PCOS · PMOS Health Collective

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PCOS · PMOS Health Collective BC's first PMOS (formerly PCOS) focused virtual naturopathic clinic. Are you ready to take control of your PMOS journey?

I’m Dr. Melanie DesChatelets, a naturopathic doctor since 2010. We’re excited to offer you a FREE PMOS Lab Guide to manage your PMOS.

Adrenal? Inflammatory? Post-pill? Insulin resistant? Or phenotype A, B, C or D? If you've been trying to work out which ...
10/02/2026

Adrenal? Inflammatory? Post-pill? Insulin resistant? Or phenotype A, B, C or D? If you've been trying to work out which bucket you belong in and keep half-fitting several of them... congratulations. You just figured out why this doesn't work, ahead of a lot of other people.

PMOS (formerly PCOS) does not fit in a neat little bucket.

Part of the confusion is that “type” gets used two completely different ways, and they get blurred together constantly.

The popular subtypes you see online, adrenal, inflammatory, insulin resistant, post-pill, come from mechanism-based theories. They were an attempt to explain why this shows up differently in different bodies, which is a reasonable instinct. But they are not medical diagnoses, they don't appear in research papers, and they are not in the clinical guidelines. What happened next is that they hardened into fixed categories with their own supplement stacks, diets and workout plans attached.

Now my soapbox: all of that happened in the name of individualising care. And the result was the opposite. Instead of looking at a whole person, we sorted people into four or five buckets and gave each bucket the same protocol.

The Rotterdam phenotypes are the real ones, and they're simply about which diagnostic features you have. A has all three. B has irregular cycles and high androgens without the morphology. C has morphology and androgens with regular cycles. D has irregular cycles and morphology without high androgens.

I'm genuinely glad research is going this way, because it will tell us whether some groups carry higher risk of certain things. But that's population data. Stretching it onto an individual is extrapolation. And even where one phenotype does carry higher risk, that is never a reason to skip screening in the others. Higher risk is not a way to exclude.

Which is exactly what the guidelines say: screen everyone, and individualise based on what is actually showing up for you, because you checked.

Here's where the labels backfire in real life. Someone decides they're not insulin resistant because they aren't gaining weight, so the labs never get run and blood sugar stops mattering to them. Or someone lands in the adrenal bucket and becomes frightened of the exact workout they enjoy and would actually do consistently.

PMOS is an enduring diagnosis. That does not mean it's frozen in time. It adapts to what you're doing, and your care should adapt too. Which is why I don't use fixed types. I look at where your body is right now and what we're tracking, so we can notice a direction of travel before it becomes a problem.

If we're just meeting... hi, I'm Dr. Mélanie DesChâtelets, ND 👋 Naturopathic doctor since 2010, clinical focus on PMOS (formerly PCOS), perimenopause + metabolic health.

If you have no idea which type you are, you're not behind. Comment SHIFT 👇 and I'll send you the Shift Society invite. The Lab Clarity mini training is waiting inside, exclusive to members.

🩺 In BC? I'm a licensed naturopathic doctor in British Columbia and I see patients virtually... the free 15-min Clarity Call link is in my bio.

There's a half of your diagnosis almost nobody talks about.Everyone focuses on what has to be present. Far fewer people ...
09/30/2026

There's a half of your diagnosis almost nobody talks about.

Everyone focuses on what has to be present. Far fewer people mention what has to be absent, and that second half is the one protecting you. Unlike the first, it doesn't change with age. Same requirements at 15 and at 45.

It exists because several conditions produce nearly identical symptoms. I call them mimickers.

Thyroid dysfunction alone makes cycles irregular. High prolactin blocks ovulation. Congenital adrenal hyperplasia can look remarkably similar. Different causes, different answers.

Four labs rule those out, for everybody, regardless of how classic the picture looks: TSH, prolactin, 17-OH progesterone and FSH.

The rare ones are rare, which is exactly why they get missed. And the people who have them deserve to be treated for what they actually have, rather than managed for something they don't.

