PCOS is Now PMOS: The Good, The Bad, The Transition

12 Hormone Truths You Need in Your 30s, 40s, and 50s

Navigating your symptoms across your 30s, 40s, and 50s can leave you feeling dismissed, confused, and disconnected from your own body. In this Season 1 Finale of Phase to Phase: The Hormone Health Show, Naturopathic Doctor Anne Hussain leaves you with the ultimate hormone health real talk so that you can find some solid footing as you wade through well-crafted marketing, internet grifting, and the general fear-mongering out there.  She takes the most important lessons from the entire season (from the hair on your head to the muscles in your pelvic floor!) so that you get the care you need and deserve. She helps you differentiate evidence-based medicine from expensive, predatory snake oil, breaking down exactly why your lived experience is far better than a (fancy) hormone test and the kind of nutrition that makes a dent in your health goals. More importantly, she dives deep into the political reality of wellness, mapping out why individual biohacking can never cure a broken, underfunded system. This episode is deeply validating and full of actionable tips (no medical advice, of course!) designed to help you advocate for your health to build health. Make sure to share it with your family and friends so that we can have the energy and agency to make this world a better place. Key Takeaways * Do I need my hormones tested and are expensive hormone lab tests worth the money? Your lived experience, aka your tracked signs and symptoms, tell us the most important data points. Your hormones fluctuate throughout your cycle and lifespan. What’s usually happening in perimenopause, PMS, and PMDD is that your body is responding to the very natural fluctuations in hormone levels. Not only that, we often cannot draw a straight line from a hormone level to a particular symptom, which means that testing doesn’t help us understand what’s going on, guide treatment, or monitor progress. There’s a time and place for testing, but it’s not *always* relevant. * Is "cortisol face" real, and should I quit intense workouts for my adrenal glands and adrenal fatigue? "Cortisol face" is an internet wellness buzzword. Cortisol is a vital hormone required to keep you alive, not a villain; it goes up and down naturally as you go through life. It’s not the cause of your stress, it’s around when you are stressed (there’s a difference!). There are very real autoimmune cortisol disorders someone can have, but social media trends urging women to shrink their lives and abandon high-intensity exercise to "protect their hormones" are misleading. Your fatigue and nervous system dysregulation isn't caused by a failure of your adrenal glands, but by being under-resourced in a stressful world (some of which is beyond our control, like geopolitics). The goal is not to avoid cortisol ups and downs or to avoid stress entirely. The goal is to increase your resilience and capacity and broaden your boundaries through adequate fuelling and balanced nutrition, physical activity, rest, sleep, fun, social connection, and any individualized support you need. * Why am I struggling to lose weight despite dieting and exercising? Weight is a complex interplay of biology, genetics, and environment (think: upbringing, mental health, access to resources, education, nutrition, etc.), meaning your willpower is not to blame (despite what the rest of the internet says!). People come in all shapes and sizes, and what they look like does not often tell you about their actual health status. With the rise of meds like semaglutide and tirzepatide, there’s a lot of body-shaming on the internet, which is sad because this is the most we’ve known about obesity medicine and just how complex it is. Yes, there is benefit to weight loss, particularly decreasing waist circumference, since visceral fat around the organs increases the risk of high cholesterol, diabetes, high blood pressure, poor pregnancy outcomes, cancer, heart disease, etc. However, there’s no one-size-fits-all solution here, and these risks can be improved upon with a small amount of weight/waist size decrease, like 5-10%.  * Which is more important for longevity and hormones: fibre or protein? How much fibre and protein do I need? Fibre is what matters far more for your hormone and heart health than protein. They’re both important, but high fibre diets are consistently associated with lower risk of heart disease, certain cancers, cognitive decline, and hormonal symptoms in PMS/PMOS/perimenopause/endometriosis. While wellness media remains hyper-fixated on protein consumption, most people hit the minimum 0.8g per kg of body weight per day target of protein. Most North Americans (yup, women included) consume less than half of the recommended 25 to 30 grams of daily fibre.  * Is leaking urine normal after having children or as we age? Leaking urine when you sneeze, cough, or jump is incredibly common, but it is not normal. Society routinely normalizes pelvic floor dysfunction, chronic bladder leaks, severe period pain, and painful sex as "just part of being a woman," but these are treatable medical concerns. Kegels are not a universal fix-all because pelvic floor muscles can be tight, loose, and/or uncoordinated. A pelvic physiotherapist can be an important medical team member.  * Does the birth control pill cause long-term infertility? Does it ruin my hormones? The birth control pill does not cause infertility, but it frequently masks (and treats) underlying hormonal conditions for years. The pill remains an invaluable, life-changing tool for family planning and reproductive autonomy (and many symptoms). However, it’s often prescribed without a full assessment so if you have something brewing under the surface (think endometriosis, adenomyosis, PCOS (now PMOS)), it can be a rude awakening when you come off the pill, especially if pregnancy is now the goal. If you’re prescribed the pill to "fix" adult acne, severe period pain, or irregular cycles, it is helping to treat and manage those symptoms but not the metabolic or structural issue underneath.  * Are ultra-processed foods and seed oils toxic to my hormones? Rampant online fear-mongering regarding seed oils and trace food additives creates unnecessary orthorexia and food anxiety. Craving convenience foods or a cookie is a normal response to corporate food engineering, not a personal moral failure; focus on adding nutrient-dense whole foods where you can, and leave room for flexibility without the side of guilt. Not only that, the processing status of a food does not always tell you about nutrients (protein powders, fruit yoghurts, potato chips, and gummy worms are all in the UPF category!). Nutrition is the long game and we want to focus, as much as possible, on whole foods and lots of plants with a dash of flexibility.  * Does alcohol affect hormone levels and increase breast cancer risk? What about soy? Alcohol is a Class 1 carcinogen, and even moderate drinking raises your lifetime breast cancer risk (and upper digestive tract, liver, and prostate too!). While outdated myths falsely claim that whole soy products cause cancer (when human trials prove soy is actually protective), alcohol is the real driver that disrupts sleep and increases cancer risk. Many people with breasts will be afraid of mammograms but not of their very regular alcohol consumption even though one saves lives and the other does not. There is no safe amount of alcohol. Period. * Can perimenopause start in your 30s? What are the signs I’m nearing menopause? Can I use hormone therapy in perimenopause? The menopause transition or perimenopause can begin many years before your final period, so yes, you can be in perimenopause in your late 30s and early 40s. Even though perimenopause is defined by changes in menstrual bleeding, earliest symptoms are often mood and sleep disturbances. Hormone Therapy (or Menopausal hormone therapy, MHT) is a highly safe, effective, and valid first-line option to preserve your quality of life, not a dangerous last resort that you have to suffer enough to "earn." There are other options as well. Obviously, lifestyle modification should always be part of the plan.  * How do I know if my period flow is heavy? What is a normal period? Heavy menstrual bleeding or heavy flow (categorized medically under Abnormal Uterine Bleeding or AUB) means losing over 80mL of blood per cycle, bleeding past 8 days, or regularly passing clots larger than a quarter. Flooding through products, needing to double up on tampons and pads, or waking up in the middle of the night to change protection, chronically being iron-deficient are all red flags. A sudden, significant shift from your personal baseline matters too–if your period jumps from a light 20mL to a heavy 70mL, that dramatic change warrants medical investigation even if it technically sits below the textbook 80mL diagnostic limit.  * What are the best supplements to cure chronic fatigue and burnout?  You cannot out-supplement a broken lifestyle foundation, a chronic lack of sleep, or an under-fuelled body. Before spending thousands of dollars on adaptogens, green powders, or thyroid support supplements, you’ve gotta make sure you’re eating enough, getting your bloodwork done, getting good quality sleep, engaging in rest and fun, connecting with others, and moving your body. Millions of women suffer from chronic under-fuelling, sleep apnea, vitamin D deficiency, or iron deficiency (low ferritin) that can lead to fatigue, irritability, headaches, low mood, hair loss, and daytime sleepiness. We won’t get too much into the invisible load women carry, the constant low-grade climate anxiety, cost of living crisis, and geopolitical strife for now (but obviously those play roles too!). Learn more about your ad choices. Visit megaphone.fm/adchoices [https://megaphone.fm/adchoices]

