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PCOS / PMOS naturopath Tegan Hollows, Wānaka New Zealand
PMOS Naturopath
Wānaka & Online across New Zealand
PCOS - now more accurately termed PMOS (Polyendocrine Metabolic Ovarian Syndrome) - is a complex hormonal and metabolic condition that affects far more than your cycle. At Naturalist, I take a testing-led, root-cause approach to PMOS care that identifies your specific type, investigates what's actually driving your pattern, and builds a plan from that picture. Not a generic low-GI diet. A roadmap built from your results.
Common signs and symptoms of PMOS
PCOS - now more accurately termed PMOS (Polyendocrine Metabolic Ovarian Syndrome) - affects around 1 in 8 women of reproductive age, and it is far more than a cycle problem. It is driven by insulin resistance, androgen excess and chronic low-grade inflammation, with gut health, thyroid function and stress physiology all shaping how it presents. That is why symptoms so often reach into skin, energy, mood, weight and fertility, well beyond your period.
You do not need all of these to have PMOS. Which symptoms you experience depends on which type is driving your pattern, and that is what testing tells us.
Cycle and fertility
Periods that are irregular, infrequent or absent altogether, often stretching well beyond 35 days or arriving unpredictably. Ovulation may happen rarely or not at all, which is one of the primary fertility challenges associated with PMOS. Some women have regular-looking cycles and are still not ovulating, which is why cycle length alone is not enough to rule PMOS in or out.
Skin and hair
Persistent acne along the jawline and chin that continues well into adulthood and does not respond to topical treatment. Unwanted hair growth on the face, chest or abdomen, alongside hair thinning at the temples rather than the crown. Skin tags and darkened velvety patches at the neck or underarms are also common, and often the first visible sign of insulin resistance.
Blood sugar and weight
Strong sugar cravings, energy crashes an hour or two after eating, and difficulty going long between meals without feeling shaky or irritable. Weight gain around the middle that feels disproportionate to what you are eating, and resistant to the approaches that work for other people. This pattern can be present even at a normal BMI, which is why it is so frequently missed.
Energy, mood and digestion
Fatigue that sleep does not resolve, brain fog, and difficulty concentrating through the afternoon. Anxiety and mood changes are strongly associated with PMOS and are driven by real hormonal and metabolic mechanisms rather than being purely situational. Bloating and digestive changes are also common, reflecting the close relationship between gut health, inflammation and hormone clearance.
Understanding your PMOS type. Not all PMOS is the same and the support shouldn't be either.
One of the most important things we do at Naturalist is identify which type of PMOS is driving your specific pattern. Because insulin-driven PMOS requires a completely different approach to adrenal PMOS. Post-pill PMOS resolves differently to inflammatory PMOS. Many women have features of more than one type, which is exactly why testing matters more than guessing.
The most common type. Elevated insulin directly stimulates androgen production by acting on the cells surrounding developing follicles - driving excess testosterone, suppressing SHBG (the protein that mops up free androgens), and disrupting ovulation. Central weight gain, jawline acne, post-meal energy crashes, sugar cravings, and skin tags are common presentations.
Importantly: Insulin resistance in PMOS is not just a diet problem. PMOS skeletal muscle has a specific defect in how glucose is transported into cells, creating a cycle where high insulin drives more androgens, and more androgens worsen insulin resistance further. This is why standard dietary advice alone often isn't enough.
The pill does not cause PMOS. But if symptoms appear after stopping hormonal contraception, two things may be happening - either PMOS was already present and the pill was masking it, or a temporary hormonal disruption is occurring as the HPO axis re-establishes its own rhythm. This can take 6–9 months.
The pill also depletes key nutrients involved in hormonal function - B vitamins, zinc, magnesium, and selenium among them. Restoring these alongside supporting the HPO axis reboot is often the most effective approach for this type. Inflammatory PMOS involves chronic low-grade inflammation driving androgen production, even at normal body weight, and even in response to normal glucose intake.
In adrenal PMOS, the primary driver is the adrenal glands, not the ovaries. Chronic stress causes the HPA axis to overproduce DHEA-S, which peripheral tissues convert into testosterone. Elevated DHEA-S is often the only elevated androgen - LH, insulin, and fasting glucose may all be completely normal.
Cortisol dysregulation also directly suppresses GnRH, which disrupts ovulation. Hair thinning at the temples (not the crown), stress-triggered cycle disruption, anxiety, and fatigue are key patterns. Often seen in high-stress women, endurance athletes, and women with a history of chronic stress or adverse childhood experiences, all of which create lasting changes in HPA axis reactivity.
The most frequently missed type - partly because the outdated stereotype of PMOS as a condition affecting overweight women still influences clinical pattern recognition. Women with lean PMOS are regularly told they cannot have PMOS because they are not overweight. This is clinically inaccurate and causes significant diagnostic delay.
The primary drivers are inflammation, gut dysbiosis, and often thyroid dysfunction working together. Gut bacterial imbalance allows toxins to enter the bloodstream, triggering a systemic inflammatory response that suppresses the hormonal signals needed for ovulation. Thyroid dysfunction is found in approximately 22–27% of this group, around three times the general female rate and directly impairs ovarian follicle development.
