PMOS / PCOS Nutritionist

How can I help support people with PMOS / PCOS?

PMOS – previously named PCOS – is a diagnosis affecting in 1 in 10 women – in part due it’s genetic link and also current Westernised lifestyle (which promotes insulin resistance the most common type of PMOS).

If you have recently received a diagnosis of PMOS and are seeking more of a holistic approach to improving your symptoms across this hormonal, metabolic and whole-body condition rather than taking hormonal birth control which will only manage the symptoms whilst taking it, then I can help you.

Your goal may be one of more of the following:

Understand more about this complex condition & how to best support yourself
Lose weight
Regulate periods
Improve skin
Reduce excess hair
Avoid a diagnosis of prediabetes
Improve fertility

I will help you with your goals by first

Taking a complete health history including any genetic predisposition for PMOS
Facilitating blood tests either through your GP or ordering a Dutch Hormone test for you in order to gain insight into your hormone status
Developing a personalised nutrition and lifestyle plan for you depending on what is driving your PMOS, based on information collected and interpretation of your test results
Book a 1-hour consultation with you to explain your results and plan ensuring that you feel heard, understood & motivated to make the changes laid out in your plan
Recommend targeted supplements at therapeutic dosages which will support your nutrition & lifestyle changes
Keep in touch over the first month when changes can be most challenging and then support you with ongoing monthly 45-minute consultations to ensure progress towards your goals

Book a free discovery call

I had contacted Angela in the midst of trying to find a solution for my PCOS symptoms that had heightened during the first lockdown, and after having done a lot of research myself I was overburdened with information. I found myself throwing everything at the problem but not seeing any results. Angela focused on the root issues and was able to fine tune my diet and lifestyle in order for me to see changes. It’s been three months now and I can honestly say I am so much happier and energetic than I have been in a long time!

Angela took a holistic approach to my PCOS hormonal imbalances, working diagnostically with blood test results together with nutrition and supplement advice which was dramatically different from anything I had followed before. I achieved most of my health goals after 3 months of working with Angela (weight loss will always be an ongoing!) and I now feel equipped with the knowledge to manage my PCOS going forward. Angela’s approach is scientific but also equally important realistic in terms of how many changes are possible at each session for busy professional women!

I saw Angela after my GP said I was facing a likely diagnosis of Premature Ovarian Insufficiency (POI), given my blood test results and symptoms and I wanted to see if there was an alternative way of addressing the issue. Angela’s approach was sensitive and caring and the plan was intelligently and individually thought through. By changing my diet, sleep habits and reducing stress, my last blood test result was normal and I am over the moon!

Testing for PMOS (PCOS)

Testing for PCOS / PMOS (using the Dutch Urine Test or Blood tests) is often key in resolving symptoms.

It will help provide insight into what is driving your PMOS but also gives us more useful information.

This includes information on key health markers which may be impairing ovulation and promoting excess androgens, including Hypothyroidism (underactive thyroid), elevated Prolactin, and nutritional deficiencies linked to healthy ovarian function such as Iodine, zinc and Vitamin D.

The different drivers of PMOS

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Insulin Resistant PCOS / PMOS

This is the most common driver of PCOS. It is associated with apple shaped obesity which can be calculated by your waist to height ratio (your waist should be less than half your height).

However, you can be normal weight & have insulin resistance PCOS so in this instance we need to test for this using a Fasting insulin blood test.

Protocols for Insulin resistance PCOS

Typical protocols for insulin resistant PCOS include:

1. Focus on low glycaemic foods which keep insulin low.
2. Reducing sugar – because sugar spikes our insulin.
3. Avoiding hormonal birth control – because this can cause or worsen insulin resistance after just 3 months.
4. Exercise – because it improves insulin sensitivity.
5. Supplements – these need to be personalised even further and in line with any budgetary constraints as there are so many that support I.R PCOS. A key one is a combined Myo-inositol and D-Chiro Inositol to improve insulin sensitivity and healthy ovulation.

Inflammatory PCOS / PMOS

An Inflammatory PCOS diagnosis is made when you have irregular periods, elevated androgens, no insulin resistance, your periods were not affected by the pill but you display inflammatory signs and symptoms including:

1. Headaches
2. Joint Inflammation
3. IBS type symptoms
4. Unexplained tiredness
5. Skin conditions

Protocols for Inflammatory PCOS

Typical protocols for Inflammatory PCOS will necessarily include following an anti-inflammatory diet (we may start with food exclusions for period of up to 3 months of common inflammatory foods such as dairy), working on gut health to restore digestive health as well as reducing exposure to EDCs.

Typical supplements which help Inflammatory PCOS will include Zinc and an anti-androgen.

Post-Pill PCOS / PMOS

A Post -Pill PCOS diagnosis is made when you have irregular periods and elevated androgens, no insulin resistance and you had no PCOS symptoms before you started the pill.

