PCOS Just Became PMOS. But What About Women in Menopause? What about the women in menopause who were never diagnosed?

Happy Sunday everyone. Mere here, and this week was full.

I look back over all the diverse conversations and situations I am privileged to support and be a part of and I am just in awe. But I also cannot sugar coat it, this week was bittersweet. My family crossed a fast and ferocious finish line of renovations and put my parents' home on the market. I got emotional seeing that home restored to the condition I remembered when my mom was with us. The rooms are clean, crisp, and there is this feeling of immense sorrow that overcomes me as the memories of her smiling while she worked away in that home and in the garden come flooding in. I see all the potential that property can continue to be. And I also knew, with an itty bit hesitation (keeping it real), it was time to turn away and walk in a fresh direction holding memories close.

I also dipped my toe back in to social media via stories as I was away from social media in full for well over 7 days. And in truth, even that was bittersweet. I don't like to yell, I don't like generalities or one-liners to sell. Yet I also love what social media has provided ….a voice, access to knowledge, access to possibilities and concepts. It has allowed a way for people to encounter information they would never hear. 

And apparently while I was offline, social media was buzzing! 

PCOS got that new name! 

That said, you all heard about this name change in January.  Back in January (!), I sent a newsletter after a weekend attending a provider level continuing education course on hormone therapy where PCOS-focused education was discussed. First takeaway: PCOS needs a new name. The proposed name discussed that weekend was FEMS, Female Endocrine Metabolic Spectrum. I told you I loved the logic. I told you the momentum was building.

On May 12th, 2026, it became official. PCOS is now PMOS. Polyendocrine Metabolic Ovarian Syndrome. Published in The Lancet. Eleven years in the making. Roughly 22,000 people globally had input, including researchers, clinicians, patients, and advocacy organizations.

I am not a super hype fan of the new name... it is a good move but I do think we could have done one better. They started off strong with "polyendocrine" and I was cheering. Then "ovarian" showed up and I thought, really? We are still anchoring this to the ovaries? Because that framing still leaves out the subset of women who do not have their ovaries. It still implies this is primarily an ovarian situation at the core. This is a metabolic and endocrine condition first. If you read that January newsletter, you understood that months before social media caught up.

Now, this got me thinking, social media really is the initial point of access for so many people when it comes to health information. Some people take that and go investigate further. Some people stop at the Instagram post and call it research. For better and worse, that is the landscape we are working in. And it is exactly why getting this stuff right when we put it out there is so important.

Which brings me to this.

One of the incredible coaches inside our mentorship asked a series of questions this past thursday that I think everyone working with women and who is a woman needs to sit with.

She asked what PMOS (the new name for PCOS) would even look like in a woman who is in menopause. If so many women went undiagnosed during their reproductive years, what are we actually seeing now? And what would LH and FSH even tell us at that stage?

I love these questions. And honestly, the answer reveals more about the limitations of the diagnostic criteria than it does about the women themselves.

Think about it. The criteria we have been working with were designed for women in their reproductive years. Or even more specifically, women within their reproductive years who have reproductive capacity via intact ovaries. They lean on menstrual cycle patterns, ovarian morphology on ultrasound, and many coaches and providers lean on that LH to FSH ratio that can skew 2:1 or even 3:1. But for a woman in menopause? She does not have a cycle to track. Her ovaries may not be functioning in the reproductive sense, or may not even be there at all. And both her LH and FSH are going to be elevated because that is exactly what is supposed to happen. The brain is calling down to the ovaries and the ovaries are not picking up. That is normal physiology, not pathology.

And what about the woman from a culture where more body hair is normal? Where hirsutism was never flagged because it did not stand out against a narrow clinical standard? Higher reported rates of PCOS exist in women of Middle Eastern, South Asian, and Mediterranean descent, but there is a real question about how much of that is true genetic prevalence versus detection bias and body hair norms influencing who even gets evaluated in the first place. The criteria assume a baseline that does not account for every woman sitting in front of you.

So that classic LH to FSH flip? It gets washed out. FSH rises, often more steeply than LH, and that ratio can actually normalize. You lose the very marker people were taught to look for.

Think about the demographic of women who are in natural menopause right now in 2026. These are the women who were told they did not need labs. That their hormones fluctuate so why bother. They were ‘too young’ to be concerned and apparently now they are ‘too old’ (sigh). That what they were experiencing was just normal. How many of them were actually navigating an undiagnosed metabolic and endocrine condition for decades? 

So could we look now? Yes. And this is where the conversation shifts from ovaries and cycle charts to the metabolic fingerprint that persists regardless of reproductive status. Low SHBG. Fasting insulin patterns. Dyslipidemia. Visceral fat distribution. Inflammatory markers. And a clinical history that tells a story if you know how to listen to it.

I do not think a woman needs to be labeled or slotted into a category to start improving her situation. But I do think she deserves to have someone connect the dots. 

This Week's Blog Goes Deeper (buckle up)

The mentee's question opened up a much bigger conversation. One that I think coaches and women alike should understand. 

In this week's blog, I get into all of it. How to distinguish a normal menopausal hormonal shift from something that actually looks like PMOS. Why elevated DHEA-S might be about stress and life load, not endocrine dysfunction. Why the "four types" of PCOS you see online are drivers, not diagnostic categories, and why that distinction separates a coach who can hold a credible conversation with a provider from one who cannot. And where the diagnostic criteria are heading when the 2028 guideline update arrives.

[Read the full blog]

If this is the kind of thinking that gets your brain firing, our mentorship is where these conversations happen every week. A coach asked this question on a call, and it turned into everything you just read. That is how we operate.

[Learn more about mentorship → HERE]

If you are navigating PCOS (now PMOS), perimenopause, menopause, metabolic resistance, or symptoms that have been dismissed or minimized, our 1:1 strategy sessions are built to help you see the full picture and map a realistic path forward.

[Get connected with a coach for your 1:1  Strategy Session → HERE]

With love and so much passion...

Mere & Sarah