Nutrition and Herbal Medicine for PMOS/PCOS: A Natural Approach to Supporting Hormonal Health

Polycystic ovary syndrome (PCOS) has been renamed as Polyendocrine Metabolic Ovarian Syndrome (PMOS), it’s a complex hormonal and metabolic condition that can affect menstrual cycles, ovulation, skin, hair growth, fertility, blood sugar regulation, mood and energy.

While there is no single diet or herbal remedy that “cures” PMOS, nutrition and carefully selected herbal medicine can form part of an individualised approach to supporting metabolic health, hormonal balance and overall wellbeing.

The key is to move away from restrictive “PMOS diets” and towards sustainable, nourishing habits that work with the individual rather than against them.

PCOS is associated with a range of features, including irregular or absent periods, increased androgen activity, acne or excess facial/body hair, and polycystic ovarian morphology. Not every woman experiences the same combination of symptoms.

Insulin resistance and higher insulin levels can occur in PMOS regardless of body size, and metabolic health is an important part of managing the condition.

Current international guidance emphasises healthy lifestyle management as a core component of PMOS care, with dietary approaches tailored to the individual.
This is important because women with PMOS are often given the message that they simply need to lose weight. A more holistic approach recognises that improvements in nutrition, physical activity, sleep, metabolic health and wellbeing can be valuable even when weight does not change.

Building balanced meals

Rather than eliminating carbohydrates or following an extremely restrictive diet, I encourage looking at the quality and balance of meals.

A useful starting point is to combine:

• Protein – such as eggs, fish, chicken, Greek yoghurt, tofu, tempeh, beans or lentils.
• Fibre-rich carbohydrates – such as oats, quinoa, brown rice, beans, lentils, wholegrains and root vegetables.
• Healthy fats – including extra-virgin olive oil, avocado, nuts, seeds and oily fish.
• Plenty of vegetables and fruit – providing fibre, vitamins, minerals and plant compounds.
• Adequate fluids – particularly water and unsweetened drinks.

Combining protein, fibre and healthy fats with carbohydrate-containing foods can make meals more satisfying and may help support steadier blood glucose levels.

There is no strong evidence that one particular macronutrient ratio is universally best for women with PMOS. The international guideline instead recommends individualising dietary approaches according to preferences, nutritional needs and health goals.

Supporting blood sugar balance

For women experiencing insulin resistance, supporting metabolic health can be an important part of a PMOS strategy.

Simple practical measures might include:

Start breakfast with protein and fibre.
For example, Greek yoghurt with berries, nuts and seeds, or eggs with wholegrain toast and vegetables.

Choose minimally processed carbohydrates more often.
Wholegrains, pulses, vegetables and fruit provide fibre alongside carbohydrate.

Pair carbohydrates with protein or fat.
An apple with nut butter, for example, is a different nutritional experience from consuming a sugary snack on its own.

Include regular movement.
Walking after meals, resistance training and aerobic exercise can all form part of a healthy lifestyle.

Importantly, this doesn’t mean that women with PMOS need to fear carbohydrates. Carbohydrates can be an important source of energy and fibre, and individual tolerance and preferences matter.

The roll of herbal medicine

Herbal medicine can be used alongside nutrition and lifestyle measures, but it is important to distinguish traditional use and promising research from treatments that have been conclusively demonstrated to improve PMOS.

Some herbs and nutrients have been investigated for effects on glucose metabolism, inflammation, androgen activity or menstrual cycles. However, the evidence varies considerably between preparations and outcomes.

Cinnamon

Cinnamon has attracted interest because of its potential effects on glucose metabolism and insulin sensitivity.

Some clinical trials and meta-analyses have reported improvements in certain metabolic markers in women with PMOS. For example, a 2024 systematic review of 12 randomised trials found a small reduction in body weight and examined effects on insulin resistance and fasting blood glucose.
However, this doesn’t mean that cinnamon should be regarded as a treatment or that taking large amounts is appropriate. Different cinnamon preparations contain different quantities of active compounds, and concentrated supplements are not equivalent to simply using cinnamon in food.

