In this article, Heidi Villegas, founder of the School of Botanical Arts & Sciences (SOBAS), explains what PCOS/PMOS is, why the name is being changed (and for good reason), plus some herbal interventions that may be helpful. She also shares an herbal tea blend that can be helpful for the most common symptom presentations of PCOS/PMOS.

I’ve met so many women over the years who have been diagnosed with PCOS, which stands for Polycystic Ovarian Syndrome. The problem is that many of these women didn’t have cysts on their ovaries, but they had other issues commonly presented in PCOS diagnoses. The old name of PCOS never told the whole truth about what is really going on in a woman’s body. In fact, the name itself has caused a lot of confusion.

When most people hear the word “polycystic” and “ovarian,” they naturally think the condition is mainly about cysts on the ovaries. But that’s not usually what is happening. The so-called “cysts” are not abnormal cysts in the way most people think of cysts. They are ovarian follicles, and they also aren’t the root cause of the condition. This is one reason a global group of doctors, researchers, patients, and health organizations recently reached consensus on a new name for women previously diagnosed with PCOS: Polyendocrine Metabolic Ovarian Syndrome, or PMOS.

Frankly, as a clinical herbalist, I’m relieved. This new name and the thought patterns around the presentation of symptoms make a great deal more sense to me, especially as a woman.

This condition, formerly called PCOS, affects about 1 in 8 women worldwide, or more than 170 million women. The name change was published in The Lancet fairly recently and announced by organizations including the Endocrine Society. More than 50 patient and professional organizations were involved in the process, which took many years of international collaboration. And honestly, I think this change is hugely positive. When a condition has the wrong name, the conversation around support often starts in the wrong place. Using the word, “metabolic” and “polyendocrine” means we’re now more honestly looking at metabolism in the body, multiple hormonal actions, and the lifestyle (and herbal supports) that can help women dealing with presentations of the imbalance.

Why the Name, PCOS, Was Changed

The old name, polycystic ovary syndrome, made the condition sound like it was mostly an ovary problem. But PMOS is much bigger than that. The new name gives us a better picture of what’s actually happening in the body.

Polyendocrine means multiple hormones and endocrine pathways may be involved.

Metabolic points to blood sugar regulation, insulin resistance, weight changes, type 2 diabetes risk, cardiovascular concerns, and other long-term health patterns.

Ovarian refers to the fact that ovulation, menstrual cycles, and fertility may still be affected.

This is much more accurate than focusing only on “cysts.”

According to the Endocrine Society’s announcement, PMOS is characterized by hormone fluctuations with impacts on weight, metabolic and mental health, skin, and the reproductive system. The old name reduced a complex, long-term endocrine disorder to a misunderstanding about ovarian cysts, which contributed to missed diagnoses, poor awareness, and inadequate treatment.

This is heartbreaking, especially for women who have spent years trying to understand what is going on in their bodies.

PMOS Isn’t Just a Reproductive Condition

One of the most important things about this name change is that it moves the conversation beyond fertility and ovaries. Yes, PMOS can affect ovulation. Yes, it can affect menstrual cycles. Yes, it can make it harder for some women to become pregnant. But it can also affect skin, hair, weight, blood sugar, mood, inflammation, and long-term metabolic health. Women with PMOS may experience irregular or missing periods, acne, excess facial or body hair, thinning hair on the scalp, fertility challenges, stubborn weight gain, blood sugar swings, fatigue, anxiety, depression, and increased risk for type 2 diabetes or cardiovascular issues.

This is exactly why this condition deserves whole-person (holistic) care. It’s never just been simply a “female hormone, fertility, or cyst” problem. I believe women have sensed this, and have been frustrated with the lack of understanding in the medical field. In working with friends and clients with the PCOS diagnosis, both myself and them have often felt something was missing.

What’s Actually Happening in the Body?

In many cases, PMOS is connected to insulin resistance.

Insulin is the hormone that helps move glucose from the bloodstream into the cells, where it can be used for energy. But when the cells stop responding well to insulin, the pancreas often has to make more and more of it. That extra insulin can encourage the ovaries to produce more testosterone. It can also lower a protein called sex hormone binding globulin, or SHBG, which normally helps bind up extra testosterone in the bloodstream. So now the body may be making more androgens and clearing fewer of them. This can contribute to symptoms like irregular cycles, acne, facial hair growth, thinning scalp hair, fertility challenges, and weight gain that feels especially hard to shift.