If we're just meeting... hi, I'm Dr. Mélanie DesChâtelets, ND 👋 Naturopathic doctor since 2010, clinical focus on PMOS (formerly PCOS), perimenopause + metabolic health.

Go and pull up your results. If those four were run and came back normal, that box is genuinely ticked and that's good news. Comment SHIFT 👇 for the Shift Society invite.

🩺 In BC? I'm a licensed naturopathic doctor in British Columbia and I see patients virtually... the free 15-min Clarity Call link is in my bio.

Four questions worth answering before any weight-focused plan. Save them, or take the worksheet.ONE. Is weight loss medi...
09/28/2026

Four questions worth answering before any weight-focused plan. Save them, or take the worksheet.

ONE. Is weight loss medically indicated right now? Labs, metabolic pathways, quality of life markers that matter to you. Not body size in isolation, not what you assume is expected of you.

TWO. Are you emotionally resourced for this right now? Honestly self-screen for a more complicated relationship with food, which deserves a provider's support first. Flagging here and skipping ahead anyway is building a home on a shaky foundation.

THREE. Do you have a consent-based team? Metabolic understanding AND genuine sensitivity to the mental health side, in the same room.

FOUR. Can we define success beyond the scale? Cycles, cravings, energy, lab improvement.

Because how you lose weight matters as much as whether you do. Restrictive dieting, weight cycling and weight stigma all carry real costs, including a higher risk of disordered eating. This is not a zero-sum intervention, and we don't explain that side well enough.

Most PMOS (formerly PCOS) care belongs in a weight-neutral lens. When weight loss is genuinely indicated, it happens with consent and with your full autonomy to know every option.

You will never see me promise you X pounds in Y weeks, and I will not post a before and after picture. You are so much more than that.

The four-question worksheet: shiftpmos.com/consent-check

🩺 In BC? I'm a licensed naturopathic doctor in British Columbia and I see patients virtually... the free 15-min Clarity Call link is in my bio.

“Do I actually have this?” is one of the most common questions I hear. Sometimes people are certain and have never been ...
09/25/2026

“Do I actually have this?” is one of the most common questions I hear. Sometimes people are certain and have never been diagnosed. Sometimes they've been told they have it and it just doesn't sit right... or it looks nothing like their friend's version. No two people with PMOS (formerly PCOS) have the exact same symptoms.

One honesty note before the rules: I'll say “20 and up” to keep this readable, but the real diagnostic line is about 8 years after your first period. Twenty is just shorthand, because that's roughly the average.

For adults it's the Rotterdam two-out-of-three rule, and other causes have to be ruled out first. The three: signs of high androgens, irregular cycles, or polycystic ovarian morphology.

High androgens can be scored on symptoms alone... midline hair growth, acne that outlasted your teens, thinning at the crown. If it's unclear, that's when labs come in: total testosterone, free testosterone, or the free androgen index, sometimes DHEA from the adrenals.

Now my soapbox, and please save this one: if you had androgen blood work done while on the combined pill, you cannot rely on it. The pill raises s*x hormone binding globulin and lowers androgen availability. Guidelines say 3 months off, with other contraception, before testing.

Irregular cycles have an actual definition. Shorter than 21 days, longer than 35, fewer than 8 a year. Or, more than a year past your first period, a single cycle past 90 days.

And the morphology myths. Not everyone needs a pelvic ultrasound... if you already meet two criteria, you don't. An ultrasound done before that 8-year mark doesn't count. And “polycystic” is not about cysts at all. It's follicle count. How many eggs are running the show. Since 2023, an elevated AMH on blood work can stand in for the ultrasound, which matters enormously if you don't have access to one or don't want an internal scan.

If we're just meeting... hi, I'm Dr. Mélanie DesChâtelets, ND 👋 Naturopathic doctor since 2010, clinical focus on PMOS (formerly PCOS), perimenopause + metabolic health.

