From PCOS to PMOS: Why This Change Matters — and Is Long Overdue

A functional medicine perspective from Dabney Poorter, FNP-C, Founder of Restore + Revive

This is a topic that feels especially personal to me.

I see patients in our practice every week who are struggling with symptoms that have been brushed off, misunderstood, or reduced to something far too simplistic. And as a mom to young girls, this conversation matters to me on an even deeper level. I care not only about how we care for women now, but also about what kind of awareness and support the next generation will grow up with.

For years, PCOS (Polycystic Ovary Syndrome) was the name many women were given for a slew of symptoms they were experiencing. But for a lot of patients, that label only captured the surface of what was really going on.

That is why this recent name change matters, and feels long overdue. The condition previously known as PCOS has now been renamed PMOS- polyendocrine metabolic ovarian syndrome. The new name better reflects the full-body nature of what so many women have actually been experiencing all along. (The Lancet; Endocrine Society)

What PCOS “was”

PCOS was the term used for a condition often associated with:

• Irregular or missing periods

• Lack of ovulation

• Elevated androgens (hormones that help regulate skin, hair, and reproductive health)

• Acne and oily skin

• Facial hair growth or scalp hair thinning

• Fertility challenges

• Insulin resistance

• Weight gain or difficulty losing weight

The name PCOS never told the whole story. Many women diagnosed with PCOS did not have ovarian cysts, and cysts were never required for diagnosis in the first place. That mismatch has caused confusion for years. (WHO ; The Lancet)

Why the name changed to PMOS

This was not a random “rebrand” or thoughtless name change.

The name change came out of a 14-year international effort involving researchers, physicians, advocacy groups, and patients themselves. More than 50 organizations were involved, and more than 22,000 survey responses helped shape the outcome. It was driven by growing recognition that the old name was scientifically incomplete and often misleading. (Endocrine Society; The Lancet)

The new name matters because it reflects what this condition actually involves:

• Polyendocrine: multiple hormone pathways are involved

• Metabolic: insulin, blood sugar, weight, inflammation, and cardiometabolic health are often part of the picture

• Ovarian: ovarian function still matters, but it is no longer presented as the whole story

In other words, this condition has always been about more than just ovaries. (University of Colorado Anschutz ; Endocrine Society)

What PMOS includes now

This is not a brand-new condition. It is a more accurate name for the condition many women have long known as PCOS.

For adults, diagnosis still generally involves meeting 2 out of 3 criteria after ruling out other causes:

• Irregular or absent ovulation

• Clinical or lab evidence of elevated androgens

• Polycystic ovaries on ultrasound or elevated AMH (Anti-Müllerian Hormone)

For adolescents (10–19 years old), the criteria are more specific. Diagnosis requires:

• Ovulatory dysfunction

• Hyperandrogenism (an imbalance of androgens, or hormones that can affect skin, hair, and cycles)

That matters because cycle irregularity can be common early on, and we want to be thoughtful about over- or under-diagnosing younger girls. (The Lancet)

Why this matters for women and girls

One of the biggest issues with the old name is that it often led women to dismiss or question their own symptoms.

It made it easier to think:

• “I do not have cysts, so maybe I do not have this.”

• “Maybe this is only about fertility.”

• “Maybe my skin, cycles, weight, fatigue, and hormones are all separate issues.”

But they often are not separate at all.

This condition can affect:

• Hormone balance

• Metabolism

• Menstrual cycles

• Ovulation

• Skin and hair

• Mood and mental health

• Long-term cardiovascular risk

That is exactly why a broader, more accurate name matters. 

PCOS Is on the Rise

This is not rare, and it is not something we should only start talking about in adulthood.

A closer look at the numbers:

• It affects about 1 in 8 women worldwide, or roughly 10–13% of reproductive-aged women

• Up to 70% of women may still be undiagnosed

• It can begin as early as adolescence

• Among adolescents and young women ages 10–24, one global analysis found incidence increased by 56.02% and prevalence increased by 58.55% from 1990 to 2021

• A meta-analysis found adolescent prevalence estimates ranging from 3.39% to 11.04%, depending on the diagnostic criteria used

( WHO ; PMC ; PMC )

As a provider, that is something I pay close attention to. And as a mom to young girls, it makes this conversation feel even more important. We need earlier awareness, earlier support, and better conversations for younger generations.

