PMOS After the Reproductive Years: Why It Doesn't Go Away

📱 Send Us a Text Message! We’d love to hear from you! Please include your name and email address so we can reply. Don’t worry — this won’t sign you up for our email list. We’ll only use your info to respond to your question. PMOS Awareness Month kicks off with a reframe: PMOS is not a condition that resolves once your cycles regulate or once you're done having kids. It is a lifelong cardiometabolic condition that happens to announce itself first through reproductive symptoms. Dr. Komal Patil-Sisodia walks through the three diagnostic criteria (irregular periods, high androgens, and polycystic ovarian morphology) and explains why the biology underneath, insulin resistance, visceral fat, and unfavorable cholesterol, persists even when periods look normal. She unpacks what worsens in perimenopause, the clinical blind spot that causes PMOS histories to get dropped from the chart, and what she actually changes in her own practice: earlier and trend-based lab monitoring, a shift in treatment goals from fertility to long-term metabolic and heart protection, and more individualized hormone therapy decisions. In This Episode Why the three PMOS diagnostic criteria are not the whole disease The underlying biology: insulin resistance, visceral fat, and cholesterol changes that often start in the teenage years What worsens at perimenopause: insulin resistance, LDL and triglycerides, and belly fat The missed clinical question that keeps PMOS histories from shaping midlife care Why 20+ years of a less favorable metabolic starting point matters for heart disease risk What changes in practice: trend-based monitoring, shifting treatment goals, and individualized hormone therapy A preview of the rest of the PMOS Awareness Month series Timestamps 00:00 — Welcome to Clearly Hormonal 01:03 — PMOS Beyond Fertility 02:14 — PMOS Is Lifelong 04:05 — Perimenopause Metabolic Shifts 06:17 — The Missed Clinical Question 07:52 — Heart Risk Over Decades 09:38 — What To Do In Practice 11:34 — Key Takeaways & Next Episodes 12:46 — Mini Course Invitation Coming Up in This Series Episode 2 — Lean PMOS (sometimes called "skinny PMOS") and why it gets missed Episode 3 — Where GLP-1s and other weight management tools fit into PMOS care Episode 4 — The long road to diagnosis and its toll on mental health Links Join the email list for the PMOS mini-course: eastsidemm.com/newsletter Thanks for listening. Find more info about Clearly Hormonal on the website or Instagram.