The New Name for PCOS, and the Six Types Most Doctors Never Diagnose

PCOS Is Now PMOS. What the New Name Changes About How You Get Treated For decades, the diagnosis pointed at your ovaries. Cysts. Fertility. Birth control to regulate the cycle, and a shrug for everything else. This year, that changed. Polycystic ovary syndrome was formally renamed polyendocrine metabolic ovarian syndrome, or PMOS, in a global consensus published in The Lancet. The point was not cosmetic. It was an admission that this was never really a gynecological problem. Dr. Terri sits down with Dr. Cassie Smith, MD, dual board-certified endocrinologist, founder of Modern Endocrine, and author of Fix Your Gut, Fix Your Hormones, recorded on location at the EVEXIAS provider training. Dr. Smith has been making this argument for years, long before the literature caught up: the insulin, the inflammation, and the gut come first. The hormones are downstream. And if you only treat the hormones, you never actually fix anything. The conversation runs from the patient who was thin, had no cysts, had one symptom, and whose insulin nobody ever checked, all the way to what is happening right now with GLP-1s, the telehealth prescribing free-for-all, and the muscle loss almost nobody is monitoring. If you have been told your cycles are irregular and handed a prescription, if you are thin but feel metabolically off, or if you are on a GLP-1 and wondering whether you are doing it right, this one is for you. What you'll discover: 00:00 PCOS is officially renamed PMOS, and why the shift moves the focus off the ovaries entirely 00:59 The six different presentations of PCOS, including lean patients with no cysts and normal testosterone 01:42 The thin patient with one symptom, an irregular cycle, and an insulin level nobody ever ordered 03:33 The metabolic dumpster fire: how gut dysfunction drives estrogen, progesterone, insulin, and cortisol out of balance 04:08 What actually happens when you come off birth control after years of symptom suppression 05:36 The lab panel Dr. Smith runs first, including Free T3, insulin, cortisol, and a gut study 06:28 The unsexy basics: sleep, real food, sunlight, walking, and getting off the phone at midnight 07:29 Delayed childbearing, coming off the pill at 33, and the fertility math nobody explains 09:29 Treating PMOS in perimenopause when fertility is no longer the goal 10:50 Low serum testosterone with high free testosterone, and what low SHBG is telling you 11:50 The estrobolome: the gut bacteria responsible for recycling your estrogen 13:39 Why endocrinology and gynecology both missed this for so long 15:32 Fat cells as a full endocrine organ, and the signals they send when they are overfull 17:29 Ten thousand smoke signals: how inflammatory cytokines confuse your immune system 19:51 Skinny fat explained, and how you can be thin with the metabolic profile of someone who isn't 22:09 GLP-1s: what they do well, and how they are being prescribed badly 22:53 There is no magic bullet, and why your health is rent, not something you own 24:34 Telehealth vial-and-titration prescribing, the gray market, and patients with no follow-up 26:52 Doing it correctly: body composition scans, protein, resistance training, realistic timelines 29:44 GLP-1s slow gut motility. What Dr. Smith does to protect the gut long term 30:05 Fiber, hydration, and the two steps that changed one patient's life before she lost a pound The rename was the easy part. Now somebody has to start treating the whole system. The Dr. Terri Show is presented by EVEXIAS Health Solutions. For more, visit: https://www.evexias.com Connect with Dr. Terri: 📱 Instagram: https://www.instagram.com/drterrideneui/ 📱 Facebook: https://www.facebook.com/DrTerriDeNeui 💻 Website: https://hormonehavoc.com/ Learn more about your ad choices. Visit megaphone.fm/adchoices