No Longer PCOS

PCOS has never been just “cysts,” and that misunderstanding has cost women years of clarity and real care. We’re Nicole Baldwin and Kelly White, board-certified nurse practitioners, and we’re unpacking the news that finally matches what women’s health providers have known for a long time: PCOS is being renamed PMOS, polyendocrine metabolic ovarian syndrome. That shift matters because it centers the full-body reality of hormone imbalance, insulin resistance, and metabolic risk instead of shrinking the problem down to ovaries alone.

We walk through the biggest signs that should put PMOS on your radar, especially irregular periods that come too often, too far apart, or disappear. We also talk through androgen-related symptoms like chin hair, acne, and thinning scalp hair, plus what an ultrasound may show with multiple small follicles. If you have two of these three patterns, you deserve a thorough evaluation. We also connect the dots on insulin resistance, including stubborn belly fat, sugar cravings, and even dark velvety skin changes that can be a clue something deeper is going on.

From there, we get practical about treatment. The goal is health first, then your priorities: cycle support, fertility planning, and reducing androgen symptoms, all while addressing glucose, insulin, cholesterol, and long-term cardiovascular health. We also share why modern tools like GLP-1 medications can be part of the conversation for the right patient, and how telehealth can help you get labs ordered and a plan started without another demoralizing visit.

If you’ve ever been brushed off, we want you to hear this clearly: don’t tolerate dismissal. Listen now, share this with a friend who needs it, and subscribe and leave a review so more women can find evidence-based PMOS and PCOS support.

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Transcript

Welcome And The Big News

Nicole 0:11

Hey guys, welcome to another episode of Tattoos and Telehealth. I'm Nicole Baldwin, and this is Kelly White. We are both board certified nurse practitioners. And today we're going to talk about some exciting news for women of all ages, really. I mean, you know, women. And I didn't even know about it yet. So, Kelly, what's what's the scoop?

Kelli 0:30

What's the scoop? So everybody's talking about it, or well, everybody in the in the women's health space, if you haven't heard about it, now is your chance to hear about it. So for years and years, they called PCOS PCOS, polycystic ovarian syndrome. And we've known for a long time in the world of women's health that it is not just multiple cysts on your ovaries. It is so much more than that. It is, you know, this whole slew of metabolic problems. In fact, I knew women that didn't look like PCOS that had all of the things. It was a metabolic issue. Well, they finally,

Why PCOS Becomes PMOS

Kelli 1:05

finally changed the name to PMOS, which is polyendocrine metabolic ovarian syndrome. And that accurately reflects that this truly is a systemic, hormonal, and metabolic disorder. So the, you know, the previous name was incredibly misleading. It made patients think that they had like these actual ovarian cysts, but the condition is just so much more than that quality of life, from reproductive issues to long-term health issues, even after reproductive point, takes away that stigma of that heavy focus on ovaries and cysts, which led to a lot of you know misconceptions about fertility. It truly caused a lot of you know unnecessary fear, fragmented care. Women were just like they were stuffed over here in this category. And then they weren't given any options as to, well, you know, what do I do now? You know, that like this, there was so much more than that. And so I think broadening the name finally with those of us that were in the know and those of us in that that cared about women's health, even though, you know, it really didn't seem like it was that critical. Like it's not that hard. You just treat treat treat the human, right? Treat the person in front of you. Um, but I think broadening the name, it really encourages providers across the board to take a full whole person approach, like like Nicole and I do. She and I both are are so good about just stepping back and being like, let's look at our person, right? Let's look at our person in front of us. But changing the name to polyendocrine metabolic ovarian syndrome, that means that it can be multiple underlying endocrine-related metabolic issues. And I think that really encourages providers, you know, to take a holistic approach to patient health, which includes managing their insulin resistance, which they very much have, all of them, related to weight changes. I had some patients that had PCOS, when it was still called that, that were thin problems, but they all had this underlying insulin resistance that led to long-term concerns related to their cardiovascular health. You know, you and I had um a long discussion last week about people with that underlying patients that probably had apolipid, you know, APOA, little A, and like problems with their cholesterol that maybe they didn't know. Um, but that allows people to now give it a whole nother look. And it what's exciting for me is that it's adapted now by the Endocrine Society means that this is gonna force them to take a step back and re-standardize guidelines and medical documentation and to fully transition not just the terminology, but like the way we look at it as a whole. Like we're gonna see guidelines change, we're gonna see approaches to healthcare change, we're gonna see approaches to