Critically - 75% of lean women with PMOS have insulin resistance despite normal BMI when tested properly. Standard metabolic screening misses this entirely, which is why the cardiometabolic risks of lean PMOS are frequently overlooked.
The hallmark presentation is profound fatigue, brain fog, bloating, and cycles that fluctuate slightly but are dismissed as normal. A common clinical clue is the day-after effect - a food choice triggers a flare of fatigue, acne, or bloating the following day, reflecting immune-mediated inflammation rather than a simple food intolerance.
How an PMOS naturopath can help
No matter where you are on your PMOS journey, I offer support at every stage. Whether you're wanting guidance on nutrition, lifestyle, supplements, and herbs, or a full, high-touch comprehensive program, I have every level of support to meet you where you're at.
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PMOS Program
Online, or in-person in Wānaka
A four-month guided transformation: the most comprehensive, in-depth naturopathic support for PMOS, whether you're newly navigating symptoms or years into the chronic fight. Advanced testing, personalised coaching, and dedicated support to transform your quality of life.
Recommended Functional Test for PMOS - EndoMAP (Endocrine MAP)
NutriPath's most comprehensive dried urine hormone assessment
The EndoMAP is NutriPATH’s most comprehensive at-home dried urine test, offering a full assessment of hormonal, metabolic and environmental factors that influence hormone health. It provides detailed insights into four major hormone pathways: oestrogen, androgens, progesterone and glucocorticoids - giving a complete picture of hormone production, metabolism and clearance. The panel also includes organic acids, endocrine disruptors and heavy metals, helping identify deeper drivers of hormonal imbalance.
Women with endometriosis, PCOS, painful or heavy periods, PMS/PMDD, fertility concerns, bloating, inflammation, mood changes, or complex hormonal symptoms. Ideal when standard blood tests are normal but symptoms persist.
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Type: Advanced dried urine hormone, metabolite, and environmental toxin assessment
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Collection Method: At-home urine collection
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Turnaround Time: Usually 2-3 weeks
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The EndoMAP is included in the Thrive with PCOS Program, the PCOS Blueprint, and the PCOS Reset package. It is also available as a standalone test through a consultation.
Testing is ordered through NutriPath and your kit is posted directly to you anywhere in New Zealand. See the functional testing page for full details on how testing works.
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What I investigate as a PMOS Naturopath
PMOS is not one problem - it is a pattern of interconnected system failures that looks different in every body. Here is what we look at and why each one matters.
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Hormonal and androgen imbalance
Identifying which androgens are elevated, where they're coming from - ovarian or adrenal and what's driving the excess is the first clinical step. The EndoMAP gives us the full androgen picture including DHEA, testosterone, and their metabolites so we can target the actual source rather than managing symptoms on the surface.
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Blood sugar and insulin resistance
Insulin resistance drives androgen production in most PMOS types - even in lean women with normal fasting glucose. We assess fasting insulin, glucose, and metabolic markers to understand the full insulin picture, then use targeted nutrition, evidence-based supplementation, and lifestyle support to improve insulin sensitivity at the cellular level.
Inflammation and immune function
Chronic low-grade inflammation both contributes to and is worsened by PMOS. It drives androgen production, disrupts ovulation, and affects gut and immune function. We identify the inflammatory pattern driving your case and address it as a clinical priority - not just an afterthought.
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Gut health and oestrogen metabolism
The gut microbiome directly influences how oestrogen is processed and cleared from the body. Dysbiosis can cause oestrogen to recirculate - worsening hormonal symptoms and metabolic patterns. We assess and address the gut-hormone axis together because in PCOS they are inseparable.
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Stress and adrenal physiology
Cortisol directly influences androgen production, insulin sensitivity, and ovarian function. In adrenal PCOS, stress physiology is the primary driver. In other types it's a significant contributor. We assess cortisol patterns through the EndoMAP and build a targeted nervous system and adrenal support strategy.
Beautiful words from Naturalist women.
Tegan is an absolute pleasure to work with. She truly listens and meets you where you are, with a level of empathy that comes from her own lived experience. What I appreciate most is her thoughtful, unrushed approach, she never pushes unnecessary treatments or tests, and instead takes the time to understand exactly what you and your body need.
She is methodical, supportive, and always available when you need guidance or questions answered. Since working with Tegan, my energy levels have improved significantly, and I feel far more in tune with my body. I am still on this journey of self-healing but so far I feel empowered to make meaningful, lasting changes to my health.
Sky | Naturalist Client
Tegan is amazing! She has made me feel so comfortable and provided a safe and supportive environment while I started this new journey with her. I have been following the health plan Tegan created for me for over 4 weeks now and I noticed changes within the first week, I feel great! Thank you Tegan x
Lauren | Naturalist Client
Tegan’s personalised approach, expertise, and genuine care made a huge difference in my health journey. She took the time to understand my needs and provided practical solutions that truly worked. I’m so grateful for her support!
