Irregular cycles, acne, hair growth or thinning, and weight that resists change, we’re ready to find the root cause with you, and heal the whole of you. Let’s begin.
You may know this condition as PCOS or PCOD. In May 2026, a global consensus of clinicians, researchers, and patients, published in The Lancet, officially renamed it PMOS (Polyendocrine Metabolic Ovarian Syndrome). The name change reflects the condition’s actual scope. It was never purely ovarian, it is hormonal, metabolic, and reproductive at once, which is why a plan targeting only one of those rarely resolves the full picture.
We use PMOS throughout this page as the current clinically accurate term, though PCOD and PCOS remain in use elsewhere and are the same condition.
PMOS affects an estimated 1 in 8 women of reproductive age, making it one of the most common endocrine conditions in this population, though the World Health Organization estimates up to 70 percent of cases remain undiagnosed. Clinical presentation is heterogeneous, and typically includes some combination of irregular or absent menstrual cycles, elevated androgen levels manifesting as acne, hirsutism, or scalp hair thinning, insulin resistance, and difficulty with weight regulation.
The condition’s diagnostic criteria (commonly the Rotterdam criteria) require at least two of three features: irregular ovulation, clinical or biochemical hyperandrogenism, and polycystic ovarian morphology on ultrasound, meaning presentation varies significantly between individuals.
| Clinical Presentation | Underlying Mechanism |
|---|---|
| Irregular or absent cycles, fertility difficulty | Disrupted hypothalamic-pituitary-ovarian (HPO) axis signaling, often reflected in an elevated LH to FSH ratio |
| Acne, hirsutism, scalp hair thinning | Hyperandrogenism, elevated circulating androgens affecting hair follicles and sebaceous glands |
| Weight resistant to conventional caloric restriction | Insulin resistance, present in a majority of PMOS cases regardless of body weight |
| Fatigue, mood symptoms | Chronic low-grade inflammation, increasingly documented in PMOS research, though its precise causal role in mood and fatigue remains an active area of study |
These features are not independent. Insulin resistance is understood to worsen hyperandrogenism, which in turn affects ovulatory function, illustrating why single-mechanism treatment approaches frequently underperform.
This checklist supports self assessment prior to consultation. It does not constitute diagnosis, which requires clinical evaluation, bloodwork, and in most cases ultrasound.
PMOS presentation varies by dominant driver, insulin-resistant, inflammatory, adrenal, or post-oral-contraceptive, and treatment approaches that don’t account for this variation frequently underperform. Assessment includes hormonal panel review, insulin and metabolic markers, gut and inflammation signals, lifestyle load, and body composition, prior to any dietary recommendation.
Built from existing labs, symptom history, and lifestyle pattern.
Adds microbiome testing. Gut bacterial composition is documented in current research to relate to estrogen metabolism, insulin sensitivity, and inflammation, all relevant to PMOS presentation. Used as one input alongside labs and history, not a standalone diagnostic.
Adds DNA-based genetic testing. Nutrigenomic testing, how genetic variants relate to nutrient metabolism, is a real and growing field, though still emerging; it does not yet support the precise individual prediction some marketing implies. Used as one input among several, not a replacement for labs, symptoms, and protocol response over time.
All three are reviewed in the first consultation, with the appropriate starting point recommended based on presentation, not upsold as a default.
Full review of labs, symptoms, cycle history, and lifestyle in the first consultation. Where recent labs are unavailable, specific testing is recommended and explained.
A protocol built around the individual PMOS pattern (insulin-resistant, inflammatory, adrenal, or post-contraceptive), with the clinical reasoning behind each recommendation made explicit.
Scheduled follow-up to track cycle regularity, symptoms, and lab movement, with protocol adjustment based on response rather than a static plan.
Continued support until cycles, labs, and symptoms stabilize, with an option to transition into general metabolic maintenance.
Sleep, stress, and recovery patterns mapped to the individual PMOS presentation.
Structured around what is documented to improve insulin sensitivity and cortisol regulation.
Adjustments to the existing diet pattern rather than a wholesale replacement.
Meals designed for the specific protocol, developed to be sustainable.
Connect via secure 1-on-1 video call from anywhere in the world. Ideal for clients requiring flexible scheduling or residing outside Kerala.
Available in Trivandrum, including in-person body composition analysis.
Existing reports are used where available. Where unavailable, required testing is specified.
* Protocol depth (Foundation, Gut, or Gene) is a separate decision from consultation mode, and is determined in the first consultation based on clinical need.
No. This is a nutrition and lifestyle programme that works alongside a gynecologist or endocrinologist, using existing reports and medications as part of the assessment.
Not necessarily. Required testing, if any, is identified during the consultation.
The protocol targets hormonal and metabolic balance relevant to ovulatory function. Fertility treatment itself remains with a specialist.
Energy, digestion, and cravings often shift within a few weeks. Cycle regularity and lab changes typically take several months and vary by individual.
No. Both online and in-person consultation are available, selected at the time of booking.
PMOS is the current clinically accurate term following the May 2026 global consensus rename. Questions about the terminology are welcome in consultation.
Take one of our clinical diagnostic tools to evaluate gut operational health or hormonal signaling bottlenecks in under 3 minutes.
Take one of our clinical diagnostic tools to evaluate gut operational health or hormonal signaling bottlenecks in under 3 minutes.