There can also be a metabolic side to PMOS, including blood sugar crashes, fatigue, cholesterol and triglyceride changes, and a higher long-term risk of type 2 diabetes and cardiovascular concerns. This is one of the reasons the word “metabolic” in the new name is so important. It points us toward the deeper terrain.

Not Every Woman Has the Same Pattern

Something else we need to remember is that PMOS does not look the same in every woman. In fact, finding and discerning patterns in health issues is a crucial skill when working with humans as individuals. In terms of PMOS/PCOS, some women have the classic insulin-resistant pattern, where weight gain, elevated androgens, blood sugar instability, and irregular cycles are all part of the picture. Other women have what has often been called lean PCOS, where weight may be normal, but androgen symptoms and cycle disruption are still present.

Other women seem to have a more inflammatory pattern, where chronic inflammation, immune irritation, or stress chemistry may be more central. And other women may experience PCOS-like symptoms after stopping hormonal birth control, when the ovaries are beginning to resume their own rhythm again.

This is exactly why holistic herbalists don’t like one-size-fits-all protocols. Our approach should fit the woman in front of us.

Why Earlier Recognition Matters

One of the sad realities is that many women wait far too long for answers.

The older name and narrow reproductive focus contributed to delayed diagnosis, fragmented care, and a lot of frustration for patients. The global name-change process specifically prioritized scientific accuracy, patient benefit, clearer communication, stigma reduction, cultural appropriateness, and practical implementation. This matters greatly because PMOS isn’t something we should ignore until a woman wants to become pregnant. Hormone imbalance can affect her health long before that. Hormone imbalances can affect how she feels in her body, how her cycles behave, how her skin looks, how her energy holds through the day, and how she experiences mood and stress.

Early recognition gives women a better chance to support the body before the pattern becomes more deeply entrenched, and then more difficult to bring back into balance.

Start With the Foundation: Blood Sugar Stability

When insulin resistance is part of the picture, blood sugar balance has to come first. This may not sound as exciting as an herbal formula, but it is foundational. Herbs can be very helpful, but they usually work best when daily habits are supporting the body instead of constantly working against it.

For many women with PMOS, this means learning how to eat in a way that keeps blood sugar more steady through the day. This doesn’t necessarily mean a harsh low-carb diet. It can just mean developing the skill of creating meals that don’t send the body on a blood sugar rollercoaster. Some simple starting points include eating protein with all meals, adding healthy fats, not eating carbohydrates all by themselves, eating breakfast if skipping it leads to crashes later, not going too long without food, and adding fiber-rich foods regularly during the day.

It means getting rid of sugar and processed foods in the diet. Perhaps reducing foods that are inflammatory to the specific woman. And in my view, this “new eating” approach should be taught to be exciting! When women experience how adding herbal spices to foods can make previously “boring” meals absolutely delicious while also supporting healthy metabolism, then this way of eating can become not just enjoyable, but fun.

Getting Movement During the Day

Movement can also help support insulin sensitivity and metabolic health. Walking, strength training, aerobic movement, and in some cases higher-intensity exercise may all be helpful. But this should always be matched to the person.

A woman who is already exhausted, depleted, and living on stress hormones may not need a punishing workout routine at first. She may do better with steady walking, gentle resistance training, better sleep, and nervous system support. Even a small rebounder can help. Exercise, even gentle movement, can create better conditions for healing and regulation in the body.

Where Herbs May Fit In

Once the foundations are being addressed, herbs can be wonderful allies. I like to think of herbal support for PMOS in three general layers.

Layer One: Blood Sugar and Metabolic Support

This is where herbs like cinnamon, fenugreek, gymnema, bitter melon, and berberine-containing herbs may be considered.

Cinnamon is a familiar kitchen herb that can be especially useful when we are thinking about blood sugar support. There are different varieties of cinnamon, and the kind commonly found in the grocery store isn’t usually the right one. Be sure to use Cinnamomum verum or Cinnamomum zeylanicum for best results.

Fenugreek (Trigonella foenum-graecum) has a long history of use as a metabolic herb and may also support lactation, which may matter for some women in the postpartum season.

Gymnema (Gymnema sylvestre) is sometimes called the “sugar destroyer” in Ayurvedic medicine and may be helpful for sugar cravings because of the way it affects sweet taste perception. Essentially, plant constituents interact with taste receptors and metabolic processes.

