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For high-performing women who are exhausted by weight gain, hormonal chaos, and vanishing energy — this is your reset. I’m Dr. Ade Akindipe, a DNP, obesity + hormone specialist, and health coach.
On this show, we demystify metabolism, gut health, hormone balance, longevity, and the root-cause mindset behind lasting transformation.
If you’re ready to stop fighting your body and start living with more clarity, energy, and confidence — this is your space.
Aderonke Akindipe, DNP, NP-C (00:01.418)
Welcome back to the elevated women's podcast. I'm so glad that you are here today because I'm about to share with you a breaking news in the world of world of women's health. And I think it's just so interesting that it's actually happening in the month of May, which is also women's health month. It's been a long time coming, this conversation. So I want to start with this question. And if you can relate with this, you know exactly what I'm talking about.
If you've ever been told that your labs were normal, but you know that something isn't right. If you've ever struggled with weight, that you feel like you're doing all of the things and it's not working no matter what you do, you get these skin infections that you keep breaking out like you're in high school, hair growing in places that you don't want it. But at the same time, you have hair thinning in places you do irregular periods, exhaustion.
mood swings, brain fog, and every doctor just tells you everything looks normal in your labs. Maybe they've told you to eat less or move more, or maybe you had irregular periods and because of that your doctor says here's the birth control pill. I'll see you when you're ready to get pregnant. Or maybe you were diagnosed with polycystic ovarian syndrome. Yes, PCOS. That's what we're going to talking about today. Maybe you were diagnosed with PCOS.
but nobody really explained what that meant, what to do about it, and how serious it actually is. If any of this sounds familiar, this episode is for you. if it doesn't, I want you to still listen because this particular condition looks very different in different women. And so it doesn't fit a particular pattern. And that's why sometimes it gets missed. So there's a very good chance you might know someone, a daughter or sister, a friend who is living with this condition.
and doesn't even know it. Because the truth is about 70 % of women who have this condition have never been diagnosed. Yeah, 70%. So we're going to change that today so people, know, women will stop going to chat GPT as their doctor and really try to advocate for themselves when they're not being heard. And that starts with the biggest news in women's hormonal health in decades. So
Aderonke Akindipe, DNP, NP-C (02:24.398)
On May 12th, so if you're listening to this a little bit later, May 12th, 2026, a landmark paper was published in the Lancet. It's one of the most respected medical journals globally, okay? And it announced that over 22,000 doctors, researchers, patients have been working on this for more than 10 years now. So polycystic ovarian syndrome was officially renamed. It's now called
polyendocrine metabolic ovarian syndrome. I know it's a long name, but it makes a lot of sense why they would pick this name, polyendocrine metabolic ovarian syndrome. Once we dive into this, it'll make more sense. One letter difference, right? So instead of PCOS, it's PMOS. But do not let the small change in that letter fool you because it's enormous. So let's break this down. The word polycystic means
many cysts, poly means many cysts. So for decades now, the assumptions are among many medical professionals, including myself, until I started getting more education. So this is not necessarily news to me because we've gone for further education. We know that there's more to it than just the ovarian cyst But now everyone is understanding more about what's happening.
If you don't have cysts on your ovaries that's visible on an ultrasound, for example, you were told that you didn't have PCOS. Women were told your scan looks fine, so it's probably not PCOS. And then they walked out of that office with no answers, without treatment, and without understanding why their body felt like it was working against them. So now we know that those cysts aren't necessarily cysts.
What shows up on ultrasound are small, immature follicles, eggs that never fully developed, not cysts in the clinical sense of cysts. So the name in the beginning just was not accurate. And because the name focused so heavily on ovaries, the condition was treated primarily as a GYN issue.
Aderonke Akindipe, DNP, NP-C (04:44.074)
It was a reproductive issue. So you go to your gynecologist and you try to get scanned. if it's not, if it's not BCOS, it's not because you don't have the cysts on there. Or they were treated like period problems because women would often, especially in their teenage years, not have regular periods. They would struggle with fertility. That was the story, but that's not the full story at all. So polyendocrine means multiple hormones are involved. Okay.
