Dr. Betty Murray explains why polycystic ovarian syndrome, now called polyendocrine metabolic ovarian syndrome (PMOS), causes stubborn weight gain in 1 in 8 women, 70% undiagnosed. High luteinizing hormone drives androgen excess, which triggers insulin resistance and metabolic dysfunction. Standard tests miss it, but fasting insulin, glucose, and testosterone levels reveal the problem.
Right now, 1 in 8 women may be dealing with this condition, and it's anticipated that 70% of women don't even know it. Hi, I'm Dr. Betty Murray, the CEO and co-founder of Minerva, and also a 22-year veteran in the health arena, both on the research side and the clinical nutrition and medical side. Now, there was a landmark paper that came out, uh, May 12th, uh, 2026, that renamed a condition that had been labeled, mislabeled for over 70 years. And in this landmark document, they also showed that that mislabeling was not only incorrect, it was harmful to women. So this is gonna be one of those things that you really wanna listen to because you may be one of those 70% of women that don't know you're dealing with it. So in this article, it created a new name for a condition called polycystic ovarian syndrome or PCOS. It got renamed to polyendocrine metabolic Metabolic Ovarian Syndrome. This is not just a semantics update. This is a massive confession from the medical world. This is 14,000 surveys of clinicians and patients, multiple studies over the course of multiple decades, and a renaming and a re-examining of what this condition really is. And they admitted that this is not even an ovarian condition and/or a fertility problem. And the hallmark diagnosis that we used for decades wasn't even necessary for diagnosis. So what does that mean to you? That means to you that you may be one of these 1 in 7 women that have been dealing with this condition from your teens. So how do you know this? So first off, let me give you some information on what to look for in your history. So the classic signs of PMOS, erratic periods, potentially acne, fluctuating late, uh, fluctuating weight are often dismissed, particularly during puberty, as kind of the rite of passage. And especially if you experience weight gain after the onset of puberty that was, was much more than other people and your peers. Now, if you've always had to work harder at maintaining your body composition, losing weight, this also could be a very, very good sign. If you struggled with acne, probably in your teen years, but especially adult acne, erratic periods, thinning hair on your scalp or chin hairs and mustache, that's also another good clinical sign. And if you experience especially kind of blood sugar issues, intense cravings, energy crashes sometimes after eating, that can also be a hallmark. So here's what you need to know. You don't have a lack of willpower if you've been dealing with this. You may have been dealing with a hidden metabolic footprint of PMOS. And if you happen to be in the window of perimenopause and menopause, you're— when your estrogen starts to drop and all your hormones are in an erratic pattern, it becomes very difficult to use old standard assessments to understand if this is what is going on. So your body may still be going through it. Your ovaries are changing, but the metabolic signature is still there. And if this sounds like your lived experience, here's what actually is happening. So PMOS doesn't happen just in the ovaries. It starts actually in your brain, and it is a part of your brain called the hypothalamus. Think of that as the director of the show, and it talks to the pituitary, who's the conductor of the orchestra. The pituitary then talks to your ovaries, your thyroid, your adrenal glands. It controls the actual function of your endocrine system. When this is going on, the hypothalamus overproduces luteinizing hormone by an average of 40%. What that does is tells your ovaries to overproduce androgens. Things like DHEA sulfate, DHEA, testosterone, and dihydrotestosterone, or otherwise known as DHT. These can do a couple things. They can cause acne, hair loss. It actually stimulates IGF-1 and insulin, so it can also create weight gain. Now, it's not just here. The reality is this causes stubborn metabolic resistance. Now, this is what your doctor's missing. If you're carrying extra weight in your fat tissues, 'cause again, this drives insulin levels higher and can cause weight gain, As the weight starts to go up, we will get the fat tissue that will actually suppress some of that activity in the hypothalamus. And so it makes your luteinizing hormone then look normal. So if you run a blood test, all of a sudden your doctor will say, "You look completely normal." And if you had previously ever had a sonogram looking for cysts and that was normal too, again, that's not even required for diagnosis, that was also going to then push you out of that diagnostic criteria. So they miss the real culprit. So your body actually has been pumping out high levels of insulin, which makes you unable to burn fat, tells your body to store sugar as fat, and keeps you in this constant state of metabolic survival. So if you're thinking now, OMG, this sounds like me, which I know when I put this out on, on social media, it was viral. And so how do I know? And how do I start to create a diagnostic framework? So here's a couple things that you can ask your clinician to work for and look at on your labs. You need a fasting insulin, glucose, and a hemoglobin A1c on your lab work. Glucose may be completely normal. Fasting insulin and hemoglobin A1c, if either one of those are elevated or even riding the high side of normal, that is a pretty good signature. You want your androgens tested. You need a total testosterone, a free testosterone, DHEA, and ideally DHT or dihydrotestosterone because if they're elevated, that's also a hallmark sign. And I highly recommend looking at a full cholesterol and lipid panel. PMOS carries metabolic syndrome, prediabetes, diabetes, and cardiovascular disease risk on top of chronic inflammation. And so often we can see those changes as well. And here's the situation. If you happen to be 40+, like I am, you may have been fighting this battle for a long time against your old biology based on an outdated map. And you were told now that you're just getting older and this is a part of perimenopause and menopause. Even as those hormones drop, the metabolic picture is still going on and your clinician, whether it's your primary care doctor, your OB-GYN, probably hasn't read this article and probably doesn't understand the metabolic effects. So here's what you wanna think about. Number one, you have the ability to actually advocate for yourself. So ask for those tests and, we are really dedicated at the Menerva Project and also on the Menopause Mastery Podcast, which I host every week, to help you understand your own body's biology. So I highly recommend listening to the podcast because every week I'm exposing research data so you can understand it in real easy-to-understand layman's terms. And if you also think this might be you, we have a quiz that can help you look at your hormones and your symptoms to see if this happens to be part of your picture. And you can get to that quiz quiz at quiz.gethormonesnow.com. That's quiz at gethormonesnow.com.