Berberine-containing herbs deserve careful attention. Berberine has been studied for its effects on insulin sensitivity, but it can also interact with medications and isn’t appropriate for everyone. In fact, before using any herb, essential oil, or supplement, you should always do your own research first and if you’re on medications, check in with your medical provider. Goldenseal (Hydrastis canadensis) has become quite famous at the moment as it contains high amounts of berberine, however it is also an at-risk plant in the wild. Most responsible herbalists no longer use it unless it’s cultivated. A wonderful and very sustainable alternative is Oregon grape root (Mahonia aquilifolium or M. repens) so I prefer to think about more sustainable alternatives such as Oregon grape root or barberry when appropriate.

Remember that the herbal choices for a person will be determined by the specific needs and individualized protocol for her.

Layer Two: Hormonal Rhythm and Cycle Support

Vitex (Vitex agnus-castus), also known as chaste tree berry, is one of the classic herbs many people think of for cycle regulation. It works through actions on the pituitary gland and may influence prolactin and progesterone patterns. It may be helpful for some women with irregular cycles or luteal phase concerns.

But Vitex isn’t for everyone.

Some women feel better with it. Some feel no difference. And some feel worse, especially if mood symptoms or PMS increase. This is why I don’t suggest Vitex for every woman with PMOS. The foundation matters first, and the herb should fit the person.

Ashwagandha (Withania somnifera) is an adaptogen well studied and known to regulate cortisol levels and stabilize the nervous system. This helps mitigate emotional spikes and potentially anxiety that occurs during the luteal phase.

Other herbs to research and consider could include black cohosh (Actaea racemosa), red clover (Trifolium pratense), and motherwort (Leonuris cardiaca) as helpers, depending on the woman.

Layer Three: Androgen Support

When symptoms like facial hair growth, acne, or scalp hair thinning are part of the picture, we may need to think about excess androgen activity. Herbs like spearmint, saw palmetto, and licorice root are sometimes discussed here.

Spearmint tea has some research behind it for lowering free testosterone. Saw palmetto is often thought of as a men’s prostate herb, but it also has actions that relate to androgen activity. Licorice root may also influence testosterone levels, but it comes with important cautions.

Whole licorice root isn’t usually appropriate for people with high blood pressure, fluid retention, certain heart or kidney concerns, or low potassium tendencies unless they are working with a qualified practitioner.

Again, this is why we don’t just “take herbs for PMOS.” We look at the person, the pattern, the risks, the medications, the constitution, and the deeper terrain.

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PMOS Isn’t a Random Hormonal Accident

One of the most helpful ways to understand PMOS is to see it as an adaptive pattern. This means the body is responding to something and is trying to regain balance.

Blood sugar swings, chronic stress, poor sleep, inflammation, nutritional gaps, sedentary living, hormonal disruption, and emotional strain may all be part of the picture. Over time, the body adapts to these stressors, and sometimes those adaptations show up as the symptoms we see.

We really need to ask better questions.

Instead of asking, “What’s wrong with me?” we can begin asking, “What is my body responding to, and what conditions can I begin to change?”

The Mental and Emotional Side

PMOS isn’t only physical.

Many women with this condition struggle deeply with anxiety, depression, fertility concerns, body image, and the feeling that their body has somehow betrayed them. These feelings can exacerbate stress, poor sleep, and anxiety around the body.

Mental and emotional needs should always be considered in any health or wellness protocol, including PMOS.

Blood sugar instability all by itself can also affect mood, anxiety, irritability, and energy. So when we begin stabilizing blood sugar, improving nourishment, supporting sleep, reducing inflammation, and gently working with the nervous system, the emotional picture may naturally begin to shift too.

This is one more reason I believe the best approach to PMOS is whole-person (holistic) care…..not just masking symptoms with a pill or three. This third layer is about supporting a woman’s body, mind, hormones, metabolism, and confidence.

What Happens Now With the New Name?

The transition from PCOS to PMOS will take some time.

According to the Endocrine Society, the three-year transition period will be supported by international education and awareness efforts for patients, health professionals, researchers, and governments. The new name is expected to be fully implemented in the 2028 International Guideline update.

So for a while, you will probably see both terms used together: PCOS/PMOS.

What matters most is that the new name helps move the conversation in a better direction. It encourages earlier recognition, more complete care, better research, and a broader understanding of what women with this condition are actually experiencing.

Heidi’s Generalized PCOS/PMOS Herbal Tea Blend

This herbal tea formulation is meant to be a long-term foundation of support. It supports the body’s regulatory systems and doesn’t try to override them. This isn’t for an acute intervention, as this type of need requires a client-herbalist relationship for proper assessment of the individual.

