#ovathemoon

Polyendocrine metabolic ovarian syndrome (PMOS) is now the official term for the condition affecting 1 in 8 women. A condition formerly known as PCOS.

PCOS, or polycystic ovary syndrome, was an inaccurate name since it referenced only ovarian cysts, though the condition involved several other hormonal and metabolic mechanisms. Patients may not have any ovarian cyst pathologies but are diagnosed with PCOS. The misleading nomenclature may have delayed and muddled treatment while confusing practitioners and patients alike. Renaming it to PMOS better describes the etiology of such a condition.

The renaming also encourages researchers and funders to expand their scope beyond ovarian pathways and include more hormone-based ones. PMOS is a name that moves the condition away from a purely reproductive condition to a broader physiological one.

Why does this matter?

Because providers may now better appreciate the widespread consequences PMOS can have on individuals. PMOS acknowledges the condition’s multifaceted nature.

There are reports of providers dismissing patients’ concerns and implying the-condition-formerly-known-as-PCOS is a purely reproductive condition that won’t need treatment until one decides to reproduce. This attitude obscures the everyday reality of the condition. PMOS affects the daily lives of those who carry its burden and being informed of it and treated appropriately could drastically improve one’s quality of life.

Renaming it to PMOS prioritizes better living. And that matters.

Note: Please ask a certified and trusted health professional about questions or concerns regarding your health.

Reading Material

Answer: It depends.

Stress is a common complaint among anyone over the age of 12. I’m convinced puberty brings about the existence of stress, and it probably has something to do with the hormones it hurls at us. There have been anecdotes swapped among friends that periods can affect your stress levels too. I don’t find it unbelievable, but do our stress levels really change depending on which part of the menstrual cycle one is in or is the stress from the cyclic show of blood itself?

The difficult thing about stress, or rather, one of the several difficult things about it, is that it could be complicated to measure in an objective way. Self-reports give us snapshots of stress data, but may be heavily biased by the participant’s beliefs. Another way to approximate stress in a slightly more objective way is through the levels of cortisol in the body. (I say slightly since cortisol levels could be affected by our interpretations of threats and thought patterns, which could make them highly variable and vulnerable to changes in mood or situational factors) Cortisol is a hormone regarded as the main stress hormone and influences many processes in the body, including metabolism and immunity. Researchers can measure cortisol levels in blood, urine, or saliva, with saliva being the simplest collection method.

Through the measurement of cortisol levels, some researchers have found that cortisol levels do change across the menstrual cycle, with higher cortisol levels in the follicular phase compared to the luteal phase (Hamidovic et al., 2020; Kulzhanova et al., 2023; Prado et al., 2025). Cortisol levels after exercise have also been found to be higher in the follicular phase, while cognitive function (our thinking and learning) fortunately was found to remain the same throughout the cycle (Mirzaei Khalil Abadi et al., 2024). An interesting deviation from this trend comes from another research team finding that the responses to stress were higher in the luteal phase (Montero-López et al., 2018), so further research is required for any conclusive statement to be made (as usual).

Wait, what is the follicular phase again? Remember that the follicular phase is the first half of the menstrual cycle from the first day of menses (period) to ovulation (when the egg is released). The luteal phase is the second half after ovulation until menstruation occurs again, restarting the menstrual cycle. For more information, this text outlines each phase in detail.

For an even further deviation from the research above, we can look to researchers who find that there are no significant changes in cortisol levels throughout the menstrual cycle (Kanaley et al., 1992; Kayacan et al., 2021; Walker et al., 2025).

So, it really does depend… These inconsistencies could be due to differences in cortisol collection methods. Though elevated cortisol levels may indicate stress, it could also mean the body is preparing to adapt to changing hormone levels, which in turn could affect cortisol and may even differentiate responses between those who experience premenstrual syndrome (PMS) and those who do not. Stress could also be measured with something other than physiological cortisol levels, such as subjective stress reports. A research team studied the relationship between subjective and physiological stress responses across the menstrual cycle and found subjective stress reports increased with increasing cortisol levels, but only in the luteal phase – in the follicular phase, increasing cortisol corresponded to decreasing subjective stress responses (Duchesne & Pruessner, 2013).

One may not be able to conclusively say that cortisol levels vary in a regular way across the menstrual cycle, but I do think it makes sense to say that cortisol levels change throughout the cycle simply because stress exists. There are many reasons for stress, and not having clear answers is one of them.

REMEMBER: Please continue to be critical of the news, articles, and information you review. This post and site are for information purposes only. They do not provide medical advice, diagnosis, treatment or care. Please contact a qualified healthcare provider if you seek care. Thank you.