Metabolic means it affects your blood sugar, your insulin and your weight, your heart health. Ovarian, yes, it affects your ovaries, but ovaries are just a part of it, not the cause of it. So now we can see the whole picture. So this is a whole body condition and it has been missed, minimized and misnamed for too long. Okay, so let's talk about what that looks like clinically.
this past week, and it's just interesting that this happened coincidentally, I saw so many women, new patients coming into our clinic. Right now we have a special that's going on where we're seeing women who are interested in looking for the root cause of their issues. It's called a metabolic and hormone assessment. And I saw probably about eight to 10 women who all had PCOS. And when they first come into the clinic,
I don't necessarily have their labs, right? It's an initial consultation. I don't have their labs. Most times it's just a form they filled out. They get on a body composition. We look at that. And then they have their symptoms that they present with and they're talking to me. And some of them already know they have PCOS and that's it. They were told I had a hysterectomy years ago. Maybe they took my ovaries. Maybe they didn't. Somehow the...
root cause they thought was ovaries. So they would take the ovaries out if they had cysts, if they have endometriosis, if they were having heavy bleedings, if they were having pain, they were taken out. Or maybe they had uterine cancer or ovarian cancer. So they removed all those, those organs. Or I had another woman who said, I had HS, hydrogenatis, hidradenitis suppurativa which is a very common dermatologic, like a skin condition, skin infection.
Aderonke Akindipe, DNP, NP-C (07:04.376)
for women who have severe PCOS. So they would get breakouts in different areas. Usually it's very moist to warm areas of the skin they would break out because the skin, the underlying skin where the root of the, hair grows gets infected. Or maybe they have pre-diabetes. Some already have full-blown diabetes, high blood pressure. Another thing too is women will say, well, my mom,
diabetes, my grandmother. So it's usually you'll see the pattern in the family. They'll say they have facial acne, they have hair growth around their chin or hair growth or acne, really bad skin, or they'll say they have mood issues, depression, anxiety, feeling really bad around certain type of time of their cycles, trouble getting pregnant, or if they've tried getting pregnant, will miscarry.
These are the stories that I heard over and over again, some for decades. Some of them already in perimenopause and some of these symptoms will start to even worsen as they get closer and closer to perimenopause. And at some point I had to stop and say, my goodness, I'm so sorry that you had to go through this because you can see the frustration, tears.
One woman actually said she was trying everything and it's very frustrating when you go to a doctor and doctor says You just need to watch the carbs You just need to watch that what does that mean? You just need to watch the carbs But she and she know she's in my office saying i've tried that It's just not working. You don't understand. It's not me. It's not that i'm just sitting here eating or the extreme fatigue right or hair thinning they can't you know, they're
brushing their hair and the hair is falling out. So this is the story of what that looks like in these women. Okay. So let me walk you through what PMOS actually looks like. We just talked about some of the things that we see in clinic. So the irregular or absent periods, okay, fewer than eight cycles a year. Cycles are shorter than 21 days or longer than 35. So heavy, painful bleeding or nothing at all.
Aderonke Akindipe, DNP, NP-C (09:24.366)
for months, this is your body telling you ovulation isn't happening the way it should. And a lot of times it's not because of the cysts, it's because of the metabolic dysfunction. So all of these different hormones, your insulin and your sex hormones are intertwined and they send signals. So unfortunately, when one is out of balance, it causes issues with others, right? Women have signs of high androgens. So most of the time it's testosterone.
So this high levels of testosterone causes excess facial hair or body hair. We call that hercotism. So acne, especially around the jaw area is very common or the chest and the back, hair thinning or loss on the scalp. These are not just cosmetic issues, they're hormone signals. Metabolic symptoms. Now this is one that's the most common.
And stubborn weight gain is one of that, but sometimes it's not necessarily an obese person. That's some of the things that might be confusing. They expect a woman to be overweight, but not all the time. In fact, this Landsat study said there's a good percentage of women that are actually within a normal BMI. Their BMI is not considered obese, but they may have PCOS. So don't just look at, they're obese. If they're not, they could still have some of those symptoms.