PCOS is Now PMOS: The Good, The Bad, The Transition

Polycystic ovary syndrome (PCOS) got a major rebrand in May 2026, and it has taken the internet by storm. In this solo episode of Phase to Phase: The Hormone Health Show, Dr. Anne Hussain breaks down the shift from PCOS to PMOS: Polyendocrine Metabolic Ovarian Syndrome. She unpacks the science behind the new 15-syllable acronym (in plain language), why the polycystic ovary label was a misnomer and recently dropped, and how this updated terminology better reflects the multisystem, whole-body nature of the condition, especially the multiple hormones and insulin resistance involved. Dr. Anne covers what this means for your current diagnosis, whether your treatment plan will actually change, and what to expect as international guidelines get an update in 2028. She also tackles the downsides and criticisms of rebranding a condition affecting millions of people across the world. Finally, she leaves you with the most important reminder that the most important parts of the conversation, whether it’s called PCOS or PMOS, are you and your wellbeing. Key Takeaways * What does PMOS stand for? PMOS stands for Polyendocrine Metabolic Ovarian Syndrome. It is the new, official medical term for what was previously known as Polycystic Ovary Syndrome (PCOS), reflecting the true multisystem nature of the condition. * Why was the name changed from PCOS to PMOS? The term "polycystic" is misleading, reductive, and incomplete. Patients do not actually develop ovarian cysts; they develop arrested egg follicles due to altered folliculogenesis which we know as polycystic ovarian morphology. The new name acknowledges that PMOS is a full-body disorder involving widespread hormonal dysregulation (like testosterone, DHEA, GnRH), metabolic dysfunction (like insulin resistance and increased cardiometabolic risk), and ovarian dysfunction (like missing periods, anovulatory menstrual cycles). * Do I have to get re-diagnosed if I already have PCOS? Nope. PMOS is an updated name for the exact same condition. Patients already diagnosed with PCOS automatically fall under the PMOS terminology without needing new testing or a separate diagnosis. * Does the PMOS diagnosis change my treatment plan? At its core, and especially imminently, no. Our fundamental understanding of the condition hasn’t changed. However, by putting "metabolic" and "polyendocrine" right in the name, it pushes the medical community to treat root hormonal and metabolic drivers rather than just treating isolated reproductive symptoms like irregular periods, so hopefully you’ll get better care! * What are the main criticisms of the PMOS name change? While scientifically accurate, a new name doesn't fix a broken healthcare system. Criticisms include the disruption of patient-led advocacy networks due to sudden SEO and algorithmic shifts, the exclusion of people without ovaries by keeping "ovarian" in the name, and the risk of corporations and grifters profiteering off the new "metabolic" label. Ultimately, your access to care is still heavily dictated by systemic policies, your postal code, and other factors. * What is the timeline for the PMOS transition? According to the official rollout strategy published in The Lancet, there is a managed 3-year transition plan. This includes updating Electronic Health Records, engaging with the World Health Organization for new diagnostic codes, and fully integrating the PMOS framework into the International Guidelines by 2028. Chapters 00:00 PCOS is now PMOS 01:12 Name change FAQs 04:34 PMOS: The how and why 07:33 Pros of the rebrand 15:19 Criticisms and Cons of renaming 22:10 Next steps in PCOS/PMOS care References & Resources: Teede HJ et al. Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: a multistep global consensus process. Lancet. 2026 May 12. PMID: 42119588.  [https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00717-8/fulltext] AE-PCOS Society [http://ae-society.org] Dr. Anne's links:  phasetophase.ca [http://phasetophase.ca] annehussain.com [http://annehussain.com]  Learn more about your ad choices. Visit megaphone.fm/adchoices [https://megaphone.fm/adchoices]

