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PCOS Is Now PMOS: Natural Treatments That Work

PCOS is now called PMOS. Learn how to manage polyendocrine metabolic ovarian syndrome naturally with diet, probiotics, and supplements backed by research.

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Key Takeaways

  • Polycystic ovarian syndrome (PCOS) has been renamed polyendocrine metabolic ovarian syndrome (PMOS) to better reflect its hormonal and metabolic complexity.

  • PMOS involves an imbalance of reproductive hormones and can cause irregular periods, infertility, weight gain, unwanted hair growth, and acne. PCOS is also linked to insulin resistance, metabolic syndrome, depression, and anxiety.

  • A major driver in many cases of PMOS is chronic inflammation that is shaped by diet, lifestyle, and gut health.

  • Research supports diets such as the reduced-calorie and DASH diets to improve PMOS symptoms, as well as healthy fats like omega-3s. Vitamin D, inositol, and other supplements can also improve symptoms.

  • Gut health plays a part in PMOS, and research shows that probiotic supplements can help manage symptoms, including insulin resistance, inflammation, and overweight.

✓ Reviewed by our Scientific Review Board · All claims supported by peer-reviewed research · Last updated April 2026

PCOS Is Now PMOS: Natural Treatments That Work -

Polyendocrine metabolic ovarian syndrome (PMOS), formerly known as polycystic ovarian syndrome (PCOS), affects 1 in 10 women worldwide, and if you’re one of them, you know the condition rarely announces itself quietly 1. Irregular periods, acne, weight changes, fertility challenges, and metabolic shifts can all be part of the picture.

The name change, officially published in The Lancet in May 2026 2, reflects what clinicians have long understood: this is a complex hormonal and metabolic condition, not simply a problem with ovarian cysts. The new name opens the door to better diagnosis and more complete care, which is great news for the millions of women who’ve gone undiagnosed or undertreated for years.

What’s also true is that a great deal can be done to manage PMOS naturally. Diet, gut health, targeted supplementation, and lifestyle changes have all shown meaningful benefits in clinical research. In practice, many women see significant improvement when these pieces come together.

This guide walks through what the evidence supports and what tends to work.

What Is PMOS?

Polyendocrine metabolic ovarian syndrome (PMOS) is a complex condition of imbalanced reproductive hormones. At its core, it involves an imbalance in reproductive hormones, most commonly an excess of androgens, the hormones often referred to as “male” hormones, with testosterone being the main one. This imbalance can affect everything from your menstrual cycle to your skin, weight, and fertility 1. 

Despite the name change from PCOS, you may still hear about “polycystic ovaries”, but research has confirmed that abnormal cysts aren’t actually a defining feature of the condition. A PMOS diagnosis requires only two of the following three criteria 3:

  • Polycystic ovaries on ultrasound 
  • Irregular or absent periods 
  • Elevated androgens (especially testosterone) or signs of hyperandrogenism (like excess facial and body hair, acne, and androgenic alopecia)

Among people with PMOS, 80% tend to gain weight and have a higher-than-normal BMI, while the remaining 20% have so-called “lean PMOS” and are a healthy weight 4.

Other common signs and symptoms of PMOS are:

  • Persistent acne or oily skin 5
  • Dysglycemia (imbalanced blood sugar) 2
  • Darker or thicker patches of skin on the back of the neck or armpits, or under the breasts 5
  • Infertility 5 
  • Metabolic syndrome (including insulin resistance and increased risk for heart disease) 2
  • Metabolic dysfunction-associated steatotic liver disease (formerly called non-alcoholic fatty liver disease) 2
  • Depression and anxiety 6 7

Additionally, more than half of women with PMOS develop type 2 diabetes by the time they turn 40 8.

An underlying driver in many cases is chronic low-grade inflammation 9, which is shaped significantly by diet, lifestyle, and gut health. That’s where there’s a lot of room to make a difference.  

Best Diets for PMOS

Eating fewer highly processed, non-nutritious calories plays a major role in improving PMOS for most people with the condition, particularly when fat loss is a goal 10. 

In fact, the main evidence-based dietary recommendation is to reduce daily calories in order to lose weight and improve metabolic and hormonal health 11 12. 

However, losing weight is easier said than done if hormones and metabolism are working against you, as they might be in PMOS. For people with PMOS, the key is finding a dietary sweet spot that naturally reduces calorie intake while keeping you full, satisfied, and well-nourished.

Below is a table of some of the diets studies have shown can help with weight loss and PMOS symptoms. These are listed in order of strongest to weakest evidence. But remember, what works in the real world for each person with PMOS might vary.

