Talking is free. Leave comments below or email me with your questions. I love connecting with health-curious folx.
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Treating PCOS with Nutrition: Why Addressing Gut Health is Key
I was once diagnosed with PCOS, and so whenever I am studying it, or hear that someone I know is dealing with it, I light up! It's such an interesting topic to me, and has impacted my life on a deeply emotional level. It’s important to me that you know that I GET IT. More deeply than most, I am right there with you.
For those unfamiliar with the term, PCOS stands for Poly Cystic Ovary Syndrome. It occurs when our body, for whatever reason (more on that later), cannot fully ovulate, meaning, the egg cannot fully break through the follicle wall and ovary wall into the fallopian tube. Instead, the egg remains in the ovary wall and creates a cyst. When this happens repeatedly, the ovary becomes covered in cysts.
PCOS Symptoms
This is an exciting topic for me. (Nerd alert!)
But for real - I was once diagnosed with PCOS, and so whenever I am studying it, or hear that someone I know is dealing with it, I light up! It's such an interesting topic to me, and has impacted my life on a deeply emotional level.
It’s important to me that you know that I GET IT. More deeply than most, I am right there with you.
For those unfamiliar with the term, PCOS stands for PolyCystic Ovary Syndrome. It occurs when our body, for whatever reason (more on that later), cannot fully ovulate, meaning the egg cannot fully break through the follicle wall and ovary wall into the fallopian tube. Instead, the egg remains in the ovary wall and creates a cyst. When this happens repeatedly, the ovary becomes covered in cysts.
The really heartbreaking part is that female-bodied individuals who've been diagnosed with PCOS are often diagnosed while in the process of trying to get pregnant.
But why aren't our health care professionals looking into this when we come to them earlier on, with PCOS symptoms of irregular periods, cystic acne, blood sugar issues, weight gain or PCOS belly, and even chronic pain...
Why do they just throw 'the pill' at us instead of investigating the root cause?
Why do we have to wait until the moment we are in a super vulnerable stage (anyone who's ridden the roller coaster of trying to conceive...), when we could have addressed it sooner?!
This, to me, is truly maddening.
The most important takeaway from this post: PCOS is not an ovarian issue - it is a GUT issue. Addressing gut health will go a long way to improving PCOS symptoms.
what are PCOS symptoms?
If you have been given a PCOS diagnosis and have been advised to seek infertility treatments, know that you have other options. PCOS treatment does not involve petri dishes, hormone shots, egg extraction, etc..
If PCOS is the causal factor in your infertility, it can be addressed dietarily, without the use of expensive infertility treatments.
PCOS IS NOT AN OVARIAN CONDITION - IT IS A GUT ISSUE.
Whether or not you are trying to get pregnant, are done having kids, or don't want kids - if you are a female-bodied person, then you, or someone you know, will probably encounter PCOS symptoms at some point.
Before we really dig in, I want to briefly share my story as it relates to PCOS.
my PCOS story
I was a "late bloomer" (first red flag), did not get my first period until I was 16 or 17. They were irregular from the start and for decades after.
Add to that, I was pretty ignorant of how my body was supposed to function, due to my parents' religious beliefs and consequently a severe disconnection from my body’s needs.
(Um, side note: Can we PLEASE normalize talking to kids about their bodies?!)
Cystic acne from my teen years and many years into adulthood, I have always had excess belly and hip fat (commonly known as PCOS belly), difficulty losing weight, symptoms of low blood sugar, the works.
When I was 18 (ca. 2000) and my periods had still not regulated, I got my first gynecological exam. I was given a prescription for 'the pill' and was told that it would regulate my cycle (and it did).
I didn’t know what I didn’t know. I trusted that my doctor knew what was best. I didn’t understand until later that if that doctor had taken the time to help me find the root causes of my PCOS symptoms, I would have been spared decades of heartache and confusion.
Fast forward to 2009, my partner and I decided we wanted children, so I stopped the pill, and we began trying to conceive. It was a few months without a period that we started to get concerned.
My GYN ordered an ultrasound, and I was diagnosed with PCOS.
The GYN prescribed Clomid (my apologies to anyone who had to encounter me during this time). Clomid is a medication that stimulates an increase in hormones involved in ovulation.
When two rounds of Clomid were unsuccessful, we were left with the decision to come up with the money to pursue infertility treatment or to just keep our fingers crossed.
We left that appointment with broken hearts, as that kind of money was truly foreign to us at the time.
The short story is, we never did have children (and are now very happy with our lifestyle without children). We tried for many years before finally making a very intentional decision to NOT have children.
