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What if your migraines were never just headaches, but part of a bigger hormonal and metabolic
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pattern your body has been trying to explain for years?
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Welcome to Migraine Heroes, a podcast for people living with chronic migraines with years of pain,
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misunderstanding and lack of answers. I'm Diane Ducarme. I've helped more than a
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thousand people reduce the burden of migraines and feel more in control.
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My mission in life? To help a million people. Each episode brings you grounded insight into
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what your body might be asking for and what can truly help. Just to keep you fully supported,
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this podcast is educational. For diagnosis or medication, always work with your doctor.
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Now, take a breath and let's dive in.
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In this episode, you will understand why the name change from polycystic ovary syndrome to
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polyendocrine metabolic ovarian syndrome may help you stop seeing your symptoms as separate
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random problems. Learn how insulin resistance, hormone shift, inflammation, stress physiology
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and migraine may overlap in the same body. And walk away with one simple practical step you can
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do today at home to lessen your PMOS symptoms. Stay with me till the end because by the end of
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this episode, you will make new connections between all you experience in your body and brain.
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Now, before we go into the science, I want to pause for the human part.
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Many people with polycystic ovary syndrome have heard the same kind of dismissal,
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kind of lose weight, go on the pill, come back when you want to get pregnant. And so,
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when someone lives with both migraine and signs of hormonal imbalance, irregular cycles, acne,
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hair changes, cravings or fatigue, anxiety, weight changes, painful menstruation,
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blood pressure crashes, they may feel as if their body is speaking in fragments.
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And the rename to polyendocrine metabolic ovarian syndrome matters because it says it's not only
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about cysts, it's a whole body endocrine and metabolic condition. In May 2026, so very recently,
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the endocrine society announced that the condition previously known as polycystic ovary syndrome
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would now be called polyendocrine metabolic ovarian syndrome and emphasizing that the condition
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affects endocrine and metabolic systems, not only the ovaries. So the endocrine society describes
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the condition as affecting one in eight women or more than 170 million women worldwide.
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And the Lancet also reported the new name and explained that the older term could be misleading
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because it overemphasized the ovarian cysts, even though cysts are not always present and are not
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the whole story. So that's a big shift. In my view, a bit of a west to east shift. The old name
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polycystic ovary syndrome, it made many people think this is a gynecology problem. And the new
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name says something much broader. It says this is a hormonal metabolism, ovulation, brain inflammation
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and whole body regulation problem. And I agree with that. For migraine sufferers, this is really
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important because migraine is also not just head pain. Migraine is a neurological condition influenced
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by sleep, hormone, blood sugar, inflammation, stress, chemistry, sensory sensitivity,
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vascular signaling and the nervous system's ability to regulate change. Maybe one day we'll
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change the name for migraine too. So the 2023 international evidence-based guideline for the
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assessment and management of polycystic ovary syndrome explain that diagnosis in adults
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generally requires two out of three features. It requires clinical or biochemical hyperandrogenism,
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ovulatory dysfunction and polycystic ovarian morphology. And so the same guideline also
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emphasizes metabolic screening, psychological features, lifestyle management, fertility care
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and long-term health risk. And so in other words, even before the rename, science was already moving
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away from the narrow idea that this condition is only about ovaries. So now how does this
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connect to migraine? Buckle up. A lot. First, we need to talk about the hormonal rhythm. So migraine
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is often sensitive to oestrogen changes. And a review published in Systematic Reviews describes
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the complex relationship between oestrogen and migraine, noting that oestrogen has long been
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implicated in migraine biology. Another review in Nature Reviews Neurology explains that falling
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oestrogen levels can trigger migraine without ovarian tum people, while more stable oestrogen
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levels may be protective. Now think about what is now called PMOS. Many people with this condition
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have irregular ovulation. Irregular ovulation often means irregular progesterone patterns, irregular
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oestrogen patterns and unpredictable cycle timing. For a migraine-sensitive brain, unpredictability
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can matter. The brain often likes rhythm, regular sleep, regular meals, regular hydration, regular
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light exposure, regular hormonal change. And when oestrogen rises and falls in a less predictable
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way, when periods come late or not at all, when bleeding is heavy or prolonged, or when there are
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long stretches without ovulation, the migraine brain may experience more instability. Now second,
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we need to talk about insulin resistance. The new name includes the word metabolic for a reason.
