Polyendocrine Metabolic Ovarian Syndrome with Dr Felice Gersh | Rational Wellness Podcast 468

View the Show Notes For This Episode

PCOS Renamed PMOS: Root Causes, Hormones, Metabolism, Labs, and Integrative Treatment with Dr. Felice Gersh

Dr. Ben Weitz introduces an interview with OB-GYN and integrative physician Dr. Felice Gersh on PCOS, newly renamed polyendocrine metabolic ovarian syndrome (PMOS) per a May 12, 2026 Lancet announcement, meant to shift focus from “cysts” to hormonal and metabolic dysfunction. Gersh argues ovaries remain central, describing impaired aromatization leading to low estradiol, high LH-driven testosterone, and downstream effects including insulin resistance, inflammation, leaky gut, altered microbiome, sympathetic activation, elevated cortisol/DHEAS, obesity, mood disorders, sleep apnea, and autoimmune risk. They discuss legacy and practical issues with renaming, updated diagnostic criteria adding anti-Müllerian hormone in adults, and PMOS as a diagnosis of exclusion. Recommended evaluation includes total testosterone, DHEAS, SHBG, thyroid panel with antibodies, lipids including apoB, hsCRP, nutrients, ANA, prolactin, and select rule-outs (17-OHP, Cushing’s, tumors). Treatment emphasizes lifestyle, plant-focused diet, time-restricted eating, exercise, supplements (myo-inositol, NAC, quercetin, melatonin, mitochondrial support), cautious pharmaceuticals (metformin/berberine, spironolactone), and cyclic bioidentical estradiol/progesterone; low-dose dexamethasone is noted for select adrenal-driven cases.

01:02 PCOS Renamed PMOS

04:51 Hormone Pathway Explained

09:04 Systemic Effects Cascade

13:15 Prevalence And Risks

17:29 Name Change Debate

18:28 Follicles And AMH

22:54 Inflammation And Immunity

26:17 Origins And Modern Triggers

31:40 Why Rebranding Falls Short

35:05 PCOS PMOS Searchability

35:48 Updated Diagnostic Criteria

37:52 Teen vs Adult Criteria

39:01 Key Lab Workup

44:07 High DHEAS Red Flags

45:00 Diagnosis of Exclusion

47:39 Lifestyle Treatment Plan

49:16 Diet and Fasting Strategies

53:45 Meds and Herbal Options

54:43 Mitochondria and Supplements

57:54 Inositol Ratio Debate

01:00:47 Hormones and Antiandrogens

01:04:03 Adrenal DHEAS Suppression

Dr. Felice Gersh is a board certified obstetrician and gynecologist and she is also fellowship-trained in Integrative Medicine. Dr. Gersh is the Director of the Integrative Medical Group of Irvine, where she sees patients. She also lectures for A4M and various other conferences and she writes on various topics relevant to women, including on PCOS now PMOS. She has written 3 books, the first of which is called PCOS SOS and the second is PCOS Fertility Fast Track.

Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure. Dr. Weitz has also successfully helped many patients with managing their weight and improving their athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.