PCOS Has a New Name. And It's Exposing a Blind Spot We've Had All Along.
PCOS has a new name, Polyendocrine Metabolic Ovarian Syndrome (PMOS), and it finally puts the metabolic dysfunction where it belongs: front and center. But if PMOS is a metabolic-endocrine condition, are we actually screening the thyroid closely enough? A normal TSH and a normal Free T4 can still be hiding a real, functional deficit in active thyroid hormone, one that shows up exactly where it intersects with insulin resistance. Here's what the research shows, what it doesn't yet prove, and why I think Free T3 deserves a much closer look in PMOS care.
The Number Statins Can't Touch: What Oral Estradiol Taught Me About Lipoprotein(a)
There's a moment I love in this work, the moment a patient's labs come back and the number that's been haunting them for years has actually moved. A patient of mine came to me with a lipoprotein(a) in the 90s, a genetically fixed cardiovascular risk marker that diet, exercise, and most lipid-lowering drugs simply cannot touch. We optimized her with oral estradiol, no statin added. Four months later, her Lp(a) was 33 (almost undetectable).
Why I built Her NOVA Wellness, a letter to the women I'm here to serve
After decades in primary care, I almost left practicing entirely. Here's the story of how I found my way back and why I built a clinic specifically for women.