Our functional medicine perspective on PMOS

While we embrace this updated name and the more accurate diagnostic framework, at Restore + Revive, we have been caring for patients with a “why is this happening?” approach since the day we opened our doors.

We do not just look at the label. We strive to look at the full picture and person sitting in front of us.

This often includes discussing and reviewing: 

• Hormone patterns

• Insulin resistance and blood sugar swings

• Inflammation

• Nutrition

• Sleep

• Stress

• Movement and muscle health

• Gut health, when relevant

• Long-term metabolic risk

For many women, the symptoms under this diagnosis are deeply connected. Most of the time, they involve some combination of hormones, metabolism, and lifestyle factors.

That is where a functional medicine approach can be so helpful. Instead of chasing symptoms one by one, we step back and ask what is driving the pattern in the first place. (WHO ; American Society for Reproductive Medicine)

What we want women and families to know

If you have been dealing with irregular cycles, acne, hair changes, weight resistance, fertility concerns, or signs of hormone and metabolic imbalance, please know this:

• Your symptoms are worth paying attention to

• This condition is about far more than ovaries

• The old name did not always reflect the full reality of what many women were experiencing

• And earlier support can make a real difference

We also know these symptoms are not limited to adults. At Restore + Revive, we have providers who care for both adults and adolescent patients, so we can support women as well as younger girls who may be starting to experience these patterns early.

Next Steps 

If this resonates with your story, we would love to help.

At Restore + Revive, our goal is to offer care that is personalized, root-cause focused, and grounded in the understanding that hormone health, metabolic health, and lifestyle are all connected.

Call us at 817-720-6220 ext 2 to schedule an appointment and learn more.

About Dabney Poorter

Dabney Poorter, FNP-C (Family Nurse Practitioner-Certified), is the Founder of Restore + Revive and is passionate about helping patients feel their best through research-based, personalized care. With a background in kinesiology, nursing, nutrition, and integrative medicine, Dabney takes a whole-body approach that includes in-depth health history review, lab interpretation, nutrition support, supplement guidance, and medication management. As a Family Nurse Practitioner, Certified Nutritionist, lifelong learner, and mom of two girls, she is deeply committed to equipping and empowering patients at every stage of their health journey.

ADHD Care That Goes Beyond the Diagnosis

A Functional Medicine Approach from Dr. Shane Rainey, DO, and Emmaline Rhodes, FNP-C

Attention-Deficit/Hyperactivity Disorder (ADHD) is often viewed only through the lens of symptoms such as inattention, hyperactivity, impulsivity, or emotional dysregulation. While these experiences are very real, we believe they rarely tell the full story.

At Restore + Revive, we take an integrative medicine approach to understanding ADHD in children and teens. This means we look beyond symptom management and focus on identifying and addressing any underlying contributors that may be influencing brain function, behavior, and overall wellbeing.

Our mission is simple but meaningful: To support the mind, body, and spirit of every child, moving beyond symptom management and toward a more complete, personalized approach to care.

This philosophy applies directly to how we evaluate and support conditions such as ADHD. 

What Is ADHD?

ADHD is a neurodevelopmental condition that affects how the brain regulates attention, behavior, and executive function.

This can impact:

• Focus and attention span

• Impulse control

• Emotional regulation

• Organization and task completion

Every child with ADHD is different. Some may struggle with focus and attention, while others may experience more hyperactivity or emotional reactivity.

It is also important to understand that ADHD is not simply a behavioral issue. It is influenced by brain function, nervous system regulation, sleep, nutrition, environment, and overall health.

How ADHD Is Diagnosed

ADHD is a clinically recognized neurodevelopmental disorder that is diagnosed based on established medical guidelines. Clinicians typically use criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), along with a comprehensive history, behavioral observations, and input from parents and teachers.