Spearmint

Spearmint tea is sometimes suggested for women with PMOS, particularly where excess androgen symptoms such as unwanted facial hair are present.

There have been small clinical studies investigating spearmint tea and androgen-related symptoms, but the evidence remains limited. It is therefore better viewed as a possible supportive option rather than a proven treatment.

Inositol

Although technically a nutrient rather than a herb, inositol deserves a mention because it is widely discussed in relation to PMOS.

The evidence is mixed. The international PMOS guideline states that inositol could be considered according to individual preferences and values, with potentially some metabolic benefits but limited clinical benefits for outcomes such as ovulation, hirsutism and weight. The guideline also notes that there is currently insufficient evidence to recommend a specific type, dose or combination for adults and adolescents.
A systematic review underpinning the guideline similarly concluded that the evidence was limited and inconclusive.
This is a good example of why “natural” doesn’t automatically mean “proven” — and why supplements are best selected individually rather than following generic social-media protocols.

Why personalised herbal medicine matters

Herbal medicine is not simply about choosing a herb for a diagnosis.

Two women with PMOS might have very different presentations.

One might primarily experience irregular cycles and insulin resistance. Another might struggle with acne and excess hair growth. Another may be dealing with digestive symptoms, poor sleep, stress or fertility concerns.

Their nutritional requirements, medications, medical history and goals may also be completely different.

For this reason, herbal medicine should ideally be tailored to the individual and reviewed over time.

It is also important to consider herb–drug interactions, pregnancy or trying to conceive, liver and kidney health, and the quality of supplements being used.

PMOS isn’t just about weight

One of the most important changes we can make in the conversation around PMOS is to stop reducing the condition to weight.

Women with PMOS can experience metabolic problems at different body sizes. Equally, someone may make meaningful improvements in nutrition, fitness, blood glucose regulation or wellbeing without seeing a dramatic change on the scales.

A healthy approach should therefore focus on health behaviours and measurable health outcomes, rather than making weight loss the sole definition of success.

Current NICE dietary guidance similarly recognises that improving dietary intake can provide health benefits even when it does not result in weight loss.

When professional support is important

Nutrition and herbal medicine can complement conventional PMOS care, but they shouldn’t replace appropriate medical assessment.

Women with PMOS may benefit from monitoring of areas such as blood pressure, glucose regulation and cardiovascular risk, alongside appropriate assessment of menstrual and reproductive health.

If periods are very infrequent or absent, medical advice is particularly important because prolonged absence of menstruation can have implications for the endometrium.

And if you’re taking medication, trying to conceive, pregnant or breastfeeding, speak with an appropriately qualified healthcare professional before starting herbal medicines or supplements.

A naturopathic perspective on PMOS

PMOS is a complex condition, and there is rarely a single intervention that explains or resolves everything.

A naturopathic approach can instead look at the whole person — nutrition, blood sugar regulation, digestion, stress, sleep, movement, menstrual patterns and individual symptoms — while keeping recommendations grounded in the available evidence.

The aim isn’t to promise a “cure” or to replace conventional medicine. It’s to help women understand their bodies and develop realistic, sustainable strategies that can support their health alongside appropriate medical care.

If you’re living with PMOS and would like individualised nutritional or herbal support, a personalised assessment can help identify which areas may be most relevant for you rather than relying on a generic PMOS protocol.

Find out more about my Naturopathy, Nutrition and Herbal Medicine consultations here.

Written by Tina Prajapat DipCNM, mANP, rGNC – Registered Nutritional Therapist, Herbalist and Naturopath specialising in women’s health and gut health using nutrition, herbal medicine and lifestyle approaches.

This article is for general educational purposes and is not intended to diagnose, treat or cure PMOS or any other medical condition. Herbal medicines and nutritional supplements can have side effects and may interact with medicines. If you have PMOS, are pregnant or trying to conceive, or take prescribed medication, seek advice from your GP, specialist or appropriately qualified healthcare professional before making significant changes to your diet or starting supplements or herbal medicines.