Diet What's Involved? What the Research Says

Reduced-calorie diet*

Cutting down on calorie-dense foods and portion sizes while emphasizing nutritious foods that help you feel full. Most of the lower-calorie diets that show a benefit for PMOS also advocate exercise to increase the calorie deficit 13 14.

Low-calorie diets may be the most effective for weight management in PMOS 15. Reduced-calorie diets can improve body composition 13 15 16 17, reproductive hormone levels 16 17 18 19, insulin resistance 14 17 18 20, and inflammation 13 17 18.

DASH (Dietary Approaches to Stop Hypertension) diet

The DASH diet is a whole-food, lower-sodium diet that focuses on a variety of fruits, vegetables, low-fat dairy products, whole grains (like brown rice or quinoa), nuts, seeds, legumes (such as beans and lentils), lean meats, poultry, fish, herbs, spices, and olive oil, as well as avoiding added sugar 21.

*Metformin is a drug often prescribed to help PMOS patients manage insulin resistance and diabetes.

Lower carb/higher protein

Lower-carb, higher-protein diets have fewer or smaller portions of carbohydrate-rich foods (like bread, potatoes, pasta, rice, and sugary foods). Instead, they focus more on lean protein (such as lean meats, fish, and poultry), plant proteins (like soy products and pea protein powder), and non- starchy veggies (like leafy greens and cauliflower).

In people with PMOS, low-carb, higher-protein diets (particularly those that are also lower in fat and total calories) may reduce body weight 22 23 24 and improve blood sugar regulation 22, insulin resistance 12 20 23, inflammation 18, and hormone balance 12 23. In contrast, a high-carb diet may increase androgens (e.g., testosterone) 12.

Keto (ketogenic) diet

Ketogenic diets are extremely low in carbs and high in fat. The idea is that keto dieters stay in a state of ketosis (which is when the body’s main fuel is fat).

Some clinical trials have shown that PMOS patients with liver dysfunction and obesity can gain metabolic benefits (like weight loss and healthy blood sugar and cholesterol) and improve their liver health on a ketogenic diet 25 26. Menstrual cycles and hormone levels may also improve 25 26.

*If you are pregnant, breastfeeding, or planning to conceive, a low-calorie diet may not be the best option for you. It’s important to consult with your healthcare provider to ensure you are meeting your nutritional requirements. 

Although it hasn’t been specifically researched for PMOS, the Paleo diet is another diet that my clients with PMOS often find helpful. This diet cuts out refined carbohydrates and focuses on good-quality proteins, nuts, fresh vegetables, and berries, all of which help reduce blood sugar levels 27 28 and might help balance hormones 29.

Healthy Fats

Incorporating healthy fats into the diet is important for people with PMOS. That’s because dietary fats are essential for regulating inflammation 30. 

A good rule of thumb is to include a small portion of healthy fat with every meal. Extra-virgin olive oil, avocados or avocado oil, flaxseeds or flaxseed oil, fatty fish, nuts, and chia seeds are all good options for reducing inflammation and supporting healthy hormone production. Anti-inflammatory omega-3 fats (DHA and EPA) have notable benefits for PMOS, with studies showing benefits for insulin resistance, metabolic health, and cholesterol balance 30. 

Omega-3 can be difficult to get enough of without intention; the best sources of omega-3 (DHA and EPA fats) are fatty fish (like salmon, sardines, and herring). Plant sources of omega-3 (like walnuts, flax, and chia) provide a different type of omega-3 called ALA that the body must convert to DHA and EPA.

If you’re not getting enough healthy fat in your diet, a fish oil supplement may also be helpful.

How Gut Health Affects PMOS

Your gut health and your hormones are more connected than most people realize. For women with PMOS, that connection is particularly significant.

Multiple studies have found that women with PMOS tend to have less diverse gut bacteria than women without the condition 31 32 33 34. This matters because lower bacterial diversity appears to be associated with two core features of PMOS: insulin resistance and elevated testosterone.

Here’s how researchers think it works. When gut bacteria are out of balance, the gut lining can become more permeable (aka leaky gut). This allows harmful substances to enter the bloodstream, triggering an inflammatory response that interferes with how insulin functions. In fact, genetic evidence suggests this isn’t just a correlation—certain gut bacteria may directly contribute to PMOS, rather than just showing up alongside it 35.

More recent research adds another layer: Women with PMOS tend to have lower levels of the bacteria that break down bile acids. When those bacteria are lacking, certain bile acids accumulate, and this buildup appears to further disrupt gut bacteria and weaken the intestinal lining 36.