A diagnosis is based on:

• Persistent patterns of inattention and/or hyperactivity-impulsivity

• Symptoms present in more than one setting (home, school, activities)

• Functional impact on daily life, learning, or relationships

In some cases, additional evaluations may be recommended to better understand learning differences, emotional health, or coexisting conditions.

What ADHD Can Look Like in Children and Teens

ADHD does not look the same in every child, and symptoms often change with age.

In Young Children

• Difficulty sitting still or staying engaged in activities

• Frequent movement, climbing, or restlessness

• Impulsive behaviors or trouble waiting their turn

• Big emotions or quick frustration

• Trouble following multi-step directions

In School-Aged Children

• Difficulty focusing or staying on task

• Easily distracted or forgetful

• Struggles with organization or completing assignments

• Emotional ups and downs

• Behavioral challenges in structured environments

In Teens

• Trouble managing time, responsibilities, or deadlines

• Decreased motivation or follow-through

• Increased stress, overwhelm, or irritability

• Sleep challenges

• Difficulty balancing school, activities, and daily life

Our Approach to ADHD Care

A thoughtful, root-cause approach supporting the mind, body, and spirit

At Restore + Revive, ADHD care is not built around a single tool or a single solution. It is built around understanding the individual child in front of us.

We take a functional approach, we look at how different systems in the body may be influencing focus, behavior, and emotional regulation. Rather than focusing only on managing symptoms, we work to identify and address contributing factors that may be affecting how a child functions day to day. 

Our process is intentional and comprehensive. It often includes diving deep into the following areas.

Nutritional Support

Supporting brain function through targeted nutrition

Nutrition plays a direct role in focus, mood, and energy regulation. What a child eats can be just as important as when they eat, therefore significantly influencing how they function throughout the day.

For example, we often see children starting their day with a high-carbohydrate, low-protein breakfast such as cereal, pancakes, or packaged snacks. By mid-morning, teachers may report that the child is “bouncing off the walls,” struggling to focus, or becoming irritable. This can be related to rapid blood sugar spikes followed by crashes, which directly impact attention and behavior.

In other cases, children may be picky eaters and have limited diets or subtle nutrient deficiencies that affect brain function and neurotransmitter balance.

In our care, we look at:

• Meal timing and blood sugar stability

• Protein, fat, and micronutrient intake

• Potential food sensitivities that may influence behavior

Small, strategic changes in nutrition can often lead to noticeable improvements in focus, energy, and emotional regulation.

Gut Health

Understanding the gut-brain connection

The gut and brain are in constant communication, and disruptions in gut health can influence mood, behavior, and attention.

For example, a child with frequent stomach aches, constipation, or irregular bowel habits may also struggle with irritability, poor focus, or emotional outbursts. Oftentimes digestive symptoms can be linked with behavioral changes.

We also find that children with a history of frequent antibiotic use or highly processed diets, have impacted their gut microbiome imbalance. This imbalance may play a role in inflammation and how the brain processes signals.

We explore:

• Digestive patterns and symptoms

• Microbiome balance and diet history

• Signs of inflammation 

Supporting gut health can be a key step in improving both physical symptoms and behavioral patterns.

Sleep + Airway Health

Improving sleep to improve daytime behavior

Sleep is one of the most powerful, yet overlooked, factors in ADHD symptoms.

For example, a child who takes a long time to fall asleep, wakes frequently, or breathes through their mouth at night may not be getting restful, restorative sleep. The next day, this can show up as inattention, hyperactivity, impulsivity, or emotional reactivity.

Some parents are surprised to learn that what looks like ADHD during the day may be closely tied to poor sleep quality at night.

We assess:

• Bedtime routines and sleep consistency

• Night wakings or restless sleep

• Snoring, mouth breathing, or possible airway concerns

When sleep improves, families often notice significant changes in focus, mood, and overall behavior.

Nervous System Support

Helping children feel more regulated and in control

Many children with ADHD are not just struggling with attention. They are struggling with regulation.

For example, a child may do well in a structured, calm environment but become overwhelmed in busy or noisy settings. This can lead to meltdowns, impulsive behavior, or difficulty transitioning between activities.