The Three Biggest Warning Signs

Kelli 3:50

the way these women are treated from from the very first step of approaching how we you know diagnose like the set of labs, how we look at them, how we like we're gonna see protocols change. And I'm excited. Like I am so excited.

Nicole 4:04

So for women who are listening that are saying, Do I have this? What are some of the key things that for patients who maybe suspect they have it, don't know if they have it, but they're like, okay, what are the symptoms? What are what am I looking for if I have this or this? Like, what would indicate to you, Kelly, that this patient needs to be worked up for this?

Kelli 4:31

What would that look like? So so some of the the big, big keys, like if you're sitting there and you're like, I truly don't know. One of the big, big things is irregular periods. Plain plain and simple. If you have irregular periods, that should be on your radar, first and foremost. Cycles that are fewer than 21 days, they're coming more frequently than every 21 days, 35 days, or you're missing periods entirely. Like we've had some, we've had some ladies come to us that they don't think about it being abnormal. They're like, well, my periods have just kind of always been weird. And you know, women in my family just never had normal periods. And I thought that was okay. It's not okay. It is not okay to not have a normal period. So if that is you, that's problem number one. That is warning sign number one. And then signs that you may have, oh, maybe you're that person that has been hair and you're young, you're young, you're not post-menopausal. I'm not talking to menopausal women here. I'm talking about my ladies that are young and still having normal cycles. So maybe you have some chin hair, chest acne, the facial hair, or maybe you have like the thinning scalp hair, like right up here across your scalp. It's kind of thinning, and you're that in that young age, those are signs that you have higher than normal androgen levels. This is the third, final, first and final foremost. You've had an ultrasound and it shows multiple small little follicles on your ovaries. Like you look at your ovary, and instead of being this nice little tiny round, solid looking thing, there's this tiny little black spots all over it. Those are tiny little follicles. So that could be something that had that could be an indication that you have. So those are the top three big things. If you've had blood work, you know that you have insulin resistance, you know you have fertility issues uh underlying. But those are three big, big, big, big things that people can stand out and say, wow, I can look in the mirror or I can look at my cycle calendar and put two and two together and be like,

Treatment Goals And Modern Options

Kelli 6:15

this kind of looks suspicious. This looks sus. So of those three things I named, if you have two of those three, please, please go be evaluated. Those are those are big indicators.

Nicole 6:24

Yeah. And the treatment is not a crazy treatment.

Kelli 6:29

Like you can, I mean, it's relatively it depends on what your goal is as to how we treat you. So the the most important thing is one, to make you healthy. So we need to talk about do you have insulin resistance? What are your glucose levels running? Do we need to get that under control so we can make you as a you know a healthy human? Check your cholesterol, check your check your insulin levels. Do we need to make you a healthy human? And then what is your goal? Is it chin hairs and the hair thinning? Do we need to address this androgen over you know excess? Is it to get pregnant? Is it fertility problem? Is it a cycle problem? And then we kind of just start figuring out what your goals are and we treat that. We've seen in the world of GLPs because we're able to grab onto that and say, we can treat the insulin resistance, we can treat the weight, we can treat the inflammation, we can treat these things because we have those tools available to us now. And that's why I am thrilled that they finally have renamed it because we are going to see guidelines change. We are going to see those protocols change.