One criterion alone isn't a diagnosis. If yours has never felt settled, comment SHIFT 👇 and I'll send you the Shift Society invite.

🩺 In BC? I'm a licensed naturopathic doctor in British Columbia and I see patients virtually... the free 15-min Clarity Call link is in my bio.

If eating mindfully feels like hard work, it isn't mindfulness.People tell me they're being “too mindful” about food. Wh...
09/23/2026

If eating mindfully feels like hard work, it isn't mindfulness.

People tell me they're being “too mindful” about food. When we look closer it's almost never mindfulness. It's constant thinking. Should I be eating this. Is this enough. I want more but maybe I shouldn't.

That's not presence. That's pressure.

And there's a reason the two got confused. In ordinary speech, “be mindful” means be careful. So we recommend mindful eating and you hear vigilance, because that's what the phrase means everywhere else in your life.

Real mindfulness is quiet. It's your body whispering, not your brain commenting. If there's a voice narrating, and particularly if it's judging, that's cognition wearing the label.

And it should feel like safety rather than performance. If it feels tense, punishing or tight, it has become one more thing to be good at, which is precisely what you were trying to leave.

If we're just meeting... hi, I'm Dr. Mélanie DesChâtelets, ND 👋 Naturopathic doctor since 2010, clinical focus on PMOS (formerly PCOS), perimenopause + metabolic health.

Awareness not obsession. Choice not fear. Progress never perfection. Comment SHIFT 👇 for the Shift Society invite.

You're doing everything and nothing's moving. And the internet's answer is always more. Another hack, another protocol, ...
09/21/2026

You're doing everything and nothing's moving. And the internet's answer is always more. Another hack, another protocol, another thing you're apparently missing.

Most people I work with aren't struggling because they don't know enough. They're struggling because nobody told them what to do first.

Picture a racetrack. Your time, your energy and your consistency are your most valuable assets. You don't spread a bet across every horse. You find the one with the best odds for you.

And there are only four that genuinely matter here: sleep, stress and recovery, movement, and eating pattern. None of that is earth-shattering. What IS different is how much each one matters, and the order they matter in.

Often one acts as a keystone. Some people start moving consistently and find they eat better without forcing it. For others, sleep unlocks the capacity for everything else. If one area has unlocked others for you before, that's probably your first move.

If we're just meeting... hi, I'm Dr. Mélanie DesChâtelets, ND 👋 Naturopathic doctor since 2010, clinical focus on PMOS (formerly PCOS), perimenopause + metabolic health.

Stop asking “does this work.” Start asking “where does this belong.” Comment SHIFT 👇 for the Shift Society invite, where my Metabolic Impact Matrix lives.

Screenshot this if your cholesterol came back high and you’re young.With PMOS (formerly PCOS), a borderline result often...
08/31/2026

Screenshot this if your cholesterol came back high and you’re young.

With PMOS (formerly PCOS), a borderline result often gets shrugged off, or the whole conversation becomes about body size. But there’s a separate condition worth keeping on the list: familial hypercholesterolaemia, a genetic condition that raises cholesterol from birth. Different cause, different stakes, and easy to miss when there’s already a PMOS explanation available.

What makes it worth asking about: a notably high LDL rather than a borderline one, cholesterol that stays high despite a genuinely solid diet, or a family history of high cholesterol or early heart events.

That’s a screening conversation with your provider. Not a diagnosis, and definitely not something to conclude from a post.

Separately, and this gets missed constantly: the international guideline recommends a full lipid panel at diagnosis. Any age, any body size. If you’ve never had one, that’s a fair thing to ask for at your next appointment.

Comment SHIFT 👇 for the community invite.

🩺 In BC? I’m a licensed naturopathic doctor in British Columbia and I see patients virtually... the free 15-min Clarity Call link is in my bio.

Save this one. “Anti-inflammatory diet” has no standardised meaning out in the world, and the definition research actual...
08/29/2026

Save this one. “Anti-inflammatory diet” has no standardised meaning out in the world, and the definition research actually uses sits behind a paywall. This is the practical stand-in: a validated 14-question Mediterranean score.