Others may constantly seek movement, fidget, or have trouble sitting still, not because they are unwilling, but because their nervous system is seeking regulation.

We can support regulation with:

• Intentional movement throughout the day

• Sensory strategies tailored to the child

• Predictable routines that reduce overwhelming situations

• Tools to support emotional regulation

When the nervous system is regulated, children are often better able to focus, respond, and engage.

Genetics & Individual Factors

Using testing to better understand how your child is uniquely wired

In some cases, we offer functional lab testing to gain a clearer picture of how your child’s body functions at a deeper level.

These insights can help us understand:

• How your child processes and utilizes nutrients

• Genetic variations and areas of biological susceptibility

• Your child's unique genetic makeup 

• How they may metabolize or respond to specific medications

This type of information allows us to move beyond trial-and-error and toward more personalized, precise care.

For example, when families are exploring medication, this testing can provide helpful guidance on how a child may respond, which can support more informed and confident decision-making.

Not every child requires this level of testing, but when used appropriately, it can be a valuable tool in building a care plan that truly reflects how your child is uniquely created.

Integrative Treatment Options

Our goal is to prepare personalized plans that meets each child and family where they are

We recognize that every family comes in with different goals, preferences, and comfort levels when it comes to treatment, especially around supplements and medication.

Our role is to provide thoughtful guidance, education, and options, while partnering with you to create a plan that feels right for your child.

For some families, the goal is to take a medication-free approach, focusing first on areas such as nutrition, sleep, gut health, and nervous system support. In these cases, we build a comprehensive plan using lifestyle strategies and, when appropriate, targeted supplementation to support brain function and regulation.

For other families, medication may be something they are already using or considering, especially if symptoms are significantly impacting school, relationships, or daily life. When medication is part of the plan, we take a thoughtful approach to:

• Ensuring it is appropriate and well-tolerated

• Monitoring response and side effects

• Supporting the body alongside medication through nutrition, sleep, and other foundational areas

In many cases, families come to us after feeling like they have “tried everything,” or they are unsure what the next right step is. Our goal is to help bring clarity to that process.

Let’s Talk About What’s Next

If your child or teen is struggling with ADHD and you feel like you’ve tried everything or you simply don’t know where to start, we’re here to help.

We take the time to understand the full picture and guide you through clear, personalized next steps.

We would love to talk with you and explore how we can support your child.

Call us at 817-720-6220 ext 2 to schedule an appointment and learn more about how we can support your child and your family. 

Meet our Providers

Meet Dr. Shane Rainey

Dr. Shane Rainey is a double board-certified pediatrician with over 10 years of experience, including seven years as a pediatric hospitalist and former Division Chief of Pediatric Hospital Medicine at Banner Children’s at Desert Medical Center. He has also served in academic roles at the University of Arizona College of Medicine and the University of Illinois College of Medicine.

At Restore + Revive, Dr. Rainey takes a functional medicine approach to pediatric care, combining conventional medicine with root-cause strategies that look at the full picture of a child’s health, including nutrition, sleep, gut health, and nervous system regulation. His focus is understanding each child individually and supporting long-term wellness of the mind, body, and spirit in partnership with families.

Meet Emmaline Rhodes

Emmaline Rhodes is a pediatric nurse practitioner at Restore + Revive, trained at Vanderbilt University with a background in pediatric nursing. Her clinical experience led her to integrative medicine, where she developed a strong interest in root-cause, whole-child care.

She focuses on helping families implement practical, sustainable plans for children with ADHD and other pediatric concerns, with an emphasis on structure, regulation, and daily support. Emmaline is passionate about supporting the mind, body, and spirit of each child while helping families feel confident and supported in their care journey.

What Is Histamine and How Is It Affecting My Child’s Health?

Q&A with Dr. Shane Rainey, Pediatrician

If your child struggles with eczema, allergies, hives, or unexplained skin or behavioral flares, histamine may be playing a bigger role than you realize. As a functional medicine pediatrician Fort Worth, Dr. Shane Rainey takes a whole-child approach to help families understand what is driving these symptoms rather than just treating them on the surface. In this Q&A, Dr. Rainey explains what histamine is, why some children become more sensitive to it, and practical ways to help calm the body naturally so kids can feel better from the inside out.