Nicole 7:23

I love that. I love that. And correct me if I'm wrong, because I know women's health is definitely you are just amazing in that. So I'm gonna ask this question because I want to know the answer myself. Is it true that most women, most with PCOS, have trouble with obesity?

Kelli 7:40

Yes, yes, and there's a reason why. And that reason is because they have insulin resistance. So most women with PCOS have insulin resistance, and therefore they have a difficult time being able to control their difficulty losing weight. They will have that stubborn belly fat that we see, they will have sugar cravings. Ladies, that is not your fault. It is inherently built into that insulin resistance. You will often see women that have the, you know, that dark velvety skin that we see on the back of women's neck. That's insulin resistance sometimes.

Nicole 8:10

I did not know that.

Kelli 8:12

So that dark velvety skin patch on the back of people's necks, that's insulin resistance. When they have that, that's a key indicator that that person could have insulin resistance. Or if they have it like under their underarms, key issue. So all of those things is insulin resistance. They'll have difficulty losing weight, stubborn belly fat. And that'll be that woman that comes to you and says, I've done all the things. Don't come at me and tell me to, you know, cut my calories. I've been in a calorie deficit for years and I can't lose weight. That is not fair. That is not fair. Don't tell me not to eat because I will throat punch you. I I like to eat. And so that is we, but we've told people that for years and years and years, and it's wrong. It's so wrong. They have an underlying inability to control that because they have this insulin resistance. And so it's real, it's a real thing. It's a real thing.

Nicole 8:56

I think it's almost like telling a menopausal woman, you know, you have night sweats, but you know, just it's okay, just use a fan and just deal with it. Like just deal with it. No, there's things you can do, and so there's things we can do for that belly fat, for that, you know, the blood test for insulin resistance is confirmative. But, you know, like Kelly's saying, there's all these highly suspicious uh things that if you have this, this, this, and this. And so if you're suspecting that you have that, let us know. Look us up, have your have your person, your in-person provider do some extra labs on you.

Kelli 9:34

And that's the great thing about telehealth, and I'm gonna plug telehealth for a minute. Even if you don't come see us, guys, you don't have to come see us. I

Telehealth Workups And Don’t Accept Dismissal

Kelli 9:40

would love it if you did. But that's the great thing about telehealth and the stigma of women's health is if you have been made to feel marginalized and you're in-person provider, and you're just like, I can't go see another person and look them in the face and then tell me I'm fat, I can't do that, or tell me there's nothing wrong, or make me feel whatever in some in some way. I get that. I've been there. I have been there recently with providers that make you look some kind of way. Go see a provider via telehealth. They can work you up via telehealth. We can order those labs for you. We can treat you. That's not something that you have to go be seen in person. Do you have to have an ultrasound in person? Well, yeah. But can we diagnose you two out of three without the ultrasound? Yeah, yeah, we can.

Nicole 10:17

Yeah. So, and it's so much easier from home in all fairness to just say, hey, this is what I need. This is what, okay, go get these labs. At least we'll get you started. So, even, you know, sometimes we'll be like, okay, here's your labs, here's our findings. Can we treat you? Yes, we can. However, if you need something in person, we'll give you all your say here, look, this is your this, this, and this, take this to your OBGYN. Take this to your Euro G Y N, whatever that looks like, so that you can kind of be ahead of ahead of the game and say, look, this is this is what I got. Don't tolerate dismissal. Don't tolerate dismissal. You need something, look us up. Kelly is amazing with women's health. You can find her at um or text 407-550-5441. Let us know if there's any way that we can help any of you out there because this is huge for the women's health community. Just absolutely huge, huge. And so you don't have to suffer. So please talk to your your regular physician, your regular GY, whoever, or just give us a call and look us up, and we'll see how we can help you. So all right, guys. Well, thank you for joining us if you how to find us, and we hope you have a wonderful rest wonderful, was that even English? Wonderful, wonderful rest of the week. All right, guys. Thanks for hanging. Talk to you soon. Bye guys.