From PCOS to PMOS: Why Your Treatment Needs to Be Personalised

If you've been told you have PCOS, there's a good chance you've heard some version of the same advice: exercise more, lose weight, cut back on carbohydrates, manage your stress and come back when you're ready to have a baby.

Sometimes those things are appropriate.

But PMOS is not one-size-fits-all. And if you've been doing everything you're “supposed” to do without seeing the changes you hoped for, that doesn't necessarily mean you're failing.

It may mean we need to look more closely at what is actually driving your presentation.

Because there has just been a pretty significant change in how we understand and talk about this condition.

PCOS has a new name

In May 2026, polycystic ovary syndrome (PCOS) was officially renamed polyendocrine metabolic ovarian syndrome (PMOS).

The change came after a global consensus process involving health professionals, researchers and people living with the condition. The reason? The old name didn't really tell the whole story.

“Polycystic ovary syndrome” makes it sound as though this is primarily a problem with your ovaries — or that having ovarian cysts is somehow central to the condition.

Neither is quite right.

PMOS is a complex endocrine and metabolic condition that can affect reproductive health, ovulation and fertility, but also metabolism, weight and body composition, skin and hair, sleep, psychological wellbeing and long-term health. And while you may still see “PCOS” everywhere for a while, PMOS is now the updated terminology.

The name change doesn't mean your diagnosis or treatment suddenly changed overnight. The current international evidence-based guideline remains the basis for care.

But I think the shift in language is important because what we call a condition influences how we think about it.

And if we think of PMOS as only a fertility or ovarian problem, we risk missing a lot of the picture.

So what does PMOS actually look like?

This is one of the tricky things about PMOS: it doesn't have one “look”.

For one person, it might look like long, irregular or absent periods and difficulty ovulating.

For another, it might be acne, unwanted facial or body hair, scalp hair thinning or other signs of androgen excess.

Someone else might be struggling with insulin resistance, changes in body composition, blood sugar regulation or weight — while another person with PMOS may be lean and have none of the stereotypical body changes associated with the condition.

It can intersect with mood, sleep and quality of life, too.

And fertility may be a major concern for one person while being completely irrelevant to another at this point in their life.

This is why I don't love the idea that there is one “PCOS diet” or one universal PMOS treatment plan.

There is a condition. There is your presentation. And there is what you actually want help with.

Those things need to be considered together.

Your period is a vital sign.

If you're living with PMOS, your menstrual cycle is worth paying attention to — whether or not you're trying to get pregnant.

Your period isn't just an inconvenience that arrives every few weeks. Your cycle gives us information about what's happening with your reproductive hormones and ovulation.

Irregular, very infrequent or absent periods can be a sign of ovulatory dysfunction, and this is one of the core features considered when diagnosing PMOS.

And yes, if you're trying to conceive, ovulation obviously matters.

But if you're not trying to conceive, it still matters.

You don't need to want a baby for your menstrual cycle to be clinically relevant.

At the same time, an irregular cycle doesn't automatically mean “it's your PCOS”.

This is one of the reasons individual assessment matters. Hypothalamic amenorrhoea, for example, can also cause absent periods and can overlap with the kinds of people who are sometimes diagnosed with PMOS — particularly in the context of low energy availability, significant exercise or stress.

The answer isn't always to eat less and exercise more.

Sometimes the answer is quite the opposite: your body needs more fuel, more recovery and less physiological stress.

That distinction matters.

There isn't just one kind of PMOS

You may have come across the idea that there are four types of PCOS: insulin-resistant, inflammatory, adrenal and post-pill.

You'll see these categories used frequently in functional and naturopathic health spaces.

They're not officially recognised medical subtypes of PMOS, so I wouldn't use them as diagnostic labels.

But I do think there is value in asking a different question:

What physiological patterns are contributing to this person's presentation?

Because two people can meet the diagnostic criteria for PMOS and have very different experiences.

One person may have prominent metabolic dysfunction and insulin resistance.

Another may have significant androgen excess, acne and hair changes.

Another may have irregular ovulation alongside low energy availability and a history of restrictive eating or high training loads.

Someone else may have a mixture of several of these factors.

And that's where things get interesting.

You don't necessarily have to fit neatly into one box.

Insulin and metabolic factors

Insulin resistance is an important part of the physiology of PMOS for many people, although it isn't present in exactly the same way in everyone.

Insulin and androgen physiology are closely connected, and metabolic health can influence ovulation, body composition and long-term cardiometabolic risk.

But here's the part I think gets missed:

Not everyone with PMOS needs to lose weight.

The international guideline recommends healthy lifestyle behaviours for people with PMOS regardless of whether they are in a higher or lower weight category, and specifically recognises that healthy lifestyle interventions can have benefits even without weight loss. It also emphasises individualised goals and awareness of weight stigma.