Q: What is histamine?

Dr. Rainey:
Think of histamine like your child’s built-in alarm system. It’s a normal chemical messenger the body makes to help the immune system respond to potential threats like allergens, bug bites, or infections.

When everything is working like it should, histamine is actually really helpful. It might cause a runny nose during allergy season or make a mosquito bite itchy so your child notices it and reacts the way they’re supposed to.

But sometimes that alarm system gets a little too sensitive. It can go off when there’s no real danger, or it can stay switched on longer than it should. That’s when we start to see symptoms like itchy skin, eczema flares, hives, or chronic runny noses, even from things that normally wouldn’t bother most kids.

So histamine isn’t the enemy. It actually has an important job. The issue is when it gets out of balance and starts overreacting.

Q: Why do some children seem overloaded with histamine?

Dr. Rainey:
There are a few common reasons we see this in kids:

• Immature detox pathways
  Some children simply haven’t fully developed the ability to break histamine down efficiently yet.

• Exposure to allergens, chemicals, or chronic inflammation can keep the immune system in a more activated state.

  • Seasonal allergens like pollen, grass, and ragweed

  • Indoor allergens such as dust mites, pet dander, or mold

  • Household toxins like cleaning products, laundry detergents, scented lotions, candles, air fresheners, and room sprays

  • Poor indoor air quality or lack of filtration

  • Chlorine and other irritants in pools or tap water

  • Ongoing low-level inflammation from things like poor diet, lack of sleep, or chronic stress on the body

• Gut dysfunction
  The gut plays a big role in histamine regulation. When the microbiome is out of balance, histamine can build up more easily. This can be triggered by things like:

  • Frequent or early antibiotic use

  • A diet high in processed foods and sugar

  • Food sensitivities that cause ongoing irritation

  • Infections or imbalances in gut bacteria

  • Chronic constipation or poor digestionEnvironmental load

Most of the time, it’s not just one thing. It’s a combination that pushes the system over its threshold.

Q: What are signs of histamine overload in kids?

Dr. Rainey:
Histamine issues can show up in a lot of different ways, which is why they’re often overlooked. Common signs include:

• Eczema or skin flares

• Hives or unexplained rashes

• Chronic runny nose or congestion

• Headaches

• Sleep disruption or frequent night waking

• Behavioral changes or emotional “flares”

When you start seeing patterns across multiple systems, that’s when histamine becomes something worth looking at more closely.

Q: Do high histamine foods matter?

Dr. Rainey:
Yes, but with an important caveat. Food can contribute to histamine load, but removing foods alone is rarely the full solution. It’s more about the body’s ability to process histamine than it is about avoiding every possible trigger forever.

That said, in some children, temporarily reducing high histamine foods can help calm symptoms while we work on the underlying system.

Common high histamine foods include:

• Aged cheeses like cheddar and parmesan

• Fermented foods like yogurt, sauerkraut, and kimchi

• Cured or smoked meats

• Tomatoes, spinach, and eggplant

• Chocolate and some citrus fruits

The key is not fear or restriction, but understanding when food is playing a role versus when it’s something deeper.

Q: How does histamine relate to seasonal allergies?

Dr. Rainey:
This is where histamine really becomes most familiar to families, especially during allergy season.

When your child is exposed to things like grass, pollen, dust, or pet dander, the immune system can overreact and release histamine. That histamine release is what causes many of the classic allergy symptoms like sneezing, itchy eyes, runny nose, and even eczema flares.

So in that sense, histamine is actually part of the normal allergic response, it’s the body’s signal that something is triggering the immune system.

During allergy season, many families turn to antihistamine medications or more natural histamine support supplements to help reduce symptoms. And while these can be helpful for symptom relief, it’s important to understand what they are doing. They are essentially helping to quiet down the histamine response temporarily, not necessarily addressing why the immune system is reacting so strongly in the first place.

