In a newly-published article by the Lancet (2025), the women’s health condition previously known as PCOS (Polycystic Ovary Syndrome) has been formally reclassified as ‘PMOS,’ or Polyendocrine Metabolic Ovarian Syndrome.1 This name change was the result of a multistep global consensus, established with engagement of 56 leading academic, clinical, and patient organizations, and more accurately reflects the disease’s multisystem pathophysiology.1 Why is the change from PCOS to PMOS so important? It was never just about the cysts. The problem with the previous name, Polycystic Ovary Syndrome, is that it placed the pathological burden on ovarian cysts- which not every woman with ‘PCOS’ even experiences- and completely overlooked the diverse endocrine and metabolic features of the condition. This narrow focus was an incredible disservice to millions of women suffering from the disease because it frequently led to delayed diagnosis, fragmented care and significant stigma around associated symptoms like obesity and hyperandrogenism. Approximately 10% to 13% of reproductive age women around the world are impacted by PMOS, but an estimated 70% don’t know they have it- often because their symptoms seem unrelated to a reproductive disorder.2 The physiological complexity of PMOS results in not just menstrual irregularities and fertility challenges, but also insulin resistance, Type II Diabetes, obesity, cardiovascular disease, sleep apnea, depression, body dysmorphia and female-pattern baldness. Recognizing that this condition is not isolated to the ovaries and opening the range of diagnostic criteria is a huge step forward in improving diagnostic criteria and women’s health care.  PCOS: A brief history Prior to this reclassification and expansion of diagnostic criteria, PCOS was viewed in the medical community as primarily a gynecological or ovarian disorder, assumed to be relatively localized to menstrual and reproductive challenges. The term ‘polycystic ovary’ implies the presence of problematic or pathological cysts in the ovary, which are not truly a feature of the condition. Instead of dangerous or harmful cysts, the condition actually causes an accumulation of multiple small, harmless "follicles" (tiny, fluid-filled sacs that hold immature eggs). The predominant diagnostic for the condition has been the Rotterdam criteria, which diagnosis the disorder based on a) hyperandrogenism, b) oligo or anovulation, and c) the presence of polycystic ovaries. 3 This diagnostic criteria, however, overlooked women whose predominant symptoms manifested as metabolic irregularities, nervous system dysfunction or other hormone imbalances alongside menstrual irregularities or while maintaining relatively normal menstrual function. From PCOS to PMOS: What the new name means The new name more broadly captures the system-wide condition involving hormones, metabolism and ovarian function, and provides a clear picture of what is truly happening in the body: Polyendocrine The condition involves reproductive hormones like estrogen, progesterone and androgens (testosterone), but is not isolated to those hormones. It also involves metabolic hormones like insulin and neuroendocrine hormones like cortisol, highlighting the strong connection between PMOS and mood disorders like anxiety and depression. Metabolic Insulin resistance is a foundational feature of this condition, and influences not just a predisposition to overweight and obesity, but a higher risk for dyslipidemia and cardiovascular disease- emphasizing the cardiometabolic burden of the disease.4 Ovarian Disrupted ovarian function does remain a core tenet of PMOS, however the emphasis on the presence of ovarian cysts is no longer the feature of focus. Ovarian involvement is more heavily weighted on anovulation, irregular cycles, elevated LH:FSH ratio and fertility challenges. The key takeaway, however, is that ovarian dysfunction is recognized as part of the story, not the entire of the story. Labwork for PMOS For women showing up with challenges around weight management, mood and/or sleep disturbance, stress sensitivity, energy management concerns, acne and menstrual irregularities, these features widen the diagnostic lens away from the presence (or lack thereof) of ovarian cysts on an ultrasound. Comprehensive lab work to assess fasting insulin and glucose, hemoglobin A1C (HbA1C), androgen levels, estrogen, progesterone, luteinizing hormone, follicle stimulating hormone and a lipid panel can all be included to pinpoint the root cause to the disruption of metabolic, endocrine and Hypothalamic-Pituitary-Ovarian (HPO) Axis function that occurs with the PMOS story.   