FURTHER READING: The following are the resources linked above, in order of appearance in the text:

Interactions of momentary thought content and subjective stress predict cortisol fluctuations in a daily life experience sampling study https://pmc.ncbi.nlm.nih.gov/articles/PMC6193976/

Physiology, Cortisol https://www.ncbi.nlm.nih.gov/books/NBK538239/

Cortisol Test https://my.clevelandclinic.org/health/diagnostics/22417-cortisol-test

Higher Circulating Cortisol in the Follicular vs. Luteal Phase of the Menstrual Cycle: A Meta-Analysis https://pmc.ncbi.nlm.nih.gov/articles/PMC7280552/

The cortisol levels in the follicular and luteal phases of the healthy menstruating women: a meta-analysis https://pubmed.ncbi.nlm.nih.gov/37750645/

Effects of the Menstrual Cycle Phase on Cortisol Responses to Maximum Exercise in Women With and Without Premenstrual Syndrome https://pmc.ncbi.nlm.nih.gov/articles/PMC11970578/

Effects of menstrual cycle on cognitive function, cortisol, and metabolism after a single session of aerobic exercise https://pmc.ncbi.nlm.nih.gov/articles/PMC11521275/

The relationship between the menstrual cycle and cortisol secretion: Daily and stress-invoked cortisol patterns https://pubmed.ncbi.nlm.nih.gov/29605399/

The Normal Menstrual Cycle and the Control of Ovulation https://www.ncbi.nlm.nih.gov/books/NBK279054/

Cortisol levels during prolonged exercise: the influence of menstrual phase and menstrual status https://pubmed.ncbi.nlm.nih.gov/1521947/

Cortisol Awakening Response and Heart Rate Variability in the Menstrual Cycle of Sportswomen https://pubmed.ncbi.nlm.nih.gov/32853053/

Impact of the menstrual cycle phases and time of day on markers of stress: salivary α-amylase and secretory immunoglobulin A https://pubmed.ncbi.nlm.nih.gov/39757714/

ANSWER: YES.

Menstrual Hygiene Day (May 28) is a day to bring global awareness to menstrual hygiene access. The date itself is symbolic, meant to represent the average period that lasts for 5 days and the average menstrual cycle of 28 days (hence, 5/28). Although menstrual cycles are highly variable and there often isn’t an average for the average person, the day itself serves as a simple reminder that menstruation care is still lacking in many areas around the world.

Despite ease of use and benefit of health, menstrual products are inaccessible or unmentionable in some areas. This phenomenon is oft referred to as “period poverty,” the situation where there is inadequate access to menstrual products, sanitation facilities (e.g., washrooms, running water), and education. Menstrual hygiene becomes increasingly difficult to access in rural areas of developing countries, however, this difficulty is also found in more “developed” countries like Canada, the US, and the UK.

Original photo under unsplash free license (photo found here). Editing: OVATHEMOON Design Team.

Period Poverty by the numbers • 1 in 6 Canadians experienced period poverty (2023) • 1 in 4 students in the US struggled to pay for period products (2023) • 3 in 10 girls in the UK struggled to afford period care (2020) • It is estimated that 500 million people around the world don’t have access to menstrual products and facilities that support menstrual hygiene (2022)

So, why does period poverty exist? Period poverty exists because of “costs” and “unawareness.” It’s due to the inaccessibility of menstrual care (e.g., products, doctors, medications), which is due to a lack of funding, financial resources, and education.

Costs For example, menstrual products can become a burden expense as people tackle with rising living costs and overall economic instability. “Pink taxes” on menstrual hygiene products further drive up their costs when economies mark up these products as luxury goods rather than basic items (the pink tax may increase the price of other “feminine” products too, making them more expensive than their comparable but more masculinely-marketed co-products). While also experiencing food insecurity, some may feel forced to forgo their period products in favour of food and other more urgent items. But because food and water may be more immediately vital for the human, it does not mean period products should be ignored or debased. Without proper period care, many feel like they cannot participate in society and must stay home from school or work while on their period.

Unawareness* Unawareness in menstrual care is bothersome at best and terrifying at worst. Some may find period products not just too costly, but also too inappropriate to prioritize along with other needs like food, shelter, and clean water.

Alas, there may still be a wilful ignorance* suffocating menstrual health care progress. Stigma around menstruation and fear around its purported otherness result in a girl’s exclusion from society. The stigma and shame underscore school absenteeism and mental health issues for many girls. Menstruation is a natural process that isn’t to be loathed or hushed up. Periods shouldn’t prevent people from accessing care, community, education, and kindness.

