Episode 414: PCOS Got a Glow Up (And What PMOS Means for Women’s Health)
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PCOS just got a glow up. This wildly misunderstood condition affects 1 in 8 women and 170 million women worldwide, and has officially been renamed PMOS: Polyendocrine Metabolic Ovarian Syndrome. In this episode, Erin is joined by TFN lead practitioner Rachel Heintz, MS, RDN, IFMCP, FHP-C, to talk about why this name change matters.
Rachel breaks down why the old PCOS label created so much confusion, and how PMOS can impact metabolism, blood sugar, cardiovascular health, skin, fertility, mental health, and more.
This is a whole-human conversation about a whole-body condition, because women are more than “just hormones walking around,” and this condition was never just about the ovaries.
In this episode:
Why PCOS was renamed PMOS, and how the new name reflects what’s actually happening in the body
The four PMOS archetypes Rachel sees most often: insulin-resistant, inflammatory, adrenal, and post-pill
How perfume, dryer sheets, and what’s under your kitchen sink can all matter for endocrine health
The fertility case study that had surprisingly little to do with the ovaries themselves
Resources mentioned:
Experiencing symptoms? It could be related to your gut.
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Rachel:
When we call something ovarian, we often limit the conversation to reproduction and endocrine health. It really is whole body health. This is, again, not just an ovarian issue. PCOS, PMOS, it expands beyond your reproductive health. It can affect your metabolism, your cardiovascular or your heart health, the health of your skin, your fertility, and your mental health as well. So the PCOS name, it just really didn't reflect the complex nature of this condition. And then the confusion around this really led to years of misdiagnosis.
Welcome to the Funk’tional Nutrition Podcast, spelled with a K, because we do things a little differently around here. I'm your host, Erin Holt, and I've got 15 years of clinical experience as a functional nutritionist and mindset coach, creating a new model that I call Intuitive Functional Medicine™, where we combine root cause medicine with the innate intelligence of your body. This is where science meets self trust. Your body already knows how to heal, and this show is going to show you how. If you're looking for new ways of thinking about your health, be sure to follow and share with a friend, because you never know whose life you might change.
Erin:
All right, friends, we are back, and I have my lead practitioner, Rachel, here with me. We are hot off the press of the IFM annual conference. Hi, Rachel.
Rachel:
Hi, Erin.
Erin:
So today we're going to talk about the fact that PCOS, or Polycystic Ovary Syndrome or Ovarian Syndrome just got a glow up. So as of May 2026, very recently, PCOS got a name change. And today we're going to talk about what that means for women's health. The condition impacts a lot of women, 1 in 8, and it affects 170 million women worldwide. So it's a condition that is pretty prominent and also pretty misunderstood. So the new name change is an effort to both improve diagnosis and care of women with this condition. And it was a pretty global effort. There were more than 50 organizations that were part of this name change over the past 14 years.
So it was a long process to develop the new name and it was officially published in the Lancet on May 12, 2026. So super, super recent. So we wanted to talk about it here. So, Rachel, why don't you tell everybody what exactly changed?
Rachel:
So it's the same condition, it just has a better name. PMOS is Polyendocrine Metabolic Ovarian Syndrome. And I want to break down the actual acronym. So Polyendocrine, this means multiple hormone systems are involved in this condition. Metabolic speaks into the fact that we can see a lot of insulin resistance, blood sugar dysregulation, and cardiovascular risk with this condition. And then ovarian, the ovaries are involved in this condition. They're just not the whole picture. And really your endocrine system, it's your body's communication network made up of a bunch of different glands.
So not just your ovaries, but your brain, your pituitary, your liver, adrenals, your thyroid and your pancreas, to name a few. And essentially PMOS or PCOS previously is a multi-system condition, now the name just properly reflects that. And like you mentioned, we were just at the IFM conference and Dr. Deanna Minick, a quote that I pulled from this conference, she said that understanding hormones in women, it requires that we first look at the functioning of the endocrine system. We want to not just focus on the hormones, but look at the whole human as well.