Adenomyosis: The Heavy Flow and Period Pain Diagnosis That’s Often Missed

Spotting between periods, heavy flow, and period pain–a few gynaecologic conditions can cause these symptoms. In fact, some of these conditions come bundled like a package. In this solo episode of Phase to Phase: The Hormone Health Show, Dr. Anne Hussain covers one of these conditions: Adenomyosis. She breaks down what adenomyosis actually is (in plain language), why it's so often missed, what it means for you and your fertility, and risk factors worth paying attention to. She also tackles the fertility conversation that rarely gets enough airtime, the diagnostic delays that leave so many people missing out on life, and management options, from the hormonal IUD and surgical approaches to the integrative strategies and physical therapies like pelvic floor physio (often borrowed from endometriosis data as research has historically lumped these conditions together). She also covers the often-overlooked definition of heavy and abnormal bleeding, the costs associated with adenomyosis, and how to advocate for yourself so that you get the care you deserve. Key Takeaways * What is adenomyosis? Adenomyosis is a condition where tissue similar to the uterine lining grows into the muscular wall of the uterus, often causing heavy menstrual bleeding, painful periods, and sometimes a tender or enlarged “boggy” uterus. It affects an estimated 20–35% of premenopausal menstruators and frequently coexists with endometriosis, fibroids, and polyps. * What are the symptoms of adenomyosis? The hallmark symptoms are heavy flow and painful periods (dysmenorrhea), but adenomyosis can also cause chronic pelvic pain, painful sex, bloating, and fatigue from iron deficiency. Around 30% of cases are asymptomatic. * What counts as heavy bleeding or abnormal uterine bleeding? Heavy menstrual bleeding is clinically defined as losing more than 80mL per period, periods lasting longer than 7-9 days, clots bigger than an inch across, flooding, or needing to double up on period products. Significant changes from your own baseline also matter, even if your numbers technically still fall within "normal" range. The cost of heavy bleeding and period pain–money spent on period products, days of work and life that are missed, energy and time spent to find appropriate care–are under-supported aspects of menstrual health. * How is adenomyosis diagnosed? Transvaginal ultrasound is now a highly accurate diagnostic tool for adenomyosis, with closer to 90% sensitivity and specificity, making it more accessible and affordable than MRI. Advocate for imaging if your symptoms fit, and/or ask for a referral to a gynaecologist. * How does adenomyosis affect fertility and pregnancy? The numbers aren’t super clear because adenomyosis often occurs with other gynaecologic conditions. That said, adenomyosis is associated with higher rates of pregnancy loss, preeclampsia, preterm delivery, and complications in assisted reproductive technology (ART) settings. Early referral to a fertility clinic and understanding your individual health are important. * What are the treatment options for adenomyosis? There’s no one-size-fits-all solution for adenomyosis. Options include painkillers like NSAIDs for period pain, combined oral contraceptives for pain and flow, the hormonal IUD (currently considered first-line), progestin-only therapies, conservative surgery, and hysterectomy. Integrative strategies are usually borrowed from endometriosis research (nutrition, exercise, pelvic physiotherapy, acupuncture, and supplements like ginger, omega-3s, addressing a vitamin D deficiency, ensuring iron adequacy, PEA) can support symptom management and long-term health alongside conventional care. This should be a shared decision made based on your goals, health status, values, and symptoms. Chapters 00:00 Adenomyosis stats 01:30 What is adenomyosis? 5:58 Risk factors 6:53 Diagnotic imaging 7:42 Infertility and fertility considerations 8:53 Conventional treatment 10:59 Integrative treatment options 14:39 Self-advocacy and tips Dr. Anne's links: What is a Normal Period Podcast Episode [https://annehussain.com/podcast/episodes/decoding-your-menstrual-cycle-what-is-a-normal-period] phasetophase.ca annehussain.com References PMID: 30969690, 37837497, 37809195, 39718325 Learn more about your ad choices. Visit megaphone.fm/adchoices [https://megaphone.fm/adchoices]