So if you're already lean, highly active and eating very little in an attempt to “fix your PCOS”, simply doubling down on restriction may not be the answer.

Androgen excess

Androgens are often at the centre of PMOS, particularly when symptoms include acne, unwanted facial or body hair or scalp hair thinning.

But again, there isn't necessarily one reason for elevated androgens, and symptoms don't always perfectly match what's happening on a blood test.

This is why looking at the whole picture matters.

Your symptoms, cycle history, clinical signs and appropriate pathology all contribute to understanding what's happening.

Inflammation

Inflammation is another area that gets talked about heavily in functional health spaces.

There is evidence of a relationship between PMOS and inflammatory processes, but “inflammatory PCOS” isn't a formal diagnosis — and I don't think every symptom someone with PMOS experiences should automatically be attributed to inflammation.

It is one potential piece of a much bigger puzzle.

Energy availability and the PMOS/HA overlap

This is an especially important one.

If your periods are irregular or absent, it's tempting to assume that your PMOS is simply getting worse.

But if you're under-fuelling, exercising heavily, experiencing significant stress or not recovering adequately, hypothalamic amenorrhoea may also be part of the picture.

This is one reason I am very wary of blanket advice to “exercise more and eat fewer carbs” for every person with PMOS.

Your body needs enough energy to feel safe enough to reproduce.

More exercise is not automatically better. More restriction is not automatically better. And “healthy” behaviours can become unhelpful when they're pushed beyond what your individual physiology can support.

So why isn't there one perfect PMOS treatment plan?

So why isn't there one perfect PMOS treatment plan?What can you actually do?

The good news is that there is a lot you can do.

Lifestyle is genuinely an important part of PMOS management. But lifestyle does not have to mean punishment, restriction or trying to make your body smaller.

The international guideline does not recommend one specific diet for everyone with PMOS. Instead, it supports sustainable healthy eating and physical activity, with goals developed around the individual.

For many people, that means building meals around adequate protein, fibre-rich whole foods and plenty of plant diversity. It may mean paying attention to carbohydrate quality and quantity without unnecessarily eliminating carbohydrates. It may mean supporting blood sugar regulation without turning every meal into a mathematical equation.

It may mean resistance training to support muscle and metabolic health — but also making sure you're actually recovering from the training you're doing.

It may mean prioritising sleep, looking at stress and nervous-system load, addressing nutrient inadequacies, reviewing medications or hormonal contraception, and investigating other factors that could be contributing to your symptoms.

And sometimes it means using conventional medical treatment.

Being interested in naturopathy does not mean being anti-medicine.

Medication, fertility treatment, hormonal therapies and other medical interventions can be incredibly useful tools. The goal isn't to replace good medical care. It's to make sure you have the support, information and individualised strategy you need to make the best decisions about your health.

PMOS doesn't necessarily end when your periods do

There's one more part of this conversation that deserves much more attention.

PMOS is often discussed through the lens of periods, ovulation and fertility — understandably, because those can be significant features of the condition.

But the metabolic and endocrine aspects don't necessarily become irrelevant simply because you're no longer trying to conceive or because your periods have changed with age.

In fact, perimenopause and menopause introduce another whole layer of metabolic, hormonal and cardiovascular considerations.

So if you've been told you have PCOS and you're approaching, going through or well beyond your reproductive years, don't assume that the condition has simply disappeared.

Your reproductive symptoms may change. That doesn't mean the whole picture stops mattering.

I'll unpack this in much more detail in a separate article.

You don't need to become an expert in PMOS overnight

If you've lived with PCOS for years, you may have tried a lot.

Maybe you've tried going low-carb. Maybe you've cut out sugar. Maybe you've exercised more. Maybe you've lost weight. Maybe you've gained weight. Maybe you've taken supplements. Maybe you've taken the pill. Maybe you've been told to come back when you're ready to have a baby.

And maybe some of those things helped.

Or maybe they didn't.

That doesn't mean there’s no hope.

It may simply mean that nobody has taken the time to step back and look at your version of PMOS as a whole.

That's the part I love about individualised care.

We can look at your symptoms, your cycle, your health history, your nutrition, your lifestyle, your pathology, your goals and — importantly — what you've already tried.

Then we can work out where the most useful levers might be for you.

Your PMOS journey probably looks very different to someone else’s— because it is.

Your care should match this.

If you've been diagnosed with PMOS/PCOS and feel like you've tried the usual advice without getting where you want to be, I'd love to help you make sense of the bigger picture.

At Sol, we take an individualised approach to women's health, with a focus on understanding what's happening beneath the symptoms and giving you practical, sustainable strategies to support your health.

You don't need to navigate it all on your own.

This article is for educational purposes and is not a substitute for individual medical advice, diagnosis or treatment. PMOS can involve complex reproductive, endocrine and metabolic considerations and working with your GP and/or relevant medical specialists is recommended.