Erin:
And for listeners that listened to last week's podcast, I really talked into this a little bit and was saying that I'm so stoked that we are finally talking about women's health. But we've kind of narrowed down women's health to just hormones. And that's not a problem because we have them. But women's bodies are more than just hormones walking around. And I think Dr. Deanna Minick does such a good job at explaining and emphasizing that everything in the body influences hormones. And our endocrine system, our hormonal system talks to every other system in the body. And so I am hopeful and excited that this new name really reflects that truth.
So let's talk about what the actual problem was with the old name. Like why do people advocate for changing the name?
Rachel:
The Polycystic Ovarian Syndrome, or PCOS, that phrase or the name was misleading. It basically implied that the primary issue or the primary feature of this condition was ovarian cysts. And not every woman with PCOS has cysts on the ovaries. And really, it's never been just about your ovaries. Another quote from Dr. Deanna Minick. This is like a fan club podcast for her. She said, “when we call something ovarian, we often limit the conversation to reproduction”. and endocrine health.
It really is whole body health. This is again, not just an ovarian issue. Pcos, pmos, it expands beyond your reproductive health. It can affect your metabolism, your cardiovascular or your heart health, the health of your skin, your fertility, and your mental health as well. So the PCOS name, it just really didn't reflect the complex nature of this condition. And then the confusion around this really led to years of misdiagnosis as well.
Erin:
Yeah. And it certainly can impact your reproductive health and it can impact fertility, and we see that quite frequently. But it's more than just reproductive health. And the funny thing about this, we keep quoting Deanna because she's the literal best, but she wasn't even talking about PCOS or PMOS in her lecture. She was actually talking about menopause. So this goes beyond just individual conditions to talk about really the whole lifespan of women, everything that we're talking about. But let's drill in a little bit more specifically to PCOS or PMOS. It's going to be hard to like get adjusted to saying the new name.
What are some common symptoms that are associated with this condition?
Rachel:
So we can see irregular or absent cycles. That I feel like is usually when women will oftentimes seek out a diagnosis when they start to miss their periods. They'll have weight loss, resistance, weight gain. Sometimes the weight gain can be pretty rapid. We're going to talk about a case study later where she gained like 24 pounds in a couple of months. We can see the loss of scalp hair. We can also see unwanted facial hair growth, hirsutism.
I never say it right. That's the official.
Erin:
I only know how to read that word. I do not know how to say it out loud. But it's hair growth where you wouldn't want it. Like jawline is an example.
Rachel:
Male pattern hair growth, acne, fatigue, mood swings, oily skin, oily scalp. And then pcos, pmos. It can also be associated with infertility. And so if we just think about this list of symptoms alone, we know that this condition doesn't just affect the ovaries as well.
Erin”
For sure. What would be some drivers or root causes of PMOS?
Rachel:
So the two most common causes that we see in practice are inflammation and insulin resistance. It's a little bit of chicken or the egg here too, because inflammation can cause insulin resistance. Insulin resistance can also cause inflammation. So when we have elevated levels of insulin, this can cause a disruption in the release of the hormones that are involved in ovulation, specifically FSH or LH. Elevated levels of insulin can also cause increased androgen production by the ovaries. Androgens are the more male hormones. So things like testosterone and then elevated insulin can also cause decreased production of sex hormone binding globulin. When we see this, we're going to have higher levels of androgens or testosterone in the bloodstream.
And this is a really hallmark sign of PMOS as well. And like I mentioned, the absence cycles are another really hallmark sign of PMOS.
Erin:
So when we're taking more of a root-cause, systems biology, functional medicine approach, we oftentimes will lump PMOS into one of four categories or types or archetypes. So can you walk us through those four types?
Rachel:
So the most classic type of PMOS is insulin resistant. We typically see high insulin on lab work, and then we can also see high androgens or high testosterone as a result. The second type of PMOS is inflammatory PMOS. And this is where that long term inflammation can increase the output or production of testosterone. And a lot of times on lab work we will see normal insulin. Sometimes insulin will be high, but not always. And then we will see other elevated inflammatory markers. HSCRP is a really easy marker to test on blood work. We can see that a lot with PMOS.
The third type is the Adrenal PMOS. And this is basically when someone has a really elevated stress response. This increases the production of dhea, the production of those androgens. And we can see if we're testing cortisol, it can kind of be all over the board, a little wacky. And then the fourth type is Post-Pill PCOS. So basically when you come off the pill, we can see a really rapid spike in androgens and testosterone. And usually, usually this subsides within three to four months of coming off of the pill. For some people it can take six plus months. But on lab work we would see normal insulin, usually normal HSCRP, but then elevated androgens as well.