Holistic and Integrative PMOS management and interventions Reframing the condition to a whole-body perspective elevates the scope of focus out of just the reproductive tract and into systemic management, prioritizing interventions that support endocrine regulation, metabolic homeostasis and nervous system stability. Diet to Support PMOS From a dietary perspective, the Mediterranean diet (MD), particularly one that is low glycemic, has been shown to be incredibly beneficial for women with PMOS through supporting insulin sensitivity, reducing the inflammatory load, and providing healthy fats for hormone function/balance.5 Periodic adherence to a ketogenic diet (KD) is also an excellent strategy for improving insulin response, reducing body weight and even reducing androgen dominance6– however long-term adherence to a KD diet may not be ideal from a mental health and sustainability perspective, so alternating a few months at a time on a KD diet with longer-term adherence to an MD diet provides a sustainable framework for a nutrition foundation grounded in multisystem balance. Supplements: Herbs and Nutrients to Support PMOS Certain targeted nutrients and botanicals can also fit within this multisystem framework to support the complex hormonal and metabolic picture of PMOS: Myo-inositol is a type of sugar molecule involved in insulin signaling, the metabolizing of carbohydrates and fats, and the production of certain hormones. In women with PMOS, myo-inositol administered for at least 24 weeks was shown to improve their metabolic profile and reduce hyperandrogenism.7 If consuming enough omega-3 fatty acids through the diet is challenging, supplementing with a high-quality omega 3 oil can be an excellent way to support hormone health and manage the inflammation associated with PMOS. Supplementing with omega-3 fatty acids has been shown to reduce androgen levels,8 improve insulin resistance9 and reduce cardiometabolic risk,10 all features associated with PMOS. Berberine, an alkaloid found in many bitter plants including Oregon grape root and phellodendron, has been shown in numerous studies to improve insulin receptor expression and glucose uptake 11. Studies have also shown that berberine is able to mitigate many of the key features of PMOS, including reducing testosterone and FAI, increasing SHBG, and mitigating the clinical symptoms of androgen excess, including hirsutism and acne.12 White peony root (Paeonia lactiflora) has been used in Traditional Chinese Medicine (TCM) for thousands of years as a treatment for gynecological disorders. While the exact mechanism of action is unknown, the constituent paeoniflorin has been shown in pre-clinical studies to regulate hormone production, improve ovarian fibrosis, reduce inflammatory parameters, and modulate aromatase activity to improve follicle development. 13,14 The combination with licorice root, a formula known as Shakuyaku-Kanzo-To in traditional Japanese medicine, has been used to regulate hormone production, particularly androgens 15. In addition to its estrogen-modifying and anti-inflammatory effects, licorice is also considered an adaptogen, making it a powerful ally in supporting the stress-response pathway within the PMOS paradigm.16 Gymnema, known in Ayurvedic medicine as ‘the sugar destroyer,’ is a powerful herb for supporting insulin sensitivity and even modifying sugar cravings. Gymnemic acids, one of the key classes of phytochemicals in the leaf, improve the ability of the pancreas to secrete insulin and lower both fasting and post-prandial (after meal) glucose levels.17 Those amazing gymnemic acids even bind to sweet taste receptors on the tongue,  reducing the ability to taste sweetness and curbing sugar cravings.18 This is an especially important effect for helping with the sweet cravings that often accompany metabolic dysregulation in conditions like Type 2 Diabetes and PMOS. Saw palmetto is another herb that has a long history of use in supporting both male and female reproductive health. The berries have been shown to inhibit the 5-alpha-reductase enzyme, which is responsible for converting testosterone into its more potent form, dihydrotestosterone (DHT).21 This results in an anti-androgenic effect that herbalists rely on for addressing many of the key features of PMOS, including androgenic alopecia (thinning hair), hirsutism and hormonal acne. Animal studies using a PMOS model have shown that Saw Palmetto reduced prolactin elevation and normalized follicle-development,22 actions that support ovulation regularity. Magnesium plays a critical role in glucose metabolism; low magnesium intake/status can worsen insulin resistance, which individuals with PMOS are already at a higher risk of experiencing. Clinical research shows that supplementing with magnesium is able to improve insulin sensitivity, lipid profiles and glucose handling in individuals with PMOS,23 and may also have the benefit of alleviating pain and inflammation associated with PMOS-related menstrual challenges. Cruciferous vegetables like kale, Brussels sprouts, broccoli and Spanish black radish contain compounds called glucosinolates, which modulates estrogen pathways by promoting the metabolism of active estrogen (estradiol) into the safer 2-hydroxyestrone (2OHE1) metabolite rather than the more harmful 16α-hydroxyestrone (16OHE1) 24. This process helps to reduce estrogen-fueled inflammation, alleviate pelvic pain, and improve irregular bleeding 25. Glucosinolates also increases liver detoxification, which helps clear the excess estrogen associated with estrogen dominance. Irregular ovulation and high androgen levels contribute significantly to a state of estrogen dominance in individuals with PMOS. Ovulation is required to trigger the production of progesterone, so when ovulation is sporadic, progesterone plummets and creates a state of relative estrogen dominance. Excess androgens, particularly testosterone, are converted into excess estrogen in fat and other tissues, worsening the imbalance. While working on the underlying endocrine imbalances of low progesterone and high androgens, supporting estrogen detoxification with cruciferous vegetables can help favorably shift hormone balance away from a state of excess estrogen. The Importance of Exercise in Managing PMOS Increased movement through both cardiovascular exercise and resistance training is one of the most powerful tools for addressing the multiple features of PCOS. Exercise supports weight management, insulin sensitivity, mood and endocrine balance. Individuals with PCOS should strive for a minimum of 150 minutes of moderate intensity exercise or 75 minutes of higher intensity exercise per week, with two weight training sessions to build muscle and increase metabolic rate. 26 Clinical Takeaway The most important takeaway here is that while a name change doesn’t change testing and treatment practices overnight, it does validate what women experiencing the condition have long known: this disease is not isolated to the ovaries. Polyendocrine Metabolic Ovarian Syndrome recognizes that this condition is a complex disorder requiring nutritional and lifestyle management across multiple systems, and offers a new opportunity for interventions to drastically improve the quality of life in women living with the disease.   Did you know WholisticMatters is powered by Standard Process? Learn more about Standard Process’ whole food-based nutrition philosophy.   Learn More

Episode 18 - airs May 7, 2026 A Functional Medicine Approach to Remembering the Mother in Maternity Care HOST: Dr. Daina Parent, ND GUEST: Sarah Thompson, Dpl.OM, L.Ac., CFMP, and Birth Doula Sarah Thompson brings a wealth of knowledge and a unique perspective on preparing for motherhood and maternal care. Host Dr. Daina Parent, ND and Sarah Thompson, Dpl.OM, L.Ac., CFMP, and Birth Doula, engage in an important conversation around the need for improved care for the mother in preconception, fertility and pregnancy. They discuss how whole food nutrition, lifestyle, functional lab testing and interpretation, and collaborative care can significantly improve pregnancy outcomes for mom and baby. Throughout the episode Sarah offers clinical pearls on how to improve diets of pregnant patients and influencing positive lifestyle changes. Sarah Thompson is the author of Functional Maternity - Using Functional Medicine and Nutrition to Improve Pregnancy and Childbirth Outcomes and Beyond Results – A Practitioner's Guidebook to Functional Lab Analysis in Pregnancy. She is a certified functional medicine practitioner, licensed acupuncturist, board-certified herbalist, birth doula, and educator with a passion for pregnancy care. She is a leader in the practice and education of maternity functional medicine. Sarah combines evidence-based research in prenatal and maternity nutrition with functional medicine and nutrition principles. Sarah’s clinical experience spans nearly 20 years. Highlights of the episode include: Foods for preconception – antioxidants from colorful whole food fruits and vegetables, omega-3s, and more The Whole Food Matrix – benefits of consuming vitamins, minerals, and phytonutrients in a whole food form Functional approach to interpreting labs during pregnancy Podcast Summary 2:15 Discovering the passion for functional maternity care 5:32 Inspiring birth stories and navigating fear around childbirth 6:52 Opportunities for growth and improvement in conventional model of pregnancy care 8:06 “Prenatal care is the care of the baby. Maternity care is the care of the mother. We have lost the care of mothers through the care of pregnancy.” 