What can we do to improve access? To improve access to menstrual health products, we can improve their access through reducing costs and improving education. Removing unnecessary taxes from products or barriers in accessing these products (e.g., perhaps provide free pads in public washrooms along with the toilet paper) could counter the costs.

Ultimately, however, education around menstrual health care and menstrual hygiene is what will promote its prioritization in healthcare and overall well-being. More people will feel empowered to take their menstrual health seriously and seek care. Governments, organizations, and businesses may feel more motivated to provide products and facilities that support period care. Businesses may even primarily produce or promote safe, sustainable, and multi-use period care that further reduce costs. A solid understanding of what menstruation is will demystify and destigmatize its presence (it is, after all, the body’s elegant way of removing an endometrium that is not needed). This knowledge creates the kindness in understanding and accepting periods and the people who have them.

FURTHER READING

#PeriodFriendlyWorld

#MHDay2025

About MH Day https://www.menstrualhygieneday.org/about https://www.menstrualhygieneday.org/participate/individual

Period Poverty by the numbers: https://www.canada.ca/en/women-gender-equality/funding/menstrual-equity-fund.html https://period.org/periodpoverty https://plan-uk.org/press/global-period-poverty-and-stigma-getting-worse-under-lockdown https://www.worldbank.org/en/topic/water/brief/menstrual-health-and-hygiene

Period Poverty: A Neglected Public Health Issue https://pmc.ncbi.nlm.nih.gov/articles/PMC10372806/

Period Poverty – why millions of girls and women cannot afford their periods https://www.unwomen.org/en/news-stories/explainer/2024/05/period-poverty-why-millions-of-girls-and-women-cannot-afford-their-periods

Pink Tax https://www.weforum.org/stories/2022/07/what-is-the-pink-tax-and-how-does-it-hinder-women/

The Shame That Keeps Millions of Girls Out of School https://www.nytimes.com/2025/01/04/opinion/girls-school-menstruation.html

10 Fast Facts: Menstrual health in schools https://www.unicef.org/press-releases/10-fast-facts-menstrual-health-schools

Period equity: What it is and why it matters https://www.health.harvard.edu/blog/period-equity-what-is-it-why-does-it-matter-202106012473

ANSWER: No.

Here are some facts about morning sickness that could help you or a loved one out.

Morning sickness is the nausea and vomiting that is common during the first trimester of pregnancy. It is naively known as morning sickness, but it can actually happen at any time during the day, including night. Morning sickness can also more literally be referred to as “nausea and vomiting of pregnancy” or NVP, and it affects around 85% of pregnant women. For most women, symptoms lessen or disappear after the first trimester, but some women may continue to have these symptoms for the entirety of their pregnancy.

Though morning sickness is common, it is always a good idea to tell your doctor about it and other symptoms you may experience during pregnancy. Morning sickness symptoms that begin after 10 weeks of gestation should be investigated for other causes that may be unrelated to pregnancy.

A more severe progression of morning sickness is hyperemesis gravidarum (the severity is perhaps suggested by the use of Latin). Hyperemesis gravidarum (HG) is severe and persistent nausea and vomiting, which could lead to dehydration, weight loss, electrolyte imbalances, and loss of nutrients. It is severe enough that it often requires hospitalization for treatment.

If you or someone you know is experiencing morning sickness (or HG), please see a doctor or other trusted healthcare professional. Even if symptoms are not as severe as hyperemesis gravidarum, morning sickness can produce or worsen several physical and psychological issues. In addition to physical pain, morning sickness may also emotionally exhaust the mother as it takes time away from regular activities or increase healthcare costs.

There are ways to manage symptoms, ranging from lifestyle changes (like diet and exercise) to pharmacological options (like certain medications). Yet, we are still at an unfortunate phase where some doctors dismiss symptoms as part of a regular pregnancy (echoing the harrowing experience of how debilitating menstrual pain is sometimes dismissed by the doctor).

This dismissal is dangerous. The pain and effects are real for both the mother and the developing baby, who may suffer neurodevelopmental delays. The more severe symptoms of HG can also provoke postpartum depression for the mother, low birth weight for the baby, and even further affect the growing child’s wellbeing with links to anxiety, asthma, and delays in brain development.

Morning sickness isn’t as quaint as we’re led to believe. Growing up and watching TV, I often saw characters poke fun at morning sickness and portraying it as a part of pregnancy to accept and contend with. This blasé attitude made it more surprising for me when learning that morning sickness is not always morning sickness… it could be hyperemesis gravidarum. If morning sickness is so readily dismissed on TV and in real life, what does that mean of our treatment of HG? What if, due to a collective lack of awareness, expectant mothers and their doctors fail to recognize the severity of their symptoms, dismissing the vomiting and the pain as another “requisite” pain of pregnancy?