This blend supports the dietary work needed to reduce insulin resistance. It helps with blood sugar support, liver clearing of excess androgens, nourishment with important minerals, and gentle support with stress modulation.

Ingredients:

.All are dried herbs.

2 parts nettle leaf (Urtica dioica)

1 part cinnamon bark, cut and sifted (Cinnamomum verum; C. zeylanicum)

1 part fenugreek seed (Trigonella foenum-graecum)

1 part burdock root (Arctium lappa)

1 part lemon balm leaf (Melissa officinalis)

1/2 part vitex berry (Vitex agnus-castus)

Directions:

Blend the dried herbs together in a bowl.

To make the tea, use about 1 tablespoon per cup of hot water. Steep for 15 minutes (longer is fine, too). Be sure to cover the cup to make sure the aromatics from the plants remain in the tea.

Drink one to three cups a day. This tea blend is safe for long-term use. You can cycle on and off of it, or use it continuously as long as it’s effective.

NOTE: For higher levels of liver support, you can use milk thistle powder (Silybum marianum) separately, and just ingest it. I usually recommend 1/2 to 1 tablespoon daily. You can sprinkle it into foods or smoothies. The reason it’s not included in the tea formulation is because the silymarin that makes it effective for liver support doesn’t extract well in water.

SAFETY CONSIDERATIONS:

More than 2 grams of total cinnamon powder can cause GI irritation for some people. The amount in this tea is well below the threshold, but if you’re using cinnamon in high amounts elsewhere, take this into consideration.
Fenugreek and vitex aren’t recommended during pregnancy.
Vitex may reduce the effectiveness of hormonal birth control. You can choose to leave it out if this is a concern.

A Wise Herbal Approach to PMOS/PCOS

Herbs can be powerful allies, but they’re not magic pills.

They work best when they are part of a grounded plan that includes blood sugar stability, nourishing food, appropriate movement, stress support, sleep, and a clear understanding of which PMOS pattern is actually present. Life style choices and reducing toxic load matter greatly.

For some women, the first step might be blood sugar support. For others, inflammation may need more attention. For another woman, post-pill hormone patterns may be the issue. And for another, the emotional toll may need just as much care as the physical symptoms.

The goal in herbalism practice is to listen well, support wisely, and help the body function with more balance. And it’s where herbalism shines!

Herbs aren’t a quick fix, most times. But God’s gifts of medicinal herbs are a wonderful part of a thoughtful, practical, safe, and effective whole-person way of caring for women and their families naturally.

If you or someone you love is dealing with irregular cycles, acne, excess hair growth, weight challenges, fertility concerns, anxiety, depression, or symptoms that make you wonder about PMOS/PCOS, it’s worth speaking with a qualified health care provider. An early diagnosis can provide information that leads to more (and potentially better herbal) choices in how to handle regaining balance in the body.

Final Thoughts

I’m extremely thrilled at this new change and development in understanding female hormone imbalance. One of the reasons women have been traditionally underserved in modern medicine is because our bodies are far more complex than men’s. Also…as we know, there has also been a history of women being viewed as inferior humans, which I could go into but won’t because that’s another entire article in and of itself.

This change in name and understanding of what may really be going on inside a woman’s body with symptom presentations of hirsutism, weigh gain, and other issues is a great step in the right direction. I’m looking forward to more insights about PMOS as time goes on.

In the meantime, we have our medicinal herbs that can support our health in amazing ways!

Hugs, Health, and Herbs,

Heidi

Sources:

Baillargeon JP, Nestler JE. Commentary: polycystic ovary syndrome: a syndrome of ovarian hypersensitivity to insulin? J Clin Endocrinol Metab. 2006 Jan;91(1):22-4. doi: 10.1210/jc.2005-1804. Epub 2005 Nov 1. PMID: 16263814; PMCID: PMC3846532. Retrived June 4, 2026: https://pmc.ncbi.nlm.nih.gov/articles/PMC3846532/

Easley, Thomas. Curriculum materials. The Eclectic School of Herbal Medicine.

Teede H, Khomami M, Morman R et al. Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: a multistep global consensus process

The Lancet, 2026 Retrieved June 4, 2026: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00717-8/fulltext

PCOS/PMOS: Understanding the Holistic Picture of Hormone Balance Through a Perspective of Herbalism - Plus, an Herbal Tea Formulation