Being a holistic healthcare provider now has taught me a lot about my PCOS diagnosis and how to address them. And although I no longer want children of my own, I no longer have signs of PCOS symptoms!
PCOS treatment
PCOS occurs when there is an imbalance of hormones. Period.
This imbalance can be caused by a number of things: Pituitary dysfunction, adrenal dysfunction, toxic overload, liver dysfunction...
It often (not always) has very little to do with the ovaries themselves.
PCOS is the end result of other dysfunctions in the body, and symptoms of PCOS can, and often do, make it difficult for a female to get pregnant.
Here’s a brief breakdown of the female reproductive system as it relates to PCOS symptom. For those who want a more thorough explanation, read this article.
Remember that this system requires our brain (hypothalamus) to communicate with the pituitary gland, which releases hormones to stimulate egg growth, which increases estrogen production, and once the egg matures and breaks through the ovary wall, then progesterone is produced. From there, we need our liver to detoxify the excess hormones that are now circulating throughout our body (yes, these hormones need a way out!).
Because other systems in our body use similar pathways, it is easy to create bottlenecks of dysfunction.
The most obvious example as it relates to PCOS symptoms, is blood sugar regulation. You might remember from an article I wrote recently in regards to blood sugar balance, that it is not just about what you eat. It, too, requires your hypothalamus to communicate with your pituitary gland, telling it to produce hormones, that travel to your adrenal glands, telling them to produce other hormones (epinephrine and cortisol), that stimulate the pancreas to release OTHER hormones.... (you get the idea).
When we are chronically stressed (meaning, our body produces cortisol more frequently than it needs to), or we overly consume sugar, processed foods, or medications, we create dysfunction in other systems of our body.
THE GOOD NEWS IS…
Unless your body has an underlying dysfunction within your individual chemical makeup, all of these things can be addressed using dietary and lifestyle changes.
And for those of you who have been told PCOS is the cause of your infertility, knowing this is life-changing.
Effective treatment of PCOS symptoms starts by looking at the root cause. Here’s what individualized PCOS treatment means for you:
reduce PCOS belly, or weight loss in the belly/hips
regulate menstrual cycles
improve ovulation cycle
improve insulin sensitivity
prevent Type II Diabetes
improve skin clarity
Individualized assessments and a customized care plan based on your body’s unique health needs are essential to getting relief from your PCOS symptoms. Anything else is just throwing spaghetti at the wall, and aren’t you tired of doing this?
That being said, there are ways to effectively support common PCOS symptoms with more foundational recommendations.
how to get rid of PCOS
Eat whole foods. Ditch anything that strays from its whole form in any way, as much as possible. Processed foods, and especially refined carbohydrates, lead to inflammatory conditions such as leaky gut, in addition to promoting insulin resistance.
Stop counting calories. You are not doing your body any favors by restricting how many calories are consumed. This is a temptation for many female-bodied individuals, especially because excess weight is often harder to shed with PCOS. The quality of food you consume carries more value than the amount of calories, in regards to hormone balance.
Regulate your blood sugar (here is a great article on how to do that). For many, it involves eating more quality fats & proteins each meal, increasing (whole) fiber, and decreasing the amount of starchy foods, grains, and sugars/sweeteners (yes, even 'low calorie'). Not only will this help your PCOS symptoms, you'll also get less "hangry" symptoms (your friends & family will thank you!)
Stop snacking. Eating more quality fats/proteins and fiber each meal will likely help you feel more satiated (satisfied) and not want to snack anyways. However, a conscious effort to not snack will help improve insulin sensitivity, which will support your adrenal glands and liver function.
supplements to improve PCOS symptoms
**Always consult with a trusted health care practitioner before adding any supplements to your regimen. Additionally, taking supplements without addressing foundational factors (discussed above) is a waste of your money. Click here to read my full Medical Disclaimer.
Myo-Inositol Plus (Bioclinic Naturals)- improves insulin response, and can help lower excess estrogens & testosterone.
HPA Adapt (Integrative Therapeutics)- supports the cohesion of the Hypothalamus, Pituitary, & Adrenal (HPA) axis
Calcium D-Glucarate (Integrative Therapeutics)- Supports the specific detox pathway, called glucuronidation, in the liver needed to deactivate and remove excess hormones, like estrogen and testosterone.
BroccoProtect (Designs for Health)- supports Phase II detox pathways in the liver. Females with PCOS often have sluggish Phase II detox pathways, and BroccoProtect helps to support these pathways to ensure the deactivation and removal of excess hormones.