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Insulin resistance means the body has to produce more insulin to move glucose from the blood
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streams into cells. And this can create energy swings, cravings, fatigue after meals, shakiness
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when meals are delayed, and inflammatory signaling. A review published in Reproductive Biology and
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Endocrinology describes insulin resistance as a major feature of PMOS with effects across
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different tissues and phenotypes. For migraine sufferers, so this is not a small detail, many
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people already notice that skipped meals, high sugar meals, alcohol, poor sleep or sudden hunger
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can trigger an attack. That does not mean that migraine is caused by sugar. It means the migraine
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brain may be more sensitive to energy instability. If someone has PMOS and migraine, then blood sugar
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mitigation may become one of the bridges between the two conditions. And that is what my advice
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for today is going to be about. Now third, we need to talk about androgens and inflammation. PMOS is
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often associated with elevated androgens. Hormones such as testosterone that may contribute to acne,
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facial hair growth, scalp hair thinning, and cycle changes. And hyperandrogenism can interact
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with insulin resistance. And insulin resistance can worsen androgen production. And this loop can
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affect inflammation, sleep, body composition, and mood. And migraine, inflammation, and neuropeptide
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signaling are part of the broader conversation. And the overlap does not mean one condition simply
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causes the other. It means they may share a terrain. Fourth, we need to talk about comorbidity,
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which simply means conditions appearing together. A 2025 systematic review in Cervalalgia examined
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the relationship between migraine and gynecological conditions including endometriosis and PCOS,
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now called PMOS, noting that these conditions appear to influence each other and may share
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pathophysiological mechanisms. This matters because many women are used to separating
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their symptoms by medical department. Neurology for migraine, gynecology for periods, dermatology
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for acne, endocrinology for insulin, psychiatry for anxiety. But the body does not live in
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departments. The body lives as one ecosystem. Now the rename may also change how people understand
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their own symptoms emotionally. The word polycystic made people feel confused or, I don't know, even
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ashamed a bit. You know, some people were told they had cysts when what was seen on ultrasound
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were actually small follicles. Some people did not have ovarian findings and were dismissed.
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Some people had obvious metabolic symptoms and were told the condition was only relevant if they
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wanted a baby. So the word polyendocrine says many hormone systems may be involved and the word
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metabolic says energy, insulin, glucose, weight regulation, appetite and long-term cardiometabolic
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health matter. The word ovarian still honors the reproductive component but it no longer
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traps the condition inside the ovaries. And for migraine sufferers, this can be freeing because
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it gives you the permission to ask better questions. Not only what painkiller should I take
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but also what happens to my migraine before my menstruation. Do I crash after a high carbohydrate
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breakfast? Do my migraine worsen when I skip meals? Do I have more attacks after poor sleep? Are my
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cycles regular? Do I ovulate? Do I have signs of androgen excess? And very importantly, could my
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brain pain be connected to my whole body rhythm? This is the power of the rename. It does not
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magically solve the condition. It does not replace medical care. It does not mean everyone needs the
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same treatment but it may help everyone to start to look at the pattern, not just the isolated
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symptoms. And so from a traditional Chinese medicine perspective, the rename from polycystic
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ovary syndrome to PMOS, it feels very natural. Traditional Chinese medicine has always looked at
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the body as a network of relationships. The question is rarely which organ is broken. The
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deeper question is often where is the flow blocked? Where is the system depleted? In this
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lens, migraine is not only pain in the head and PCOS, now better described as PMOS, may often be
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understood through patterns such as buckle-up, spleen-tree deficiency, dampness, phlegm accumulation, liver tissue
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stagnation, blood stasis and sometimes kidney deficiency. And these words may sound poetic
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but they point to real lived experiences. So for example, spleen-tree deficiency in traditional
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Chinese medicine is not the same as western spleen diagnosis. In the app, we call it digestive
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function. It refers more to the body's ability to transform food into usable energy and fluids.
