My first month back at the office, I had two slots blocked on my calendar every day labeled “BLOCK - DNS,” one mid-morning, one mid-afternoon. I would head to our office wellness room, pump in tote bag, to pump between meetings. By the end of that month, I’d realized that I’d massively underestimated how disorienting it is to ramp back into work mode, and that so much had changed at work in just five months (AI had a big part in this). And now, as I sit down to write this “monthly” MyAdvo newsletter (two months out from the last issue…) I’m struck by how much has passed, both in my body and in women’s health news. Have you ever felt like so much is happening that you just don’t have time to process any of it? I feel like a hamster on a wheel, but my life also feels very full in a good way (contradictions I’m still trying to work out—or just let exist—since having a baby). More than ever, that’s what this newsletter is for: taking the time to make sense of it all through naming, reflecting, researching, and sharing, so we can keep learning from each other.
MyAdvo community news 👥
What’s on my mind: The name finally fits 💭
Reflection question 🪞
Founder health update: What comes back after weaning 🌱
Women’s health in politics: Mifepristone ⚖️
MyAdvo monthly reads 🔖
When I get asked about how things are going with MyAdvo since becoming a mom, I sometimes get a tug of disappointment, like I’m not doing enough. But then I answer, and I hear myself with renewed conviction. I’ve finally given myself permission to take time with building. Right now, I’m trying to hit tiny milestones while I balance being a sales director at a tech startup, a women’s health founder, a new mom, and a partner. For example, since coming back from maternity leave, I gave myself two goals: work the newsletter back up to a monthly cadence and open a highly requested “Fertility & TTC” channel for our community. Just being able to find the time to write consistently would be a massive win for me.
I was raised thinking I could do it all if I just put my mind to it (your typical lean-in millennial ra-ra). But I’m in a different season right now (I did a lot of that reckoning during pregnancy), and it’s brought me back to the roots of why I continue to build MyAdvo. I feel the most drive, accomplishment, and purpose when I’m of service to women and learning how to navigate systems. So how are things going with MyAdvo? Well balanced!
Special shoutout to our incredible members who referred their friends with endo, fibroids, adeno, or PMOS to MyAdvo these past few months: Nicole N., Eleis, Sofia, and Brenna. Thank you for helping our MyAdvo family grow 💖
Here are a few highlights from our chats this month:
How standard is lupron in endometriosis treatment?
What grocery lists or recipes are anti-inflammatory?
What to do about cystic acne when you have PMOS?
Does a vibration plate help with adeno bloating?
Join the conversation by becoming a MyAdvo member.
Before I even got pregnant, I’d heard that PCOS symptoms could subside, even disappear, after having children. I didn’t think of it much at the time and to be honest thought it was similar to the dismissive comments women with endometriosis would hear about just getting pregnant to help their pain. But I am paying attention now, especially because I’m on the lookout daily for any PCOS symptoms versus postpartum ones. My hair falling out, for example, I’m just chalking up to postpartum. Interestingly enough, my fatigue isn’t the same as before. I’m tired because I can never get enough sleep to recuperate, but I’m not “tired but wired” like before. My cystic acne is bad right before my period but seems to subside afterwards. Since I stopped breastfeeding, the hirsutism (those damn chin hairs…) have come back somewhat with a vengeance. But my periods are relatively regular, coming every 32-34 days (more on that in the Founder Health section). So it’s all a bit of a toss-up at this point.
I was originally diagnosed with adrenal PCOS because my periods were irregular and my androgens (testosterone and DHEA-S) were off the charts. But I didn’t have polycystic ovaries. I worked with a functional medicine provider rather than my gynecologist to get diagnosed and just casually let my gynecologist know at one of my annual appointments that I had been diagnosed. As much as I like my gyno (she’s also my OB), she didn’t really pick up on it. Just told me to keep her posted on my testing.
PCOS which stands for polycystic ovarian syndrome points you toward your ovaries, and toward a gynecologist’s office. Historically, that’s exactly where most of us ended up. Which meant the symptoms like fatigue, acne, mental health, weight gain (caused by insulin resistance) would go unaddressed, and often, PMOS wouldn’t get diagnosed if cysts were not present on the ovaries.