We are at a rich point in our medical development where good research can be done and good treatments can be given. Yes, morning sickness is common, like how endometriosis is common, but that does not mean those feeling pain with this or other conditions should just have to resign themselves to a decreased quality of life. Morning sickness should be researched and treated when appropriate, much like any other condition.

REMEMBER: Please continue to be critical of the news, articles, and information you review. This post and site are for information purposes only. They do not provide medical advice, diagnosis, treatment or care. Please contact a qualified healthcare provider if you seek care. Thank you.

SHORT ANSWER: It depends.

PLEASE NOTE: The following blurb is based on the article by S. LaBue (Jan 2 2025): https://slate.com/technology/2025/01/mychart-patient-portal-fertility-journey-pregnancy-anxiety.html

Also to confirm, TMI here refers to “too much information” (and not to some newly identified disease or procedure).

CLAIM: Analyzing your fertility charts (and perhaps any medical charts) before seeing the doctor could cause more anxiety and push patients to obsess over extraneous details.

LaBue (not pictured above) contemplates her fertility journey and her perusal of medical evaluations made available to her online. Her article posits that having access to these charts could invite more pain than peace as patients read through the details and use them to make their own diagnoses.

THOUGHTS & TAKEAWAYS: Although having access to your medical information can be overwhelming, it is ultimately a great source of personal data that patients have the right to access and own. This data can be shared with different doctors, which becomes especially important if patients are seeking additional medical opinions. As patients, most of us are not well-versed in medical terminology and may not fully understand reports upon first glance. It’s easy to obsess over each detail, and it is something I have done myself. I’ve found that countering the obsession with some reflection helps. For example, one could examine reports and come up with questions to ask the doctor. This could both reduce anxiety and give patients and providers an opportunity to better understand the patient’s health. Taking a moment to reflect on the data could prevent the rushed consequences of people wanting “answers faster than they can think of questions” (LaBue, 2025).

The writer included an interesting example where she messaged her doctor about a virus reported in her charts and how it could affect her baby. The doctor messaged back before double checking the patient’s charts, generating an unnecessary anxiety for the two. This example shows that, if there is no emergency that requires immediate action, both doctors and patients could be more thorough and patient with their research and communication.

Human bodies do not operate in standardized and perfect ways; there are many different ways they can function while still doing what they need to do. Sometimes that may mean some biomarkers are not within ideal ranges or there are variations in hormone levels from day to day. Giving yourself some grace and space to reflect on your health may give the most potent benefits to your overall health. Fertility becomes an increasingly stressful concept with age, especially for many women (who don’t consistently churn out new eggs as many men do with sperm). This stress is significant. As the writer alludes to in their piece, the stress itself may be what undoes one’s health.

DISCLAIMERS/NOTES: The above blurb is my short reflection on the article referenced above (LaBue, 2025). My reflection does not fully capture LaBue’s views or article. LaBue’s article provides her reflection on the psychological effects of immediate access to medical chart data on her fertility journey. If you would like more details, please review the source article here.

SHORT ANSWER: No.

REMEMBER: Please check the resources for further details and be critical of the news, articles, information you review. If you’d like to learn more, please read on!

CLAIM: There is a common belief that women who live together or spend a lot of time together (e.g., at work or school) can have their menstrual cycles sync up and align over time. This can be referred to as menstrual synchrony, but there is not much evidence for it.

THEORIES & FINDINGS: • The 1971 McClintock Study Menstrual Synchrony and Suppression is one of the first studies propagating this menstrual synchronization phenomenon. o McClintock studied 135 college students and concluded their periods synchronized due to social interaction or their proximity to each other. • However, since that study, there have been numerous other studies and reports that debunk the idea of menstrual synchronization and question the original study’s data analysis. • Another factor to consider is the varying lengths of menstrual cycles and periods. Some people have a 3-week cycle, while some have a 4-week cycle, and others have other kinds as well. And individuals do not have consistent cycles – sometimes cycles change due to stress, diet, or other hormonal changes. Some may have periods that last for 3 days and some may have a 5-day period. This variation makes it possible and probable that there will be the occasional overlap of cycles.

TAKEAWAYS: There is still not much evidence for menstrual synchrony and several research reports over the past few decades cast doubt over its inherent legitimacy. The synchronization is more likely due to coincidence or simple math where every so often the cycles will align. This is similar to how two groups of cicadas align their emergence every couple of centuries (which recently happened earlier in 2024!). Or, like cicadas, women who live/work together may be experiencing similar environmental factors that affect their cycles similarly. Who knows! Despite these explanations, however, there is a lot of anecdotal strength in synchronizations and some people prefer to believe in glossy fiction than dull fact. Further research could dispel the myth once and for all (unless some new evidence to the contrary is found).

