ThriveHer Ep 27: It’s Not About the Ovaries: Why PCOS Is Being Renamed — And Why It Changes Everything

Speaker A: 00:00:03

Welcome to the ThriveHer podcast where we empower women to take control of their unique health conditions and wellness journey during perimenopause and beyond. Our goal is to help you dream big and reach your fullest potential in every part of your life.

Each week the podcast dives into expert insights, natural solutions and inspiring stories to support you on your journey. And now, here's your host, your no nonsense naturopath, Rochelle Wade.

Speaker B: 00:00:31

There is a name that about one in eight women carry through their adult lives. A name that affects fertility, metabolism, mood, skin, hormones.

A name that has shaped the way millions of women understand their bodies and themselves. Pcos, Polycystic Ovary Syndrome. Except here's the thing. A significant number of women who have it don't actually have polycystic ovaries.

And this week, the Lancet, the most respected medical journal in the world, published the outcome of a global consensus process that officially gave this condition a new name. And I'm going to tell you what that name is, why the old one was causing real harm, and what it actually means for you.

Now, for those that don't know me, I'm Rachelle Waite and I do hold master's degrees in reproductive medicine, women's health medicine, and immunology with a focus on autoimmunity. This is exactly the territory my training was built for. Most women here, Polycystic Ovarian syndrome.

And they picture cysts on their ovaries and that's what the name tells them to picture. But those cysts aren't cysts. They're actually follicles, immature egg follicles that haven't developed properly.

And here's what most women and a lot of GPs don't know. Up to 30% of women with PCOS diagnosis have completely normal looking ovaries on an ultrasound. Nothing unusual at all.

So the name has been wrong from the start. What this condition actually is, at its core is a metabolic and hormonal problem. The hallmark is elevated androgens.

That's what we consider the male type hormones, testosterone being the main one. And the driver in most cases is insulin resistance.

And when your cells stop responding properly to insulin and your body produces more of it, and that excess insulin tells your ovaries to produce more testosterone, that's the mechanism. That's what's actually happening. The result, irregular cycles, difficulty conceiving, acne that won't clear.

Hair thinning weight that won't shift no matter what you try. Brain fog, mood instability, exhaustion that doesn't match how you're sleeping does this Sound familiar?

Here's where the clinical problem gets serious. A woman goes to her gp, irregular cycle, skin issues, weight she can't shift. Ultrasound comes back normal.

Doctor says you don't have pcos, sends her home. But she does have it. The diagnosis only actually requires two or three criteria. Irregular cycles, elevated androgens or polycystic ovaries.

On a scan, two out of three, you don't need polycystic ovaries. But because the name of the condition includes the words ovary and cyst, women do keep being missed.

And they leave their appointments blaming themselves for something that was never their fault to begin with. So what did 56 leading global organisations, 14,360 survey respondents and years of international workshops to see decide to call it instead?

Polyendocrine Metabolic Ovarian Syndrome. Pmos. Now, before your ears and eyes glaze over, stay with me.

Because every single word in the name was chosen deliberately and understanding it changes how you think about your own health. Polyendocrine. Poly, meaning multiple. This condition doesn't involve one hormone problem. It involves multiple hormonal systems.

Insulin, androgens, the neuroendocrine system. It's all dysregulated, all interacting. And that's a fundamentally different picture to the one gland misbehaving. Then we look at metabolic.

Because insulin resistance is central to everything. This is not just a reproductive condition with some metabolic side effects, it's a metabolic condition that affects reproduction.

The distinction changes the entire treatment conversation. Ovarian. Because ovarian dysfunction is real. The follicle disruption, the ovulatory problems, the hormonal dysregulation coming from the ovaries.

It's not just cysts. And that's the most important change. No cysts, because that word is gone.

Because it was never accurate and it's been misleading women and their doctors for decades. So why does this matter so much? Because the name shapes the investigation.

When a GP hears polycystic ovary syndrome and the ultrasound's clear, they rule it out.

When the name says metabolic and polyendocrine, the investigation goes somewhere completely different, the treatment goes somewhere different and potentially so does the outcome. This isn't a rebrand, it's a correction that's been a long time coming.