PCOS is now PMOS
On May 12th, PCOS was officially renamed PMOS: polyendocrine metabolic ovarian syndrome. This acknowledges that the condition is a syndrome of hormonal dysregulation, often driven by insulin resistance and excess of male hormones. The name change centers what most patients have always experienced: insulin resistance is a core feature of the condition, and helps explain why people with PMOS have higher rates of Type 2 diabetes and heart disease. Fittingly, the person who led the 14-year effort to get here, Professor Helena Teede of Monash University, is an endocrinologist, not a gynecologist. The published consensus involved 56 professional organizations and nearly 22,000 patients and clinicians across six continents over a decade.
The rename also matters for who treats you. Gynecologists are now acknowledging that the old framing created gaps: when the condition was categorized as gynecological, the metabolic workup for insulin resistance, lipids, and glucose tolerance routinely got deprioritized. It’s becoming acknowledged that seeing an endocrinologist or a reproductive endocrinologist doctor may be the first stop. One heads-up: both PCOS and PMOS will be used interchangeably for the next few years as clinical guidelines, medical education, and disease classifications update across 195 countries with the goal of getting there in 2028.
Endometriosis can be clinically diagnosed without surgery, according to ACOG
The same reckoning is happening with endometriosis. In March, ACOG released its first-ever comprehensive diagnostic guidelines for endometriosis. The biggest change: a clinical diagnosis (based on symptoms and a physical exam) is now enough to start treatment. No laparoscopy required. Surgery is still the only way to definitively confirm the disease, but it’s no longer a gatekeeper to care. For a disease that takes an average of 4 to 11 years to diagnose, that’s huge.
A few other things worth noting:
The guidance tells clinicians to suspect endo when patients show up with chronic pelvic pain, painful periods, painful sex, bowel or bladder pain that flares with the menstrual cycle, or infertility tied to any of these symptoms. Naming it out loud matters.
It applies to adolescents, not just adults — finally acknowledging that endo often starts in the teens and gets dismissed as “just bad cramps” for years.
Negative imaging doesn’t rule it out. ACOG is telling doctors to start treatment based on symptoms even if the MRI or ultrasound comes back clean. Anyone who’s been told “your scan looks fine, so you’re fine” knows why this matters.
And critically: the new framing acknowledges that endo doesn’t live in one specialty. The early symptoms show up everywhere — at the GI clinic, the urologist’s office, the pediatrician’s, the back-pain specialist’s — which anyone who’s spent years getting their symptoms dismissed or bouncing between doctors already knew.
Both feel overdue. Both feel hopeful. But guidelines take years to fully trickle into everyday clinical practice. In the meantime, most of us are going to have to do the bringing-it-up ourselves. That might look like asking your gynecologist if they’re familiar with the PMOS rename and who they’d refer you to for the metabolic workup. Or showing up to an appointment for suspected endo and saying, “I know ACOG’s new guidance says you can clinically diagnose this. Can we start there?” The science is moving to help us get diagnosed more quickly and more accurately. Now we have to make sure the care moves with it.
How do you advocate for yourself when the clinical knowledge is still catching up? Have you talked to your provider about the PMOS rename or ACOG's new endo guidance?
I’m seven months postpartum. But did you know that postpartum symptoms can last up to two years?
It surprised me too. The “6 weeks postpartum” model, where your OB clears you at the standard checkup and you’re supposedly back to normal, was always more administrative than medical. Hormone levels alone don’t return to pre-pregnancy baseline until lactation fully ends. Postpartum depression can peak at 6 months and last for years untreated. About a quarter of women experience symptoms up to three years after birth. Libido can stay suppressed for over a year postpartum, especially while breastfeeding.
Which is to say: my body sort of began attempting to recalibrate once I stopped breastfeeding about a month ago. If you read my last issue, you know that journey was its own thing entirely. What I didn’t write about then was what I’d already been wondering in the background: once I wean, what comes back?
After giving birth, I bled a little bit even though I had a C-section. This is normal and is called lochia (postpartum bleeding). It can last 4-8 weeks and typically starts as a heavy bright red flow before transitioning into a pinkish-brown then white discharge. During my hospital stay, I was told to watch out for soaking an entire pad in 1 hour and passing clots larger than a golf ball as this could be an indicator of postpartum hemorrhage. This can happen up to 12 weeks postpartum, by the way.
Once the lochia stopped, I wanted to know when my actual period would come back. I was hoping breastfeeding would buy me some time.
It didn’t.
My period came back within 2 months of giving birth.