Stubborn weight gain, this is usually especially around the belly. They have trouble losing belly weight. It's one of the reasons I love getting a body composition on women because just because you weigh 130 pounds does not mean that you're metabolically healthy. And we've talked about that in previous episodes. So we get a body composition and the visceral fat levels are usually very high. That is a key. You don't even need to see that on the labs.
high visceral fat and they'll tell me they've been doing all the things. They've been trying to work out. They've been cutting carbs. One key they will say is I tend to do better when I'm low carb or I'm on a keto diet. That's a big sign right there. Difficulty losing weight, feeling very, very tired after eating, sugar cravings, brain fog.
Aderonke Akindipe, DNP, NP-C (11:39.873)
And ladies, if you're in your mid-40s and beyond, this could be also overlapping with perimenopausal symptoms. Some of them even complain of hot flashes and night sweats. These often point to insulin resistance, which is a major, major driver of PCOS or PMOS, and it almost always can lead to type 2 diabetes. Skin changes, darkening of the skin in the fold, under the arms, behind your neck, in your groin.
This is called acanthosis nycrogans, and it's a classic sign of insulin resistance that often gets completely overlooked. Mental health. This one is a huge one. Anxiety, depression. I had one lady that came in this week, this past week, who said she's trying to wean herself off of these meds. That's her goal. She said her goal for the next three to six months is to get off multiple antidepressants because we're not fixing the root cause. So one stops working, we add another one.
Right? So emotional dysregulation. These are not separate issues. They're part of the whole hormonal picture. Fertility challenges, difficulty getting pregnant, or a history of miscarriage. Okay. Now here's what I need you to hear. You do not need to have all of these symptoms to have PMOS. The diagnostic criteria require only two of the three key features. And you absolutely do not need, you know, a very ovary ultrasound.
that has cysts on there. So many women who have PMOS have no cysts at all. Okay. And the other thing is, yes, the diagnostic criteria are there, but I, know, and that's why sometimes you really need to look at the patient. And that's what I try to practice in my clinic, because even if you don't have the exact diagnostic criteria, and that's what caused the problem in the first place, we were relying so much on ultrasound.
listening to the patient, difficulty getting pregnant, insulin resistance, getting a body composition, all of those little things can clue us into what's happening. And you may not fit the diagnostic criteria, but very much have metabolic syndrome or PMOS. So why so many women are still being missed? First, like I just said, the diagnostic criteria historically was you have to find the cyst, okay?
Aderonke Akindipe, DNP, NP-C (14:08.14)
those doctors aren't the problem. It's just that the diagnostic criteria, if you're trained a certain way and it's not there, you start looking for other possible diagnoses. And sometimes we're looking for zebras, but it's right under our nose. Or sometimes there are some providers that will start to treat. They can see that their blood sugars are rising. They can see that there's some form of metabolic dysfunction. Maybe they're
liver enzymes start to rise, their cholesterol starts to rise. But the problem is we're treating things in isolation. you have type two diabetes now. you have high blood pressure. But we're not treating the root cause, which is the hormonal insulin resistance typology. And then the other thing is PMOS can span multiple specialties. So sometimes you'll see a dermatologist that's treating the acne. You see a gynecologist.
treating the irregular periods, you see an endocrinologist who's watching your blood sugar, see a cardiologist who's doing your blood pressure. And then you have a therapist that's addressing the anxiety, right? But there's nobody sitting in the center connecting all those threads and saying this is one condition. The other thing is the stigma around this diagnosis because PMOS is often associated with weight. Some women and some doctors unconsciously attribute symptoms to lifestyle
rather than biology. Thin women get missed because nobody expects them to have PCOS. Heavier women get told, just eat less, lose weight, without being given the tools or the underlying diagnosis that would help them do that. And the fourth is that, and this one makes me really emotional, women have been conditioned to minimize their symptoms.
We've been told our pain is normal, our fatigue is normal, our irregular cycles are normal. It's not normal. Getting a birth control pill is not going to fix it. Eat less, move more. A woman literally broke down crying, saying, I am trying, somebody needs to help me. So if you're listening to this, this is, we've talked about the news, we've talked about the symptoms, we've talked about the gaps.