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Erin
Okay, and now let's go into the million dollar question that probably everybody wants to know about. How do we address this? How are we approaching this in practice if somebody comes to us with PMOS or suspected PMOS.
Rachel:
So we've always treated PMOS like the whole body condition that it is. So we'll start with the discussion around someone's diet or nutrition plan. We're going to assess glucose control and insulin. We really want them balancing their blood sugar. I say this all the time. We go inflammation hunting. We dive into their gut health. Because so much of your immune system is located in your gut, we like to optimize your nutrient status. We oftentimes, but not always, we'll test your hormones, we'll look at your sex hormones, we'll look at your cortisol, we will evaluate your menstrual cycle. Sometimes we'll monitor for ovulation how frequently you're getting your period. And then we'll also of course talk about endocrine disrupting chemicals and counsel on reducing those as well.
Erin:
And one clinical pearl that I took away because I know we have a lot of practitioners that listen to the show and I did like kind of a clinical pearl dump last week, but I didn't mention this that I thought was really great. So oftentimes in practice we'll have our clients take pictures of their food and send us pictures of their food so they don't have to do like this big food log. But I thought what was a really great idea is to take pictures of your personal care products and send those to your practitioner or if you are a practitioner, having your clients do that because that really showcases how much exposure people are getting to potentially endocrine disrupting chemicals. I would even like go so far as to be like, show me under your kitchen sink, show me your cleaning products. Like what are you getting exposed to? Because not everybody is aware. And I mean we get so like siloed in our thinking. We think that like everybody knows what we know. And the more regular-degular people I talk to out in the mean streets, I'm like, oh, like people are still using perfume, people are still using dryer sheets. Like the majority of people are. And so this stuff is so, so, so important.
And again, just to continue on with our theme of a Deanna Minick fangirl show, I love what she said. She was discussing endocrine disrupting chemicals, especially in relation to the endocrine system, the hormone system. And she also said that this includes emotional toxins. So what are we carrying around all the time that leads to low level inflammation? And if we know that PMOS is an inflammatory condition, we have to think about this too. And so nervous system regulation, emotional wealth, does oftentimes have to come online as part of this discussion. And I, I recognize saying all of this or hearing this on a podcast can feel a little overwhelming. If you're listening to this and tuning into this because you suspect that you have PMOS, it might feel like, okay, well, this is like literally everything. This is my diet, this is my blood sugar, this is my gut, this is my hormones, this is my perfume. This is everything.
And it's kind of like, yeah, it is. It kind of is. And when we're working with someone, it doesn't mean that every single one of these in every single person needs to be addressed or things need to change, but we do need to assess them to see if they are contributing factors for you.
We do work with a lot of chronic inflammatory conditions, things like autoimmunity, endometriosis, MCAs, SIBO, eczema, and of course, PMOS. When people come to us, it's not just one thing we have to move a lever on. It's usually multiple, but those levers look different based on the person, based on the individual, not necessarily based on the condition that they have. And I've really talked about this concept a lot, especially in regards to autoimmunity. Like, people will be like, well, how do I heal rheumatoid arthritis? Or how do I heal Hashimoto's? And it's not so much condition specific, it's really individual specific. It's more like, what do you need? We have to understand why there's immune disregulation in the first place. We have to understand why there's unchecked inflammation in the first place. And that is so individualized to you. So that is why we take a root-cause, systems biology approach in our practice, because we are addressing you as the individual. We are not treating your condition. We are uncovering the reasons why you got that condition in the first place and addressing those individual root drivers that are so specific to you. And that is why we have such a high success rate with our clients, even the clients that have been struggling for years and years, even the ones with chronic conditions, because we take this approach. So let's contextualize all of this a little bit and talk about some actual specific client examples of people that we've worked with in practice.
Rachel:
So right now, Nicole is working with a client. She has PCOS/PMOS, and her goals when she came to us. So she wanted help regulating her hormones. She wanted help losing weight and keeping it off. She had tried GLP1s to get rid of the food noise. It helped a little bit. And then she started to feel really sick. And then another one of her goals is optimizing her longevity, just living as long as possible.