Answer honestly, then ignore your total. Your NO answers are the useful part. Pick one, the easiest one, and turn it into a yes this month. Each one you convert moves your inflammation score in the right direction, and a higher score is also associated with lower cardiovascular risk.

One caveat I keep: the validated form includes a w**e item, and given what we now know about alcohol and cancer risk, I’m not suggesting anyone start drinking to score a point.

Comment SHIFT 👇 for the community invite. I walk all 14 questions with you in the full video.

🩺 In BC? I’m a licensed naturopathic doctor in British Columbia and I see patients virtually... the free 15-min Clarity Call link is in my bio.

Your cholesterol came back a little high, and nobody seemed particularly worried.Maybe because you’re young and active, ...
08/29/2026

Your cholesterol came back a little high, and nobody seemed particularly worried.

Maybe because you’re young and active, so it got waved through. Maybe because the conversation turned into your body size instead. Neither of those responses was actually about PMOS (formerly PCOS).

I’m not raising it to frighten you. I’m raising it because of what the shrug costs, and it isn’t what you’d expect.

It isn’t that a borderline number is dangerous today. It’s that one test is a snapshot, and a snapshot is the wrong unit. What builds cardiovascular risk is exposure over decades. It’s the length of the movie, not one frame.

Which makes being young the opposite of a reason to wait. If the driver is lifetime exposure, early action is where the leverage is.

And PMOS genuinely changes how your body produces, transports and clears cholesterol. Those shifts turn up at a healthy weight, and in people whose diet is already doing the right things.

The international guideline recommends a full lipid panel at diagnosis. Any age, any body size. If you’ve never had one, that’s a fair thing to ask for.

If we’re just meeting... hi, I’m Dr. Mélanie DesChâtelets, ND 👋 Naturopathic doctor since 2010, clinical focus on PMOS, perimenopause + metabolic health.

Catching this early is the good news, not the bad news. Comment SHIFT 👇 and I’ll send you the community invite.

🩺 In BC? I’m a licensed naturopathic doctor in British Columbia and I see patients virtually... the free 15-min Clarity Call link is in my bio.

If you have PMOS, that “slightly high” cholesterol number might be your heart’s early warning system... and catching it ...
08/29/2026

If you have PMOS, that “slightly high” cholesterol number might be your heart’s early warning system... and catching it early is actually the good news.

Here’s what often happens instead: you’re young and active, so a borderline number gets shrugged off. Or you’re in a larger body, so the whole conversation becomes “just lose weight.” Both responses miss what PMOS does: it changes how your body produces, transports, and clears cholesterol... shifts that can show up even at a “healthy” weight, even when your diet is on point.

And one test is just a snapshot. What drives cardiovascular risk is exposure over decades. It’s the length of the movie that matters, not one frame. That’s exactly why the international PCOS guideline recommends a full lipid panel at diagnosis... any age, any body size, any symptom picture. If you’ve never had one since your diagnosis, that’s a fair question to bring to your next appointment.

One more thing worth knowing: familial hypercholesterolemia, a separate genetic condition that raises cholesterol from birth. Notably high LDL deserves a screening conversation with your provider. Not diagnostic... just a check worth making.

The hopeful part: the levers converge. Heart-supportive eating patterns also support blood sugar and inflammation. Small steps early can compound for decades.

If we’re just meeting... hi, I’m Dr. Mélanie DesChâtelets, ND 👋 Naturopathic doctor since 2010, clinical focus on PMOS (formerly PCOS), perimenopause + metabolic health.

Want your labs to make sense? Comment SHIFT 👇 and I’ll send you the community invite... my free PMOS lab guide (what to ask for, what it means) is waiting inside.

🩺 In BC? I’m a licensed naturopathic doctor in British Columbia and I see patients virtually... the free 15-min Clarity Call link is in my bio.

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