Can Fiber Help PMOS?

Feeding beneficial gut bacteria with plenty of plant fiber can help them produce short-chain fatty acids, which support both metabolic and hormonal health 37. Some clinical research confirms that women with PMOS can benefit from increasing their fiber intake, but the keyword is gradually 37 38.

For women with a sensitive stomach, food intolerance, or IBS-type symptoms, adding too much fiber can create digestive upset. In those cases, starting with probiotics is often a gentler and more effective first step, as probiotics offer some specific benefits for PMOS beyond gut health alone.

Probiotics Work for PMOS 

Probiotics can offer valuable support for managing PMOS via their microbiome benefits. For this reason, they are usually the next step I recommend to my clients after they’ve made healthy diet changes.

Numerous meta-analyses show that probiotics can significantly improve various aspects of PMOS, including 39: 

  • Insulin sensitivity 39 40
  • Triglyceride levels 39 40
  • Inflammation 39
  • Hirsutism (excessive hair growth in unwanted places) 39
  • Testosterone levels 39
  • Overweight 39
  • Antioxidant balance 39

That said, some research has found that probiotics may be less useful for helping with hormonal balance 39, body composition 41, and blood sugar control 41 42. However, there are no known downsides to taking probiotics, so it usually makes good sense to try them.

In our clinic, we often find clients respond best when we use probiotics from multiple categories rather than relying on a single strain or species.

  • Lactobacillus and Bifidobacterium blend 
  • Saccharomyces boulardii (a beneficial yeast)
  • Soil-based probiotic, typically a Bacillus species

For those who respond well to this combined approach, a formulation that includes all three categories in one product simplifies things considerably and has the added benefit of being shelf-stable and easy to travel with.

Lifestyle Support for PMOS: Exercise, Sleep, and More

Diet and lifestyle modifications, especially exercise, remain a cornerstone of PMOS management. Other lifestyle changes that reduce stress and insomnia can have a big impact, too. I’ll describe my favorite ways to help people change their lifestyle and form habits that will support hormone health.

Best Exercise for PMOS

Many types of exercise show promise for improving the symptoms of PMOS. High-intensity interval training (HIIT) has the strongest evidence for improving insulin resistance and BMI 43, but yoga and tai chi have also shown meaningful benefits for hormone levels, testosterone, and menstrual regularity 43 44 45. The best exercise is ultimately the one you’ll do consistently.

Sleep Tips for PMOS

Sleep disturbances are very common in people with PMOS 46. Practical steps for better sleep that make a real difference include getting morning sunlight, keeping consistent sleep and meal times, avoiding caffeine after midday, limiting evening light exposure, and keeping the bedroom cool and dark 47 48 49. For more persistent insomnia, CBTi (cognitive behavioral therapy for insomnia) 50 and acupuncture both have clinical support 51. 

Mental Health and PMOS

Unfortunately, PMOS often introduces depression, anxiety, and a lower quality of life 2. But the good news is that a couple of interventions can support mental health in people with PMOS. These are: 

  • Cognitive behavioral therapy (CBT), which can reduce depression in women with PMOS 52
  • Mindfulness-based stress reduction (MBSR), which, in one randomized controlled trial, cut the worries of PMOS patients in half compared to those who didn’t do MBSR 53.

Other Potentially Useful Supplements

A gut-healthy diet with probiotics and healthy lifestyle changes are central to how we balance hormones with PMOS clients at the clinic. However, for clients who need extra help to restore their hormonal balance, the following supplements are also worth considering.

Inositol

Sometimes mistakenly grouped with the B vitamins (it’s actually a naturally occurring sugar), inositol has been shown to significantly improve the likelihood that women with PCOS will begin having regular periods again 54. Inositol is also as good as the diabetes medication metformin at improving body mass index, hormone levels, blood sugar, and insulin in people with PMOS 54 55. 

DOSE: Studies used a range of 600–4,000 mg/day for 7–24 weeks, but always work with your doctor to get the right dose for you. Myo-inositol (or just “inositol”) is the type used in studies and what to look for in supplements.

Vitamin D 

Of all the true vitamins studied for PMOS, vitamin D has the most promising effects on menstrual cycle regularity. In a meta-analysis of 12 studies, 56. 

DOSE: When working with clients who might benefit from vitamin D supplementation, I recommend they start by testing their current vitamin D levels. Depending on their starting point, they’ll typically need to take between 400 and 2,000 IU vitamin D per day to achieve the 100–125 nmol/L (40–50 ng/mL) vitamin D level that I think is optimal 57 58 59. It’s always ideal to work with a trusted clinician to get your levels right.