And based on lab work, so stool testing was recommended. Dutch testing and blood work. Stool testing showed she had a lot of inflammatory opportunistic bacteria. So that's a source of inflammation. Dutch testing showed elevated quinolinate on the organic acids profile. This is another marker of inflammation. And then on her blood work, she had elevated HSCRP. So for reference, we want to see this. Less than 1. Hers is 17.4, so pretty elevated. We know that this gal is quite inflamed. She had a positive ANA. So this tells us that there's autoimmune activity present in her body. Her insulin was also elevated. So she was definitely someone where she had a lot of inflammation, but also insulin resistance. Insulin was almost 18. And then on her lipid profile.
Erin:
By the way, yes, that's a high one.
Rachel:
And then triglycerides. So triglycerides are kind of like the bad fats in the bloodstream. When our triglycerides get too high, it can correlate with insulin resistance and metabolic dysfunction as well. So again, her PMOS type, she checks the box for both that inflammatory PCOS based on all the inflammatory markers, but then also that insulin resistance. So the perfect example of how insulin resistance drives inflammation and vice versa for this individual. Treatment strategies have really been focused on treating her gut, balancing her blood sugar, you know, dialing in her diet, and, like, addressing inflammation that's kind of showed up across all of her testing as well.
Erin:
And so based on all of this, would you say the drivers of inflammation were coming from the gut, coming from the diet, coming from the elevated insulin, or sort of like all of the above?
Rachel:
A little bit of all of the above. I think the gut was a big source of inflammation for her, and she wasn't. She came to us not eating in a way that was supportive of her blood sugar. So checks a lot of boxes, for sure.
Erin:
Yeah. And I just want to shout that out too. You know, we've been doing this work for a long time, you know, between Rachel and I, like over 20 years collectively. So that makes me feel old. It kind of comes back to like that siloed thinking of like or just like thinking like. Everybody knows this. And I was really surprised to hear how much food and nutrition came up in the IFM lectures. We were there with doctors and medical professionals, people who were practicing in more of a conventional way and some people practicing in more of a functional way.
And it was really exciting to see how much everything came back to food, nutrition and diet. And I know a lot of people that listen to the show and a lot of our clients already have their diets like super dialed in, super, super squeaky clean. So it's not always the counseling that we have to do, but that is really the first step. And those are levers that you can pull so easily. I don't want to say easily like it's a cakewalk, but those are things that you have so much control over more often than not. And it really, really can move the needle on a lot of these things. So that is really exciting to see.
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Erin
I know that you have another example of someone who came to us specifically for pcos. I'm going to say PCOS because it was still PCOS at the time.
Rachel:
It was. So a former client of mine, when she came to me, her chief concerns were pcos. So she was having bloating, increased hormonal and cystic acne. She had significant weight gain. So she went from 128 to 148 pounds over the course of three to four months. Cystic acne, folliculitis, really fatigued. And then one of her bigger picture goals is she wanted to optimize her fertility and she wanted to get pregnant.
Erin:
Can you just explain what folliculitis is in case somebody's not familiar?
Rachel:
It's basically like inflammation of the follicles in the skin. So just a very inflammatory skin condition as well. Well, not fun.
Erin
And it kind of shows up as like little red bumps sometimes.
Rachel:
And then for her, she even had some like pustules as well.
Erin:
Oh.
Rachel:
So for her lab work, we originally started off with blood work and stool testing. And on her blood work it showed that her blood sugar markers, they looked optimal. A1C was 4.8, insulin was 2.6. Fasting glucose 81. So we knew this was not an insulin resistance picture. Her blood work did show that she had functionally low free T3. So her free T3 was 2.6 and her free T4 was optimal at 1.06. And so we know that T4 gets converted into T3 in our liver and our gut.
And free T3 is really, really important for fertility. We really want to see free T3 greater than 3 for just optimizing likelihood of getting pregnant. So when I saw this on blood work, I'm like, okay, we need to lean into the liver, we need to lean into the gut treatment more. Her stool testing revealed a lot. She had H. Pylori. She had a lot of opportunistic bacteria overgrowing, including autoimmune triggers.