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When this transformation is weak, a person may feel tired after eating, crave sweets, feel heavy,
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retain fluids, gain weight easily, have stools or never put on weight at all. These are two facets
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of the same coin. From a western view, we might think about blood sugar regulation, digestion,
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insulin resistance and energy metabolism. From an eastern view, we might see the body struggling to
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transform and transport nourishment. Then comes the dampness and the phlegm and what in the app we
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call thick fluid build-up. But in traditional Chinese medicine, dampness is a kind of heaviness,
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sluggishness and accumulation. It can show up as bloating, swelling, brain fog, cyst-like patterns,
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mucus, weight gain, a sense of being stuck. And phlegm can be visible like mucus or invisible
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like nodules or lumps or cluttered thinking. And when the old name focused on cysts, traditional
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Chinese medicine might have said this is not only about the ovary. It's about the body's fluid
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metabolism and accumulation throughout the body. In that sense, a new name toward metabolic
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speaks language. Traditional Chinese medicine has been speaking for centuries. Then there's the
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liver qi stagnation, what the app calls state of tension overload. In traditional Chinese
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medicine, the liver helps regulate the smooth flow of emotion, menstrual rhythm, digestion,
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movement of energy. And when liver qi stagnates, you may see more PMS, more breast tenderness,
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irritability, frustration, sighing, yawning, headaches, neck tension, jaw tension, painful
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menstruation, clots or migraines that come around the cycle, in particular before the menstruation.
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And so many migraine sufferers know this pattern deeply. The body tightens, the mood shifts,
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the sleep becomes lighter, you wake up at 1 to 3 am, you have like a sharp stabbing pain in the
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brain, cravings rise, and then the head pain arrives. So there's a Chinese saying that states
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when there is free flow, there is no pain. And when there is pain, there is no free flow. So this does
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not mean pain is simple. It means pain often reflects blocked movement, blood, fluids, energy,
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emotion, rhythm. And for someone with migraine and PMS, the body may be showing blocked flow in
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multiple ways. Irregular cycles, gluggy digestion, metabolic instability, emotional tension,
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and neurological pain. Now traditional Chinese medicine would also pay attention to the kidney
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system, which is associated with reproductive essence, growth, fertility, bones, deep reserves,
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and hormonal life stages. In the app, we called it depleted reserves. And if the kidney system is
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depleted, cycles may be irregular, fertility may be affected, fatigue may feel deep, and the body
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may have trouble recovering. In migraine, this can look like a person who's not only triggered by one
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food or one weather change, but whose whole system feel under-resourced. This is why the rename
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matters philosophically. The old name said, look at the ovary. The new name says, look at the whole
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woman. Look at the whole hormonal system, the whole metabolism, the whole rhythm. And for migraine
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sufferers, this is deeply important and deeply validating. By the way, this is such a better
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description of the hard work we've been doing since 2019. And PMS and migraine combined is hard
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work. Because perhaps your migraine is not random. Your menstruation symptoms are not random. Your
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cravings are not weaknesses. Your fatigue is not laziness. Perhaps your acne, hair changes, mood
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shifts, irregular cycles, and headaches are not separate failures. Perhaps they're the signals.
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Not signals that you're broken. Signals that your body is asking for rhythm, nourishment,
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steadiness, fluid support. And this is hard work. Now today, I'd like you to try one blood sugar
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stabilizing breakfast. That's going to be my advice of the day. Before coffee, before rushing,
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before skipping your morning completely, give your body a real breakfast with proteins. You can
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choose. Can be eggs, Greek yogurt, can be tofu, can be smoked salmon, chickens, beans,
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rehydrated nuts or seeds, leftovers from dinner. That's a really easy one, especially if it's just
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fresh from the dinner. That's one of my favorites. Add fiber and healthy fat if you can. Avocado,
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vegetable, berries, olive oil, chiasis or not. Chiasis is always re-soaked overnight. So
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this is not about dieting. It's about reducing the roller coaster. For many people with PMOS,
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blood sugar can rise and fall more sharply. And for many people with migraine, those swings can
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lower the threshold for an attack. So today, instead of trying to solve everything, try sending
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your body one clear signal early in the day. I am not starting from depletion. I am starting
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from steadiness. And remember, every small step you take moves you closer to freedom.
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You are powerful, you are resilient and you're not alone. Keep rising, Migraine Hero.