Turns out, breastfeeding can keep your period at bay (called lactational amenorrhea), but this is highly variable from person to person. It’s most likely if you are on-demand or frequently feeding, keeping up a 4-6 hour nursing schedule even through the night. This is because frequent nursing releases the hormone prolactin, which suppresses the release of gonadotropin-releasing hormone (GnRH) and lutenizing hormone (LH) that prevents ovulation and the subsequent menstrual cycle. (To note: Even if you are breastfeeding and/or don’t have a period postpartum, this does not 100 percent mean you will not get pregnant! More on the effectiveness of breastfeeding as birth control another time). If you are pumping or have long pauses between feeds, the prolactin level may not stay high enough to suppress the other hormones and your period may come back. In my case of combo-feeding and exclusively pumping, my period came back very quickly.
Ironically, my period has been quite regular, compared to my PMOS irregular flow I was experiencing over a year ago, but also VERY heavy (like bloodbath, staining the bed sheets heavy the first day of my period) Which led me to a new set of questions: is this my new normal, or should I be looking at my fibroids more seriously? Will my PMOS symptoms come back?
I have an appointment lined up once my hormones from breastfeeding settle. More to come as I figure it out in real time.
If you’ve been following along since my June, July, and August newsletters, you know I’ve been tracking how post-Roe reproductive politics keep expanding beyond abortion, touching SSRIs during pregnancy, IVF, emergency care, and the dismantling of medical expertise under RFK Jr. This month is the biggest jolt to that landscape since Dobbs itself.
🚨 What just happened
On May 1st, a federal appeals court ruled that mifepristone — the abortion pill — could no longer be mailed or picked up at a pharmacy. It would have to be dispensed in person, at a clinic, effective immediately.
Two weeks later, on May 14th, the Supreme Court paused that ruling. So for now, mifepristone is still available by mail and at pharmacies. But it’s a pause, not a final answer.
Why this matters at scale: medication abortion is now 63% of all U.S. abortions. And mifepristone isn’t just an “abortion pill.” It’s ACOG’s recommended treatment (with misoprostol) for managing miscarriages and about 10-20% of known pregnancies end in miscarriage. It’s FDA-approved to treat high blood sugar in people with Cushing’s syndrome. The fight over mifepristone is being framed as an abortion fight. It’s also a women’s health fight, full stop. If the May 1st ruling is reinstated, access shrinks in every state, including the ones where abortion is legal.
🗺️ What this could mean, depending on where you live
If the ruling is eventually reinstated:
In states with abortion bans (like TX, LA, ID, TN, AL): the mail pathway is gone. In 2025, 91,000 abortions reached people in those states via telehealth. That access disappears.
In states where abortion is legal: a woman in rural Montana could end up driving 250 miles to a clinic for a procedure that’s legal in her state. In Wyoming and Montana, medication abortion is 95% and 84% of all abortions. Losing it would overwhelm clinics fast.
At the pharmacy, everywhere: no more picking up your prescription. Clinic only.
⚖️ What happens next
The Supreme Court’s pause is temporary. It can:
Leave the pause in place while the case continues → mail and pharmacy access stay open, possibly for months or years.
Lift the pause → the in-person requirement snaps back nationwide.
Rule on the actual merits → the Court would finally decide whether the FDA’s telehealth rules were lawful in the first place. (It dodged this question in 2024 on a technicality.)
And Louisiana’s case isn’t the only one. Texas and Florida are running a separate lawsuit trying to pull mifepristone off the market entirely. Combined with an FDA safety review being pushed by political pressure (not new science), the worst-case scenario is mifepristone being removed from every state.
That would also set a precedent: federal courts overruling FDA scientific decisions for political reasons. Which has consequences for every drug, not just this one.
🛡️ Why your state’s laws may not fully protect you
This is the part most people miss. You might think living in a state with strong abortion protections, like New York, where I live, or California, Michigan, Colorado, means you’re insulated.
But the FDA is federal. When a federal court rules on what the FDA can or can’t do, that ruling applies everywhere. State laws, state constitutional protections, and shield laws that protect providers can’t override it. Shield laws protect doctors from other states prosecuting them. They don’t protect against federal rulings on a federally regulated drug.
For New Yorkers specifically: in-clinic care and medication abortion you receive at a clinic would still fully protected. The only thing in limbo would be pharmacy pickup and mail delivery.
From policy to podcasts, research updates, trends, and other news to support your self-advocacy journey.
🧬 PCOS officially renamed PMOS in global consensus led by Monash University
🔗 Endometriosis triples the odds of also having fibroids, per new meta-analysis of 3+ million patients
⭐️ Eiza González opens up about living with endometriosis, adenomyosis, and PMOS
⚖️ The 5th Circuit’s mifepristone ruling and what’s next at the Supreme Court
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