She had Candida. And then on her stool testing, she had elevated steatocyte and this marker. When it's elevated, it means that she has a lot of undigested fat in her stool. So if she's not digesting her fat, she's not getting those fat soluble vitamins. And this is a big problem when you're trying to get pregnant. Right. We want to optimize your nutrient status. Something else that we saw in stool testing, she had elevated beta glucuronidase.
Beta glucuronidase is an enzyme. When it's high, it means that you are reabsorbing estrogens that you should have been pooping out. So thinking about that thyroid profile, the gut, the liver, if you're reabsorbing your estrogens, that's again, more demand on your liver. So treating her gut was essentially a way to take some of the burden off of her liver to then optimize her thyroid to optimize her fertility. So it's all connected. And then another marker on her stool test that was clinically significant is she did have moderately elevated calprotectin. It was 101. I mean, we want to see this in the single digits, as close to zero as possible is what I like to see.
And so for her, you know, this marker to me suggested she had more of an inflammatory response that was driving the PCOS.
Erin:
Yeah. And just calprotectin is a marker of inflammation in the gut, just for those who are maybe not familiar with that term.
Rachel:
So we worked on her blood work, we worked on her gut. Things were moving in the right direction and she was like, okay, I want to optimize. Like, I really want to focus on getting pregnant. Her skin was improving, energy was improving, things were trending in the right direction. We ran an HTMA just to like, fine tune. Pregnancy is a really nutrient dependent process. It's a really mineral dependent process. And, like, let's just fill in any gaps.
I love running HTMA’s for my women who are pregnant or who are trying to get pregnant, even postpartum. Again, just because breastfeeding pregnancy is really nutrient dependent. So the main takeaway is she had low sodium and low potassium on her HTMA. So this could be related to long term stress, long term inflammation. She also had low copper and some of her other micro minerals were more depleted. So again, just more of like a stress inflammation picture. And a month or two after we ran the HTMA, she and I should clarify, she was actually like, I want to get pregnant now and it's not happening. So she was moving forwards with ivf.
And I think like a week before she went in to the IVF clinic, she got a positive pregnancy test. This was early 2024 and her baby was delivered in September of 2024. And really for her, the treatment strategies were removing overgrowths in the gut had nothing to do with ovaries. We supported digestion, we repleted deficiencies, we really leaned into nervous system support. So just like such an amazing example of we treat the whole human. And she was able to reach all her goals.
Erin:
Yeah, that is a really good example of, like, why we have to look at all systems and then also, like, why, as the practitioner, you really have to be a little bit of a detective with the clues that you're finding on labs and really know how to, like, interpret and understand these labs, which is crucial because labs are only as good as the interpretation of them. So to see that thyroid conversion, that was like a little bit wonky and trying to figure out, okay, do we need to go to the liver? Do we have to go to the gut? Is it both actually, is just the hallmark of an excellent provider and clinician, I think. I also like how, you know, like, healing often happens in layers. And so some clients will come in and we'll address, like, the big smoking guns, and then we like, sort of get them to a good place and they're like, okay, now I'm ready to dive into this. Okay, like, now I'm actually ready to attempt to get pregnant and try to conceive. So I just appreciate that because that is something that we're consistently seeing with our clients. And then last thing that I want to say, just because I've been talking about GLP1s so much on the podcast lately and on Instagram, is that Nicole's client is a great example of how GLP1s are not the panacea that sometimes they're made out to be.
I am a fan. I think they have such great use cases, but this is not the magic bullet in every single individual in every single situation. So this is an example of somebody who tried it, didn't have the great, great experience with it, great success with it, and actually needed more of a root cause approach where we had to look at the different systems and address those in order to further move the needle. So this was all great. Thank you so much. Hopefully this helps people understand why the name change is a positive thing, why it's better represents the actual condition and also what you can do about it. If you are struggling with PMOS and if you are in that situation and you need support, that's what we're here for.
So you can fill out an application to work with us in the show notes. Thanks for being on the show, Rachel.
Rachel:
Thank you.
Thanks for joining me for this episode of the Funk’tional Nutrition Podcast. Please keep in mind this podcast is created for educational purposes only and should never be used as a replacement for medical diagnosis or treatment. If you got something from today's show, don't forget, subscribe, leave a review, share with a friend, and keep coming back for more. Take care of you.