I like to take the approach of not just trying to block histamine, we ask why the body is becoming so reactive in the first place. That’s where gut health, immune balance, and environmental load all come into play.

The goal is not to fear histamine, but to better understand it so we can support the body in a more sustainable way.

Q: How do you calm histamine naturally?

Dr. Rainey:
The goal is not to eliminate histamine completely, but to help the body process it more effectively and reduce unnecessary activation. Some foundational strategies include:

• Gut support
  Supporting a healthy microbiome can improve histamine breakdown and immune balance.

• Nutrient cofactors
  Nutrients like vitamin C, vitamin B6, zinc, and others help the body metabolize histamine more efficiently.

• Fresh, whole foods
  Emphasizing fresh meats, fruits, and vegetables while minimizing highly processed foods can reduce overall inflammatory load.

• Anti-inflammatory fats
  Foods like olive oil and avocado support cell and immune health.

• Herbs like turmeric and ginger
  These can help calm inflammation and support immune regulation.

• Reducing inflammatory triggers overall
  This includes environmental exposures, gut irritants, and chronic stress on the system.

The goal is to lower the “background noise” so the immune system is not constantly in overdrive.

Q: What are some practical ways to help calm histamine, specifically during allergy season?

Dr. Rainey:

There are a lot of simple, everyday strategies that can help reduce the overall histamine load on a child’s body, especially during high allergy seasons when pollen, grass, and environmental exposures are higher. Some of the most helpful things I recommend include:

1. Shower and change clothes after being outside

   Pollen and environmental allergens can stick to skin, hair, and clothing. A quick shower after outdoor play, or at least changing clothes, can significantly reduce ongoing exposure in the home.

2. Keep windows closed during high pollen days

   I am normally a huge fan and big believer in opening windows for fresh air. But during allergy season, especially for kids who are sensitive, it can actually make symptoms worse by letting pollen and other allergens inside. In those seasons, it may be best to keep windows closed to help reduce exposure indoors. If budget allows, indoor air filtration systems can also be a helpful tool to support cleaner air in the home.

3. Rinse face, hands, and hair in the evening

   If a full shower isn’t realistic, even a quick rinse before bed can help remove allergens and reduce nighttime symptoms.

4. Support hydration

   Proper hydration helps the body’s natural detox and clearance pathways function more effectively.

5. Reduce overall inflammatory load

   This includes focusing on whole foods, minimizing processed foods, and supporting good sleep, since stress and poor sleep can make histamine responses worse.

6. Consider targeted nutrients and supplements

   Certain nutrients can help support histamine balance and immune regulation, including:

   • Vitamin C

   • Zinc

   • Vitamin B6

   • Omega-3 fatty acids

   • Quercetin (a natural plant compound that supports histamine regulation)

   • Probiotics (to support gut balance and immune function.

The goal isn’t to eliminate histamine entirely, but to help the body handle it more efficiently so kids are more comfortable, especially during peak allergy times.

A final note from Dr. Rainey

When families first hear about histamine, it can sometimes feel like one more complicated piece of the puzzle. If your child has been dealing with chronic symptoms like allergies, eczema, or frequent “flares,” it’s completely understandable to feel frustrated or overwhelmed trying to connect all the dots.

As a pediatrician and a father, I understand how hard it is to watch your child feel uncomfortable and not have clear answers. Most parents I meet are simply trying their best with the information they’ve been given, and often that information is oftentimes incomplete.

My hope is that this helps you start to see histamine not as something to fear, but as a signal. When we learn how to read those signals, we can better understand what the body is trying to tell us and begin to support it more effectively.

If you feel like your child may be dealing with histamine-related symptoms and you want a deeper look, we’d be happy to help. You can schedule a free meet-and-greet or a functional medicine pediatric appointment with me to take a deeper look into your child’s overall health. 

You can call us at 817-720-6220 Ext. 2 or email integrative@restoreandrevivefw.com.

Disclaimer: The information provided in this blog is for educational and informational purposes only and is not intended as medical advice. Always consult with your healthcare provider before starting any new service, product, or treatment. Please note that prices, offerings, and other details mentioned in this post reflect information available at the time of publication and may have changed since.