Stop Blaming Cortisol with Dr. Jordan Robertson

"Cortisol Face." "Cortisol Belly." If you spend any time in the wellness corner of the internet, you’d think cortisol was the ultimate villain ruining our health, bodies, and lives. But is this misunderstood stress hormone actually to blame, or is wellness culture just capitalizing on women’s fatigue in a world in which we’re under-resourced and over-extended? In this episode of Phase to Phase, Dr. Anne Hussain is joined by Dr. Jordan Robertson, ND, founder of The Confident Clinician, to inject some much-needed critical thinking into the cortisol conversation. They break down why cortisol is actually a vital player in keeping you alive, why paying for routine cortisol testing is essentially throwing money into a bonfire, and what you should actually be testing for instead (hint: sleep apnea and iron deficiency). Dr. Jordan introduces the concept of allostatic load, your body's true capacity to handle stressors. Together, they challenge the current narrative telling women to "do less" and avoid high-intensity workouts to protect their hormones. Instead, they offer a refreshing, empowering reframe: true nervous system regulation isn't about avoiding hard things; it's about adequately fueling and resourcing your body so you can push your boundaries, build resilience, and operate at your best. Takeaways * Cortisol is not the enemy. It’s a necessary buffering system that helps your body mount a response to physiological and psychological demands. It doesn't cause the distress; it just shows up to help you survive it. * Cortisol testing doesn’t tell you much (unless you are being screened for overt adrenal diseases (like Cushing's or Addison's)). Routine cortisol testing for general fatigue is virtually useless due to massive inter-individual variability. It won't explain your symptoms, and it shouldn't dictate your treatment.  * Focus on “allostatic load," not the actual individual hormone. Instead of trying to "fix" your cortisol with trendy supplements, focus on your body's overall capacity to handle stress. True resilience is built through foundational resources: adequate sleep, solid nutrition, and periodized recovery. * Stop fearing high-Intensity exercise. Women are increasingly being told to avoid hard workouts to "protect their cortisol." In reality, you should exercise as hard and as often as you can adequately recover from. Intentional physical stress builds long-term metabolic resilience and better cortisol responses in the long run.  * Look for the real culprits first before blaming your adrenal glands for your sluggishness. Iron deficiency, sleep apnea, and chronic under-fueling (like running on nothing but coffee and a banana until noon) perfectly mimic the symptoms of nervous system dysregulation (and will make your PMS worse too!).  * Burnout makes your capacity feel small, like living inside a tight electric fence where every minor stressor zaps you. The goal isn't to stay inside that tiny fence forever by doing less; it’s to resource your body so you can push those boundaries outward and confidently take on hard things. This is hard, but not impossible, to do when we already have a high burden of responsibility. Get help! Chapters 00:00 Cortisol online 01:44 Jordan's intro and mission 06:40 Cortisol's role 11:00 Allostatic load and building resilience 21:19 Intentional stress and coping 23:20 HIIT and recovery 27:37 Cortisol testing 35:45 Habits that help for stress 42:50 Changing your mind Links: Dr. Jordan Robertson’s Links:  Follow Jordan on Instagram [https://www.instagram.com/drjordannd/%E2%81%A0] Learn about The Confident Clinician https://www.instagram.com/theconfidentclinicianclub/ [https://www.instagram.com/theconfidentclinicianclub/] https://confidentclinicianclub.com/ [https://confidentclinicianclub.com/] Dr. Anne’s Links:  phasestophase.ca [http://phasestophase.ca] annehussain.com [http://annehussain.com] More About Jordan Robertson: Jordan Robertson is on a mission to elevate integrative and naturopathic medicine to the standards of care that conventional medicine practices while simultaneously solving the unpaid research-labour crisis of Naturopathic Doctors. With a 15-year career in facilitation, research inquiry and critical appraisal at McMaster University, Jordan has taught thousands of students how to be better communicators, work in teams and research nutrition, integrative care, medicine and “space medicine” (that last one while co-facilitating a course with NASA). Jordan is the founder of The Confident Clinician, a database, clinical decision-making tool and home for over 700 full-time members, 60 fellows in her leadership program and over 5000 clinician subscribers to her free integrative magazine, The Stacks. She’s known for helping clinicians see their own potential, inspiring curiosity, vulnerability and “mind-changing” and for giving clinicians the push they need to become the best at what they do. Learn more about your ad choices. Visit megaphone.fm/adchoices [https://megaphone.fm/adchoices]