Aderonke Akindipe, DNP, NP-C (16:34.038)
Now let's talk about what you actually do. First thing is if you're not sure where you are and you just know something is off, you can start by tracking your cycles because cycles, irregular cycles could be it. If you don't know how long your cycles are, when they come, how heavy they are, start now. There's lots of apps that can help with that. Use a journal, use a sticky note. You know, I don't care how you do it, but the information is critical.
and then you can bring this to your provider. Number two is request a more comprehensive lab panel. Not just one number. When you go to your doctor, ask specifically for the following tests. When it comes to your metabolism or your metabolic function, you want a fasting insulin, fasting glucose, hemoglobin A1C. Even if your
glucose is normal, it's very possible that your fasting insulin can be high. I have a patients where their fasting glucose is 95, which to me, we're practicing if you're fasting your blood sugars on the higher end, because your normal should be between 60 and about 100, right? But if you're fasting and your blood sugar is 99, I'm already concerned that your sugars tend to run higher. When you're eating, you're probably spiking it much higher.
So what we check is your fasting insulin. Higher insulin means your pancreas is working hard to drive your sugars down, to bring sugar, glucose, energy into your cells for it to use for energy. But if your blood sugars are high, your cells don't have the energy they need to function, and that's why you are so tired all the time. That's why you're living on coffee. That's why your sleep is disturbed.
So those things go together. Fasting insulin, fasting sugar, hemoglobin A1C. There's some other tests you could probably do that a little bit more. know, HOMA IR is another one. There's a C peptide. Those are more advanced studies that don't necessarily need to be, but if we need to get there, we can do those tests. You need a full androgen panel that looks at your testosterone levels because that tends to be elevated in women. Total and free testosterone.
Aderonke Akindipe, DNP, NP-C (19:00.248)
then there's another hormone called DHEAS. If that's high, can also be an issue that's part of the whole hormone driving the high testosterone. LH and FSH, that's luteinizing hormone and follicle stimulating hormone. These two hormones are the ones that the brain tells the ovaries to, they're produced in the brain by the way, and it tells the ovaries to produce more hormones, your sex hormones.
so that, and depending on the provider that you go to, sometimes that can clue me into if there's a chance you might have PCOS. Thyroid panel, because sometimes there's an overlap when there's a lot of hormonal dysfunction. Sometimes these women also have low thyroid function. So fatigue, hair falling out, those are all hypothyroid symptoms as well. Cholesterol panel, looking at your triglycerides.
Triglycerides basically a stored sugar stored energy and they you know, that's usually You might be developing fatty liver disease. Maybe your blood sugars already, you know, your inflammatory markers already going up So lipid panel inflammatory markers like CRP Homo cysteine are great ones. I'm going to put together a cheat sheet For you to bring to your provider to check it's going to be in the show notes for you. Okay So many of these are not standard
you have to ask for them. So you need to ask for them by name, right? The other thing I want you to do is write down every symptom you have, not just the ones that seem medical, your acne, your fatigue, your mood, your hair, your weight history, your family history of diabetes, heart disease, hormone issues. Bring that list to your doctor, to your appointment. That paints a better picture for your provider versus I think I'm depressed.
and you just handed an antidepressant, right? The other thing is you need to advocate for yourself. You have this podcast, the Lancet study, it's basically on social media now, it's everywhere, it's on Google. You can print it out and bring it to your provider and say, hey, this is what I'm hearing about PMOS. I don't have ovarian cyst. Maybe you had an ultrasound and you didn't have ovarian cyst, but some of the symptomology sounds like what you might be going through. Bring it.
Aderonke Akindipe, DNP, NP-C (21:25.73)
And if a provider dismisses your concerns or tells you everything is normal without explaining, then it's okay to ask for a second opinion. You know your body, you deserve a provider who listens to you. Then I want you to begin with lifestyle as medicine. Right now, without waiting on a diagnosis, okay, the research is very clear that lifestyle interventions are among the most powerful tools for managing PMOS.