FOR MORE DETAILS:

Menstrual Synchrony and Suppression https://www.nature.com/articles/229244a0

Women do not synchronize their menstrual cycles https://pubmed.ncbi.nlm.nih.gov/26181612/

Menstrual synchrony: Fact or artifact? https://pubmed.ncbi.nlm.nih.gov/26181611/

Do women who live together get their periods together, or is it a myth? https://www.washingtonpost.com/wellness/2024/04/22/women-menstruation-periods-synchrony/

Menstrual synchrony pheromones: cause for doubt https://academic.oup.com/humrep/article-abstract/14/3/579/632869?redirectedFrom=fulltext

AS USUAL: Please check the resources for further details and be critical of the news, articles, information you review.  If you’d like to learn more, please read on! 

REPORT: There is little research on women, periods, and exercise.  With what scant research is available, however, an international team of researchers found that differences between follicular and luteal phases and between oral contraceptives and placebo phases are not associated with significant differences in exercise performance or muscular hypertrophy. 

FINDINGS:

Among the studies analyzed, no differences in carbohydrate and fat oxidation at rest and in acute aerobic exercise were found between the different phases of the menstrual cycle. 

Though differences have not yet been found, there aren’t enough research studies to say this with confidence and some studies do not accurately define menstrual cycle phases according to hormonal changes.  Essentially, the methodology is inconsistent throughout different studies.

TAKEAWAYS:

Exercise performance may not follow fluctuations in the menstrual cycle.  Or, not enough research has been done to show that it does. 

There may not yet be enough data to determine whether certain points in the menstrual cycle have a bearing or an effect on one’s exercise or athletic performance. 

Anecdotally, however, there are many instances where some have reported that there are.  These may be due to individual differences in menstrual cycle symptoms, nutrition, hormones, muscular strength or other factors.  There isn’t enough data or research to give us conclusive statements to rely on, but that does not mean the countless self-reports of menstrual cycle fatigue or optimal phases are wholly discredited.

Reading about the relative scarcity of research in women’s health may not be surprising news, but is another stark reminder that women’s health care is woefully left to the wayside.  More research looking into different facets of women’s health not only uncovers the data we need to tailor treatments or diagnose concerns, but also boosts our ability to make informed decisions.  Without standardized research, women’s health and care are being compromised. 

FOR MORE DETAILS:

This is a summary post of a recent article on menarche (the term for the “first period”). I found it pretty interesting and something to keep an eye out for future research. As usual, continue to use your critical thinking skills, and if you'd like to learn more, read on!

REPORT: Recent research (May 2024) shows that air pollution may be linked to girls starting their periods earlier.

BACKGROUND: • It has been estimated that menarche (the term for the “first period”) now starts up to four years earlier in American girls compared to a century ago. • Decreasing ages for the onset of puberty are more noticeable in lower socioeconomic status and ethnic minority groups (A. Gaskins, associate professor at Emory University in Atlanta, the US). • Puberty is controlled by two systems in the body: the HPA axis and the HPG axis. o HPA: hypothalamic-pituitary-adrenal (i.e., from the hypothalamus in the brain to the pituitary gland beneath the brain and the adrenal gland atop each kidney) o HPG: hypothalamic-pituitary-gonadal (i.e., to the gonads, the testes or ovaries)

THEORIES: • A former belief was that childhood obesity was the only reason for premature puberty since fat cells produce proteins that fuel the HPA and HPG axes. o However, this idea doesn't explain why menarche would start earlier in those without childhood obesity. • Current research indicates that toxins could be affecting the HPA and HPG axes, disrupting their activity. o Toxins include toxic gases expelled into the air from vehicle emissions or manufacturing output. o These gases include: sulfur dioxide, carbon monoxide, nitrogen dioxide, and ozone.

TAKEAWAYS: • Toxins may also be in products that are often marketed to girls (including makeup or menstrual hygiene products, like tampons). • Earlier menarche may be caused by multiple factors, including childhood obesity, environmental/household toxins, and psychosocial factors (like childhood stress) • Overall, it is important to consider menarche ages since earlier ages of onset could lead to poor health outcomes later on

FOR MORE DETAILS: Please refer to the BBC article that this summary post is based on. A. Gaskins, associate professor at Emory University in Atlanta, the US, is quoted in this article and explains about the impact of earlier menarches in girls around the world.

Resource Links https://www.bbc.com/future/article/20240605-how-air-pollution-is-impacting-girls-puberty https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3287288/