Megaspore Probiotics (Microbiome Labs)- Introducing a good quality probiotic to support the elimination of excess hormones after they've been neutralized by the liver, is essential to making sure they don't get reabsorbed into your body. Elimination is key!
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What’s your PCOS story?
Share your thoughts on PCOS in the comments below, and help another PCOS warrior feel less alone.
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Common Hormone Balancing Mistakes | Hormone Imbalance | Hormone Balance Supplements
Hormone imbalance is when there is either too much or too little of any hormone. While addressing the effects of the hormone imbalances might help with your symptoms, as a holistic practitioner, my goal is to figure out why there is a hormone imbalance and help you address the hormone imbalance at the root cause.
The following are some common mistakes I see in individuals working to address hormone imbalance, specifically in relation to female sex hormones.
What is hormone imbalance?
Your body is run by hormones, which are chemical substances that are transported throughout the body and act as messengers to stimulate certain actions from cells or tissues.
Hormones regulate many body functions, including:
hunger
fullness
digestion and motility
glucose metabolism (blood sugar balance)
mood
period cycles, menstruation
muscle building
bone density
stress response
thirst
sleep-wake cycle
sexual function
You can see from that list just how important hormones are, and your body works hard to keep them in balance.
Hormone imbalance is when there is either too much or too little of any hormone. While addressing the effects of the hormone imbalances might help with your symptoms, as a holistic practitioner, my goal is to figure out why there is a hormone imbalance and help you address the hormone imbalance at the root cause.
The following are some common mistakes I see in individuals working to address hormone imbalance, specifically in relation to female sex hormones.
Whether you’re working to regulate your period cycle, get rid of PCOS belly, reduce PMS symptoms, dealing with PCOS (now, more accurately named PMOS - Polyendocrine Metabolic Ovarian Syndrome) symptoms (Polycystic Ovarian Syndrome), trying to get pregnant, or approaching menopause, it’s important to work from the ground up.
common mistakes with addressing hormone imbalance
7 of the most common mistakes I see people make when addressing hormone imbalance are:
Not addressing root cause - There are many ways to address hormone imbalance with hormone supplements, medications, or modalities to address symptoms of hormone imbalance like PCOS belly and irregular periods. And these all have their place in some cases, but the biggest mistake I see is not looking for and addressing the reason(s) why your hormones are imbalanced to begin with.
Not prioritizing rest and sleep - A busy lifestyle complete with a lack of boundaries and inability to say ‘no’ will keep your Sympathetic Nervous System activated (fight or flight). When this happens, your brain is actively working to prepare your body to flee a tiger, not regulate ovulation. Other examples of chronic stressors include:
chronic over-exercising
poor blood sugar regulation
people-pleasing behaviors
eating on-the-run
no downtime, or having to “earn” downtime
Ignoring the impact of dietary and environmental toxins - Your body is doing everything it can to deal with what is thrown at it. Many modern products that have been designed to offer us ease and convenience, are loaded with endocrine disrupters and substances that are considered toxic to your body and contribute heavily to hormone imbalance symptoms like PCOS belly, weight gain, and irregular periods. Skincare products, household cleaners, air fresheners, plastics in packaged food and cookware, even low-quality supplements.
Not addressing liver health, gut health, drainage, and bowel movements - Piggybacking on the last topic, your liver is responsible for preparing toxins for elimination from the body. Excess hormones are considered a toxin to the body, if not eliminated. If your liver is congested due to a diet rich in processed foods or is burdened by toxic overload, it will not be able to keep up, and those toxins will be reabsorbed into the body.
Not eating enough (and not addressing digestion) - Skipping meals is a stress to your body and nervous system. But also poor digestive health means you are not able to break down foods and utilize their nutrients, even if you are eating the most nutrient-dense diet.
Not addressing blood sugar - Blood sugar management is not just about how much sugar you consume. It involves eating satiating meals, eating a balance of quality-sourced animal proteins, green leafy vegetables, healthy fats, and whole grains, and minimizing processed foods.
Not getting enough whole-food fiber - I’m not talking about foods engineered to have more fiber content on the nutrition label. I’m talking about fibrous vegetables, fruits, and grains in their whole, unprocessed forms. Fiber binds to bile (from the liver) and toxins and escorts them out of the body (elimination). Fiber is an important part of the detoxification process and is essential to addressing hormone imbalance.
what’s your story?
What’s your experience with PCOS belly, hormone balance, and anything that goes with it? Did you learn anything new from this post or have any questions?
Share your thoughts in the comments below!
And if you want some help figuring out the best course of treatment for your hormone imbalance symptoms and PCOS belly, I can help you figure it out.
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