So in general, anti-inflammatory diets are really good, like reducing as much ultra-processed foods as you can. So anything that comes in cans, packaged, and I know for a lot of women it's difficult because you may struggle with time. But there are options. Frozen Isles is something I recommend for women who are on the go.
where you have mixed vegetables that are frozen. A lot of these are frozen at the peak of when those vegetables and fruits are ripe. So you can use those, throw them in the pan if you need to do a stir fry, add some protein to it. That's better than eating those pre-packaged that are usually stored in the pantry. They tend to have a lot more preservatives and a lot more added sugar, a lot more added sodium. That's one way we can make it. I live in Alaska, so if you're listening and you're not in Alaska, you may have access to readily available
fruits and vegetables all the time, but we struggle here in Alaska because everything is shipped here and sometimes by the time we get them, they're not as fresh. I advocate for, sometimes if it's, know, if you're really desperate, reach for the canned ones, but we want to try not to. You want to do as fresh fruits and vegetables as possible. Refined sugars, seed oils, those tend to be the ones that cause more inflammation. So you want more of
again vegetables, fiber, lean proteins, and healthy fats, the ones that are rich in omega-3 fatty acids. Then strength training. So remember we talked about how blood sugars tend to be an issue for women who have PMOS. When you have high sugars, your insulin goes up. So it's very important to make sure that you are strength training. It is the best way
Aderonke Akindipe, DNP, NP-C (23:49.391)
to drive insulin sensitivity up, the insulin starts to work better, your cells are using energy and you're burning fat. You're using the stored energy, if that makes sense. When you have a lot of stored energy around your liver or in your belly, the best thing to do is incorporate daily, if possible, at least three days a week of strength training. Then you need to prioritize sleep. Poor sleep.
directly worsens insulin resistance and your stress hormone cortisol. So scrolling before bedtime doesn't work anymore. You need to stop doing that. You need to have a very good sleep hygiene. And if there's problems with your sleep, if you're doing that and you're not able to stay asleep or fall asleep, there's many options and that you need to go to a provider that and to get really personalized advice about what would work for you. If in perimenopause, it might be hormone replacement.
There might be herbs you can try, might be supplements you can try. Stress management is important. Stress hormone cortisol drives, it just worsens insulin resistance, which worsens hormonal imbalance. So you don't have to wait for a diagnosis. The other thing, actually this is one of the first things I should have said before everything else, is you need to know what your blood sugars are doing. You need to know what's driving your blood sugar up. And one of the things, and all my clients, they know this one. In fact, sometimes we will,
actually start the process in the clinic is to get a continuous glucose monitor. You don't need a prescription for it. Purchase it online. There's different brands made by those big companies like Abbott and Dexcom. One of the ones we use in clinic is called Lingo. You can apply it yourself. It's very easy. They're good for two weeks. And you can see in real time what different things, different foods, what stress.
is doing to your body, what lack of sleep is doing to your body, and you can start to work on reducing your sugars based on your lifestyle. And then the other thing you need to do is find a provider who specializes in metabolic and hormone health, someone like my clinic. This may be a functional medicine provider like myself, a reproductive endocrinologist, an integrative OB-GYN. Look for someone who understands that this is a lifelong process. This is not
Aderonke Akindipe, DNP, NP-C (26:14.422)
just a gynecologic issue or tells you you have no ovarian cysts, or just get a birth control prescription because that's not really dealing with the whole picture. So I want to close today with something important. If you've been dismissed, if you've been told you're fine when you don't feel fine, if you've been carrying symptoms for years with no answers, you were not wrong. You were not dramatic. You were not making this up.
And this study that came out shows that. That's why they changed the name. So that should empower you that, yes, I don't have ovarian cysts, but can we look into this? Your body has been telling the truth this whole time. The medical system just didn't have the right language to hear it. PMOS finally gives us that language. Polyendocrine, hormones, metabolic, your whole body chemistry, ovarian, yes, your reproductive system.
So, all of it together makes the whole diagnosis. So, take what you've learned today, share this episode with a woman in your life who has been struggling without answers, have the conversation with your provider, ask the questions, order the lats, and remember, the most elevated thing you can do for yourself is to refuse to accept that how you feel is just how it is. You deserve better, and now, finally, medicine is starting to catch up.
Until next time, stay elevated.