9:00 How nutrition and lifestyle affects mother and baby 13:07 Preconception preparation – preparing the body for pregnancy 18:34 Foods for preconception – antioxidants from colorful whole food fruits and vegetables (polyphenols, flavonoids, anthocyanins, and others), omega-3s, and more 22:54 Oxidative Stress Defined 25:22 The Whole Food Matrix – benefits of consuming vitamins, minerals, and phytonutrients in a whole food form 28:09 Managing cravings for unhealthy foods during pregnancy and balancing with nutrient dense foods 30:04 “How do I make what you’re doing work better for you?” - individualized nutritional support 33:04 Simple ways to add polyphenols to meals 36:19 Elevating everyday recipes to increase nutrient density and phytonutrient content 39:42 An individualized approach to herbs in pregnancy 42:52 Functional Medicine approach to common issues in pregnancy 49:43 The interconnectedness of systems and functions of the body in pregnancy 50:59 Modifiable lifestyle factors to improve pregnancy complications 53:47 Functional approach to interpreting labs during pregnancy 1:04:00 Collaboration in Care – it takes a village of practitioners working together to deliver holistic pregnancy care 1:06:00 Advice to practitioners and patients: importance of individualized maternal care and focusing on aspects of pregnancy and birth we can control This podcast is sponsored by Standard Process About Standard Process - Only at SP

Episode 14 - airs November 20, 2025 Why is it that women experience stress more intensely than men? Drs. Daina Parent and Annette Schippel discuss the connection between women’s hormones and the effects of stress on the female body. Dr. Schippel shares her personal and professional experience navigating the stages of a woman’s reproductive journey and how endocrine health plays a significant role in hormone balance. Drs. Parent and Schipple emphasize the importance of working with qualified healthcare providers trained in herbal medicine in order to find the right herbs for each person and symptom picture. Dr. Schippel offers invaluable clinical tools and takeaways to create a strong foundation for any woman to navigate stress management and optimal wellness with nutrition, herbs, lifestyle and more. Dr. Annette Schippel is a chiropractor and a graduate of Logan College of Chiropractic, she brings over 25 years of experience to her work. She owns two thriving family practices that focus on pediatrics, women’s health, and clinical nutrition, and she regularly sees patients from across the United States and around the world. Known for her expertise in functional medicine and endocrinology, Dr. Schippel has become a respected educator, author, and speaker. She has written and co-authored numerous clinician manuals and lectures domestically and internationally on topics in nutrition and functional endocrinology.  She has had the privilege of visiting Medi-Herb in Australia for 3 years to receive advanced training in phytotherapy.  She also had the honor to speak on alternative approaches to Metabolic Syndrome at the 2014 International Health Management Forum in Bejing China. Use the audio player above to listen now! And don't forget to follow and like our podcast channel to stay up-to-date on upcoming episodes. Highlights of the episode include: Female hormones and stress sensitivity Adrenal burnout and perimenopause: the resiliency of the stress response affects hormone balance How herbs modulate and synergize with hormones Podcast Summary 2:24 Female hormones and stress sensitivity 4:00 The HPA Axis and the stress response 5:35 The thyroid adrenal connection 7:57 Cortisol, DHEA and the adrenal cortex 9:15 Prolactin, dopamine and high prevalence of autoimmunity in women 11:30 Key differences in male and female hormones: estradiol, testosterone, and DHEA 15:27 Peri- and menopausal hormone shifts 16:33 Adrenal burnout and perimenopause: the resiliency of the stress response affects hormone balance 21:13 Clinical strategies for adrenal support to mitigate perimenopausal symptoms – diet, exercise, sleep, digestion, and mental health 25:42 Herbs for adrenal support and endocrine balance – rehmania, ashwagandha, chaste tree, schizandra and more 29:33 How herbs modulate and synergize with hormones 30:02 Social media trends – perspectives on ashwagandha 33:06 Why guidance from a healthcare provider with herbal knowledge matters – finding the right herbs for each person 35:35 Choosing the right herb – how patient health history and symptom picture inform herbal selection 44:39 Using blood chemistry to inform patient protocols 45:55 Personalizing herbal protocols for different stages of the lifespan 48:38 Nutrients and herbs for libido and vaginal dryness and how adrenal resilience plays a role in these symptoms 50:32 Circulation, sexual health, and blood-flow support 52:53 Improving vasodilation through nitric oxide; whole foods and herbs that support circulation (beets, mountain spinach, red algae, and more) 54:45 Herbs as modulators – herbs won’t increase or decrease hormones too much 55:16 The truth about wild yam creams 58:54 The practitioner-patient journey - navigating better health together 1:01:51 Key clinical takeaway for supporting women’s health and stress management – how to build a good foundation and never lose sight of what you’re trying to build This podcast is sponsored by Standard Process About Standard Process - Only at SP https://youtu.be/06W6QnbDbSU?si=HhkXX9NerHPbhcDu