Now, the reason I bring this up is I want to take this somewhere that almost no one else seems to be covering. PMOS does not disappear at menopause.

For many women, symptoms actually get worse during perimenopause and they get bl and it gets blamed entirely on perimenopause Now, I see this in my clinic more than anything else. A woman in her early 40s, she's had a PCOS diagnosis for years. Years, or she's been told that she's grown out of it.

She's now got irregular cycles, worsening insulin resistance, skin flaring up, mood all over the place, sleep disrupted. And, wait, she can't explain. And her GP puts it down to perimenopause.

And look, it might be perimenopause, but it is also her underlying PMOS picture being amplified by the hormonal changes of perimenopause. Here's why. Oestrogen plays a direct role in insulin sensitivity.

As estrogen drops in perimenopause, insulin resistance worsens in a woman who already has metabolic disruption, which is what PMOS is. That drop accelerates everything. These aren't two separate conditions happening at the same time. It's the same body at a different life stage.

And that's why having a clinician who understands both is not optional. It's essential. So this has been pretty heavy, science wise. But now you know what this condition actually is.

You know why the name was wrong and what the new one means. And you know why perimenopause can make it so much harder to untangle. The question I always get at this point is, okay, so what do I actually do?

The honest answer is actually quite a lot. But none of it's complicated once you understand the mechanism. So let me walk you through what matters most. Blood sugar. First.

If you have PMOs or suspect you do, the most powerful thing you can do is stabilise your insulin environment. Not through restriction, through strategy.

Protein at every meal, fats that support your hormones rather than spiking, your blood sugar and carbohydrates, used as a tool, not a foundation. Every time insulin spikes and crashes, your ovaries get a signal they don't need. Calm that signal and the whole picture starts to shift.

Then we need to address the inflammation. PMS is inflammatory.

The higher your inflammatory load from diet, from stress, from disrupted sleep or from gut dysfunction, the worse the androgen excess becomes. Your Omega 6:3 ratio is a direct driver of that.

When it's chronically out of balance, you create a systemic inflammatory environment that makes everything harder. The good news? This is measurable, not a guess.

My clients take the Xinzino balance test, which gives your exact ratio and actually looks at your entire fatty acid profile. So we know exactly where you are. We don't assume where you are. I'll put the link in the show notes next is to not ignore your gut.

Your gut microbiome is directly involved in how your body processes hormones. Now, there's a community of gut bacteria called the estrobolite that's responsible for clearing estrogen.

And when that's disrupted, hormonal clearance is disrupted. When we support it, hormonal patterns improve. And your gut and hormones are not separate conversations. And I really want you to hear this.

Trust your body and what it's telling you. If your results come back normal, but you don't feel normal, that is a clinical signal, not a personality flaw.

Not anxiety, not getting older, a clinical signal. Irregular cycles, skin that won't settle, weight that makes no physiological sense. These things have a mechanism and they have an explanation.

Your body is not broken, it is communicating. The question has never been whether something is happening. It's whether anyone around you has been trained to listen.

The rename of PCOS to Polyendocrine Metabolic Ovarian Syndrome is not medical housekeeping, it is the Lancet 56 global organisations.

And then finally acknowledging that the condition has been misunderstood, misdiagnosed and undertreated because the framing was wrong from the very beginning.

Now, if you've carried this diagnosis or you've suspected, you've had it and never been properly investigated, or you're in perimenopause watching old symptoms amplify and nobody's connecting the dots, this is the moment to stop managing and start understanding. That's exactly what we do inside the Thrive her tribe. Not symptom management mechanism. Understanding.

Every weekday the daily nudge lands directly in your WhatsApp because understanding your body isn't a once a year GP appointment, it's daily practice. The Elevate membership starts at $47 a month, less than a single consultation and I'm actually there every single day.

So head to ThriveHerd VIP to join. I'll put the link in the show notes and if this episode landed for you, share it.

Text it to the woman in your life who's been told her results are fine and knows something isn't right. She needs to hear this too. Until next time, keep believing in yourself. Keep striving, keep thriving. Because your best life is just a step away.

Speaker A: 00:12:19

Thank you for joining us on this episode of the ThriveHer podcast. We hope you found valuable insights and practical tips to help you on your path to achieving everything you want in life.

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