Kate | Naturalist Client
I can’t recommend Tegan highly enough! She has been incredibly supportive and caring throughout my journey, and I’ve seen amazing improvements in my overall health and well-being. Her knowledge, care, and personalised approach have made all the difference. I’m feeling so much better, and I’m so grateful for her guidance and support.
Sarah-Lee | Naturalist Client
I had the pleasure of working with Tegan recently, and felt grateful for her expertise and care. She was incredibly thorough in her approach, taking the time to understand my concerns and create personalised herbal tonics that significantly boosted my immune system and helped alleviate a persistent cough. Tegan's holistic approach made me feel at ease and truly listened to, which made a big difference in my healing journey. Additionally, she shared some wonderful nourishing recipes that have been a great addition to my routine for overall well-being. I highly recommend seeing Tegan as a Naturopath - her knowledge, professionalism, and warmth are unmatched!
Zoe | Naturalist Client
Tegan’s nurturing demeanor and wealth of knowledge have been incredibly helpful on my personal journey. She’s provided me with practical tools to become more mindful of how I nourish and care for myself, both physically and mentally. Her approach is compassionate and empowering. I highly recommend her to anyone looking to deepen their connection with themselves and nature.
McKenzie | Naturalist Client
Naturalist has been an incredible asset to my health journey. Tegan is not only knowledgeable and skilled in creating personalised health plans, but she also truly listens and provides realistic, transparent recommendations. After working with Tegan for just two months, I have experienced my first pain-free period!
Rebecca | Naturalist Client
Meet Tegan, your PMOS Naturopath
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I'm a degree-qualified Naturopath and Medical Herbalist based in Wānaka, with a clinical focus in endometriosis, PMOS, and complex hormonal health.
My approach is testing-led and evidence-based - I investigate the underlying drivers of your symptoms rather than managing what's on the surface. I work alongside your GP, specialists, and fertility team, not instead of them, because integrated care produces better outcomes than any single approach alone.
I also bring lived experience to this work. I've navigated endometriosis, PMOS, and the frustration of being told results are "normal" while your body says otherwise. That experience shapes how I show up for every client, with clinical precision and genuine understanding of what it actually feels like to experience the isolating and negative effects of managing complex hormonal conditions alone.
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Common questions about naturopathic PMOS support
Yes. PMOS cannot be cured, but naturopathic care can make a meaningful difference to symptoms and long-term metabolic health by addressing what is actually driving your pattern: insulin resistance, androgen excess, inflammation, gut health and stress physiology. The aim is to identify your PMOS type and build a plan around it, working alongside your medical care rather than instead of it. I also work very closely with long-standing or complex PMOS cases inside my purpose built program Thrive with PMOS
Rather than treating PMOS as a cycle problem alone, a naturopath approaches it as a metabolic and endocrine condition affecting the whole body. That usually means a thorough history, functional and pathology testing to identify your PMOS type and drivers, and a personalised plan across nutrition, herbal medicine, evidence-based supplementation and lifestyle. Everything is built from your results, not a generic low-GI protocol.
Broadly, insulin-resistant PMOS (around 70% of cases), adrenal PMOS, post-pill and inflammatory PMOS, and lean PMOS driven by thyroid, gut and inflammatory factors. Many women have features of more than one. The distinction matters because the treatment is genuinely different for each — insulin-driven PMOS requires a different approach to adrenal PMOS, which is why testing matters more than guessing.
Yes, and lean PMOS is the most frequently missed type. Women are regularly told they cannot have PMOS because they are not overweight, which is clinically inaccurate and causes significant diagnostic delay. Around 75% of lean women with PMOS have insulin resistance despite a normal BMI when tested properly, standard metabolic screening misses this entirely.
The main functional test is the EndoMAP, a comprehensive dried urine panel showing how your body produces, metabolises and clears androgens, oestrogen, progesterone and cortisol. This is usually paired with comprehensive pathology including fasting insulin, glucose, thyroid and inflammatory markers, and where relevant gut microbiome testing. Together these identify your PMOS type and the specific drivers behind it.
Supporting regular ovulation is a central goal of PMOS care, and improving insulin sensitivity, reducing inflammation and supporting hormone balance can all contribute to more predictable cycles. Outcomes vary between women and depend on individual circumstances. Naturopathic support is designed to work alongside fertility specialists and any medical treatment you are receiving, not to replace it.
Naturopathic support is designed to work alongside your GP, endocrinologist or fertility team and any medication you are taking. Where there is potential for interaction, for example between herbs and medications, that is assessed carefully as part of your plan. If you are considering coming off hormonal contraception, that is something to plan together rather than do abruptly.
This varies, but meaningful change in PMOS usually takes around three to four months of consistent, structured support, because we are addressing underlying metabolic and hormonal drivers rather than masking symptoms. Some women notice earlier shifts in energy, cravings or skin, while cycle regularity tends to build more gradually.
Your symptoms are not random.
There's a reason and there is a way forward.
If you've been told your results are normal while your body says otherwise, it's time to investigate properly. Book a Clarity Call and we'll spend 40 minutes talking through your history and working out the right next step for your situation.