The Real Problem with Ultra-Processed Foods: It’s Not the Dye

What do a tub of protein powder, a bag of salt and vinegar chips, and a can of chickpeas have in common? They’re all processed foods. If you listen to the extreme corners of wellness TikTok, processed foods are “toxic” and you should feel terribly guilty about eating them (and feeding them to your family!). But is that actually true? In this solo episode of Phase to Phase, Dr. Anne Hussain tackles the ultimate health buzzword: Ultra-Processed Foods (UPFs). She goes over what actually makes a food processed or ultra-processed using the NOVA Classification System, she takes you through the science and impact of UPFs on your health, breaks down the massive difference between a flash-frozen vegetable and a hyper-palatable cookie, and why panicking over a drop of artificial dye while ignoring the systemic impact of cheap palm oil completely misses the forest for the trees (pun intended!). This episode will take you through why craving chips isn't a failure of your willpower, how to navigate our current food environment, and how to build flexible and resilient nutrition strategies when life is busy and shelf-stable snacks are everywhere.  Key Takeaways * Are all processed and ultra-processed foods bad? Lumping all packaged and processed foods together as “unhealthy” or “toxic” is a mistake. Protein powder, canned beans, and fruit yoghurt are technically processed, but offer nutritional value and much-needed convenience for our busy lives. We do want to minimize or avoid the sugar- and salt-ladened, hyperpalatable, low-on-nutrition UPFs because they tend to replace nutrient-dense foods, but not all UPFs are made equal. * Do I need to avoid all UPFs? A small amount of candy or artificial dye on occasion isn’t going to make a huge difference in your health (unless you’re allergic to it!). The real culprits driving chronic disease are a lack of fibre, excess sugar and salt, and cheap, environmentally destructive refined oils like palm oil that are contributing to deforestation. So, definitely minimize and avoid UPFs when possible, but focus more on adding nutrient-dense whole and minimally-processed foods as much as possible.  * What is the NOVA Food Classification System and what is a processed food anyway? Researchers categorize food by the purpose of its processing. Group 1 includes whole foods (like frozen berries, fresh spinach, oats, etc.), while Group 4 includes UPFs that are industrial formulations designed to be hyper-palatable and/or convenient, replacing other food groups (like candies, chips, and hot dogs, but also protein powder and fruit yoghurt). * Why are ultraprocessed foods everywhere and often cheaper than fresh produce? UPFs are scientifically designed in labs with the perfect ratio of sugar, fat, salt, and carbs to make you want them more. Craving them isn't a moral failure; it's a multi-billion dollar success of the global food industry that lobbies for corporate profits at the expense of the health of average people and our planet.  * What should I focus on in my own nutrition? We need a sprinkling of flexibility to create room for enjoyment, tradition, nostalgia, and convenience, so you don’t need to fear the occasional UPFs (frequency and quantity matters!). Our bodies are quite resilient, especially if we lay down some solid nutritional foundations. So, focus on balanced meals that have carbs (including fibre), protein, healthy fats and offer vitamins, minerals, and antioxidants.  Heart & Stroke Foundation on UPFs [https://www.heartandstroke.ca/what-we-do/media-centre/news-releases/ultra-processed-foods-cause-third-of-heart-and-stroke-deaths] NOVA Food Classification System Adaptation: Food, Nutrition & Fitness I: The Digestion Journey Begins with Food Choices (Compiled in 2018 by EduChange with guidance from NUPENS, Sao Paulo) [https://ecuphysicians.ecu.edu/wp-content/pv-uploads/sites/78/2021/07/NOVA-Classification-Reference-Sheet.pdf] phasetophase.ca [http://phasetophase.ca] annehussain.com [http://annehussain.com] Learn more about your ad choices. Visit megaphone.fm/adchoices [https://megaphone.fm/adchoices]