For better absorption and utilization, choose vitamin D3 rather than D2 60. Combining D3 with vitamin K can also support bone mineral density 61.

Omega-3 Fatty Acids

A meta-analysis showed that omega-3s can help reduce waist size, blood sugar, insulin resistance, triglycerides, and LDL cholesterol in PMOS patients 62.

DOSE: The study found that any amount of omega-3s from fish oil or flaxseed oil was helpful. Work with your doctor to find the form and dosage best for you. 

Vitamin E

A meta-analysis found that vitamin E, a powerful antioxidant, helped reduce triglycerides, LDL, and total cholesterol, as well as C-reactive protein (a marker of inflammation) and unwanted hair growth in women with PMOS. Vitamin E also increased nitric oxide (an important chemical messenger that helps blood flow) 63.

DOSE: Most studies used 400 mg/day for 8–12 weeks, but ask your doctor what’s right for you.

Coenzyme Q10 (aka CoQ10 or Ubiquinol)

CoQ10 is a vitamin-like substance that is part of every cell in your body. It helps your mitochondria produce energy and protects your cells from damage.  

CoQ10 is also naturally present in some foods, such as liver and other organ meats, fish, and chicken. 

Research suggests that CoQ10 supplements can also improve insulin resistance, blood sugar, sex hormone levels, testosterone, triglycerides, and cholesterol in women with PMOS 64.

DOSE: Doses of between 50 mg and 300 mg are typical. Ask your doctor what is likely to work best for you.

Chromium 

This trace mineral plays a role in how insulin helps the body regulate blood sugar levels. A meta-analysis of randomized controlled trials found that chromium (as chromium picolinate) can help reduce BMI, free testosterone, and insulin levels in patients with PMOS 65.

DOSE: Studies used 200–1,000 micrograms/day for 8–24 weeks, but please ask your doctor what dose is right for you.

Resveratrol

Resveratrol is a polyphenol (type of plant chemical) found naturally in grapes and other fruits and vegetables. It has antioxidant and anti-inflammatory effects, and one meta-analysis found that it helps reduce total cholesterol and improve acne severity in women with PMOS. It also lowered excess prolactin, but did not improve other hormones 66.

DOSE: Studies found benefits when patients used 800–1,500 mg/day resveratrol for 40–90 days, but check with your doctor. 

Herbal Blends 

Several herbs may help to balance hormones in general and for people with PMOS. When I’m using herbals in clients with PMOS, I’ll usually recommend a proprietary blend (Progest-Harmony or Estro-Harmony), depending on symptoms and whether they’re pre- or postmenopausal. Which herbs may be best for you is something to figure out with your healthcare provider and may take some trial and error.

Here are some potentially useful herbs to look out for:

  • Berberine can improve insulin resistance in those with PMOS 67
  • Chasteberry (aka Vitex) may lower prolactin and improve menstrual regularity in PMOS, and it might help with infertility issues 68
  • Black cohosh may improve pregnancy rates when used alongside clomiphene citrate (a medication that can stimulate the ovaries to produce eggs) in women with PMOS 68
  • Licorice may reduce testosterone levels in women with PMOS 68
  • White peony (also known as Chinese peony): When combined with licorice, it may help reduce testosterone, and when combined with cinnamon, it may help improve ovulation in PMOS patients 68

PMOS FAQs

The Bottom Line on PMOS

Though managing PMOS (formerly named PCOS) is challenging, understanding the condition and making targeted diet and lifestyle changes can significantly improve your quality of life. 

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Research shows that inflammation and poor gut health often play a significant role in the insulin resistance and higher testosterone levels that occur in PMOS. Addressing these by eating a balanced diet, supplementing with probiotics, making positive lifestyle changes, and possibly adding other targeted supplements can improve symptoms, fertility, and overall quality of life.

However, if you are finding PMOS or other hormonal issues too tricky to resolve alone (or if you can’t find a practitioner to fit your needs and help you), we’d be delighted to help. Just reach out to one of our experienced health practitioners. If digging deeper into gut-healing therapies interests you, you may also benefit from reading my book, Healthy Gut, Healthy You.

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Dr. Michael Ruscio is a DC, natural health provider, researcher, and clinician. He serves as an Adjunct Professor at the University of Bridgeport and has published numerous papers in scientific journals as well as the book Healthy Gut, Healthy You. He also founded the Ruscio Institute of Functional Health, where he helps patients with a wide range of GI conditions and serves as the Head of Research.

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