One of the only findings of post-pill PCOS is that your Luteinising Hormone (LH) will be high compared to your Follicle Stimulating Hormone.

LH prevents follicles from developing and stimulates them to make androgens and again often the advice is to go back on the pill but this is only delaying and possibly worsening your PCOS status.

Protocols for Post-pill PCOS

Typical protocols for Post-Pill PCOS include:

1. Seeing if things correct themselves over time but also to ensure your diet is nourishing ovarian function which must include carbohydrates as your body needs starch to ovulate.

2. Supplements – there are some excellent supplements which help restore ovulation and periods especially Zinc which is depleted after the pill.

Adrenal PCOS / PMOS

Adrenal PCOS is less common (it accounts for approximately 10% of PCOS diagnoses) and occurs with elevated adrenal androgens – DHEAS which can be identified through the Dutch Hormone Test or a simple blood test.

It is driven by an abnormal stress response or adrenal axis, is often linked with stress at puberty and differs from other PCOS conditions as you may ovulate with adrenal PCOS.

Protocols for Adrenal PCOS

1. Stress – Not surprisingly the key protocol if you have Adrenal PCOS is to introduce stress reducing lifestyle practises to restore and repair adrenal health and focus on blood sugar balancing meals.

2. Supplements should always be personalised but if clients are not already taking Magnesium and these are not contraindicated with any medications they are taking this would be my first go to!

What are the symptoms of PCOS / PMOS?

PMOS, previously PCOS, is quite a common diagnosis affecting around 10% women. It is a whole body hormonal condition that can last a lifetime.

There are a variety of symptoms related to a lack of ovulation which results in a high level of androgens (generally thought of as male hormones and include testosterone, androstenedione & DHEA-S).

Common symptoms include:

1. Irregular periods (especially too late or too many days of bleeding)
2. Excess facial & body hair
3. Acne
4. Hair Loss
5. Weight gain
6. Infertility
7. Long term risk of diabetes & heart disease

How is PMOS / PCOS Diagnosed?

Diagnosis of PCOS / PMOS is not straightforward and many clients contact me because they have been told by a medical practitioner that they may have PCOS / PMOS following an ultrasound and have been offered Hormonal Birth Control.

Oftentimes clients are seeking more clarity and alternative more natural approaches to their PCOS but are overwhelmed with the wealth of information on the internet.

In fact, PCOS cannot be diagnosed by ultrasound and according to The Androgen Excess and PCOS Society you must have all 3 of the following to be diagnosed with PCOS / PMOS:

1. Irregular periods or polycystic ovaries on ultrasound.

2. High androgens on a blood or urine test or symptoms of high androgens e.g excess facial hair.

3. Other reasons for high androgens have been ruled out e.g hypothyroidism, high prolactin.

Susceptibility to PMOS (PCOS)

Genes

It is worth noting that you can be born with genes that put you at risk of PCOS / PMOS. For example:

Genes that make your ovaries overproduce androgens.
Genes that influence how likely you are to develop insulin resistance.
Genes that determine how your hypothalamus functions (which is a part of your brain which links your nervous system to your hormone function) and communicates with your ovaries.

Exposure to endocrine disrupting chemicals (EDCs)

Early exposure to EDCs (think pesticides, phthalates, BPA) can alter how your hypothalamus communicates with your ovaries or how sensitive you are to insulin and make you more susceptible to PMOS (PCOS).

Modifying Risk of PCOS / PMOS

You can modify your genetic expression and ovarian function with:

1. Diet,
2. Lifestyle
3. Supplements

All of which will improve your symptoms but it is important to note that a personalised nutritional strategy is key to success in improving your symptoms.

The reason for this is that there are different drivers or types of PCOS (PMOS) and whilst there may be overlap in some cases between the different types, identifying the key driver or underlying cause for your PMOS will lead to a different diet, lifestyle and supplement protocol which once identified will help improve your symptoms more quickly.

Get in touch

If you have any questions or would like to learn more about how I can help with PCOS, please don’t hesitate to contact me using the form below.

Angela Loftus BSc, PGDip, DipION, CFMP is a fully qualified Nutritional Therapist and Certified Functional Medicine Practitioner registered with BANT (British Association for Nutrition and Lifestyle Medicine) and CNHC (Complementary and Natural Healthcare Council). She is based in Chorleywood, Hertfordshire and works with clients both in person and online across the UK.

Angela graduated as a Nutritional Therapist from the Institute for Optimum Nutrition in 2015 and as a Certified Functional Medicine Practitioner in 2021. She has spent ten years working with over 1,000 clients.

PCOS is one of her primary areas of specialism and she has extensive clinical experience identifying the specific driver of each client’s PCOS – whether insulin resistant, inflammatory, post-pill, or adrenal – and developing personalised nutrition and supplement programmes to address it. She has worked with women with PCOS across all life stages, from early diagnosis through to those managing PCOS in the context of perimenopause.