Today's episode is a little different because there is breaking news in the women's health world, and I think this is one of the more important shifts we've seen in a long time when it comes to how we understand female physiology.

As of May 12th 2026, PCOS, which stands for Polycystic Ovarian Syndrome, has officially been renamed PMOS or Polyendocrine Metabolic Ovarian Syndrome. And before anybody rolls their eyes and thinks, okay, okay, so they changed the name. I want you to stay with me for a minute here, because this matters then what most people realize.

This came from a massive international consensus published in The Lancet involving researchers, clinicians, advocacy groups, and over twenty two thousand voices globally over the course of about fourteen years. And the reason this matters is because the old name PCOS centered the conversation almost entirely around the ovaries, when clinically, the condition has always been much bigger than that.

For years, women have been told you don't have cysts, your ultrasound looks normal, your labs are fine, and meanwhile they are struggling with a plethora of symptoms like fat loss, resistance, irregular cycles, acne, hair thinning, blood sugar dysregulation, fatigue, fertility issues, mood shifts, sleep disruption inflammations, and symptoms that clearly extended far beyond reproductive health alone.

And what I appreciate about this shift is that the biology did not suddenly change overnight. The language finally caught up with the physiology because many women diagnosed with PCOS never had visible ovarian cysts in the first place, and many women with ovarian cysts never had PCOS. Which tells us something very important.

The ovaries were never the entire story, and I've spoken of this on previous podcasts. This new terminology, polyendocrine, metabolic ovarian syndrome, reflects something we've been discussing for years inside the SF coaching method, which is that women's health is deeply interconnected.

Think hormones, metabolism, stress, physiology, sleep. These do not function in isolation.

Everything speaks to everything. These systems work together and this shift toward PMOS finally acknowledges the crosstalk between the endocrine system, metabolism, reproductive function, inflammation, nervous system regulation, and overall physiological health.

So today I want to break down what changed and why it matters.

Time Stamps:

(0:40) Breaking News In Women's Health

(3:45) Why PCOS Was Confusing

(6:45) The Shift To PMOS

(12:25) Names Influence Clinical Focus

(20:10) Previous Women's Health Shift I Previously Covered

(24:10) The Systems Lens

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This Podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, other professional health care services, or any professional practice of any kind. Any reliance on the information provided in this Podcast is done at your own risk and Sarah Fechter Fitness LLC expressly disclaims any and all liability or responsibility for any direct, indirect, incidental, special, consequential or other damages arising out of any individual use of, reference to, reliance on, or inability to use, this Podcast or the information presented in this Podcast. All contents and design for this Podcast are owned by Sarah Fechter Fitness LLC. Always consult your professional team before beginning any exercise or nutrition program.

Today's episode is coming the day after Mother's Day, and I want to use that timing intentionally because many women just spent a weekend pouring into everyone else coordinating plans, showing up, hosting, texting, calling, making sure everyone around them felt loved, seen, included, celebrated, fed, remembered, and taken care of.

And listen, I love that. I love women who care deeply. I love women who lead their families well, and women who show up with a full heart.

But today, I want to bring that same level of ownership back to you, because after twenty five plus years of coaching women from beginners who have never touched weights before, to athletes to women who have been training for decades, to high level physique athletes, busy moms, business owners, executives, and women who are already doing a lot right.

I can tell you something with full confidence. I have never met one woman who has all five of these inputs fully dialed in.

Not one.

And I don't say that as criticism. I say that because this is where so much opportunity exists.

In this episode, we'll discuss those opportunities and I'll give you real life examples you will probably see yourself in as well.

Time Stamps:

(4:32) Going Deeper With Progressive Overload

(12:05) Muscle Requires Fuel

(13:15) Division 1 Athlete Example

(14:01) 40 Year Old Woman Example

(14:41) The High Achiever Example

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This Podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, other professional health care services, or any professional practice of any kind. Any reliance on the information provided in this Podcast is done at your own risk and Sarah Fechter Fitness LLC expressly disclaims any and all liability or responsibility for any direct, indirect, incidental, special, consequential or other damages arising out of any individual use of, reference to, reliance on, or inability to use, this Podcast or the information presented in this Podcast. All contents and design for this Podcast are owned by Sarah Fechter Fitness LLC. Always consult your professional team before beginning any exercise or nutrition program.

I want you to think about someone in the early phase of coaching, or even someone further along, who needs a reframe and a new perspective in how they're looking at their coaching process.

They're asking good questions. They're excited. They're paying attention. They're engaged in what they're doing. And when I hear certain questions around fat loss, I can quickly tell where the disconnect is.

The question itself gives insight into how fat loss is being understood, and that understanding drives the decisions and the emotions that follow. It shapes whether you're making choices that move you forward into a stronger, more informed version of yourself, or whether you're stepping back into recognizable patterns that keep you repeating the same old cycle.

So today, I want to walk you through some of the most common fat loss questions that came directly from a recent Zoom we hosted inside the SF coaching method for both new and current clients. And more importantly, I want to show you how much those questions actually reveal.

Because when you start looking at fat loss through the right lens, everything about your expectations, your timeline, and your decisions begin to shift.

Time Stamps:

(0:42) The Early Stages of Coaching

(5:40) Our Added Layer of Support

(7:02) Why Isn't The Scale Moving Yet?

(11:54) A More Capable System

(16:10) Finding Maintenance Calories

(18:35) Interpretation

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This Podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, other professional health care services, or any professional practice of any kind. Any reliance on the information provided in this Podcast is done at your own risk and Sarah Fechter Fitness LLC expressly disclaims any and all liability or responsibility for any direct, indirect, incidental, special, consequential or other damages arising out of any individual use of, reference to, reliance on, or inability to use, this Podcast or the information presented in this Podcast. All contents and design for this Podcast are owned by Sarah Fechter Fitness LLC. Always consult your professional team before beginning any exercise or nutrition program.

For the month of April, I've been unpacking real client case studies inside the SF coaching method. And today I want to give you a slightly different lens. Yes, we mostly work with women, but we do coach men as well. And this one is worth sharing because you're going to hear parts of yourself inside the story, even if the demographic looks different on paper.

This client is a high level CEO type A, the one leading the room making decisions, carrying the responsibility for a large team, and operating at a pace that doesn't leave much margin. Early mornings, long days, constant output, and a schedule that can very easily take over if you allow it.

He reached out about six months before becoming a dad for the first time. This was the decision to step into the next chapter of his life with intention before things compounded. He's building a family, leading a business.

He's responsible for people at work and now at home, and he wanted his health to reflect that level of leadership, not just visually, aesthetically, although that's a part of it. He wanted to understand how to fuel his body in a way that matched the demands of his life.

He wanted consistency. He wanted to feel strong, energized, and in control of something that had been pushed to the side for a very long time as he was building his business, he had a very real vision of the kind of dad he wanted to be present, strong, engaged, healthy and confident in his own skin.

We'll breakdown his struggles and successes working together and I hope you hear yourself in his story.

Time Stamps:

(0:52) Type A CEO Case Study

(3:01) Starting With Data

(5:50) Nothing to Cut From

(10:30) The Building Routines Phase

(14:23) Life Isn't A Straight Line

(17:38) The Recomposition and Metabolic Result

(19:00) Everything Requires Energy

(28:26) Ownership Through Investing In Coaching

(30:30) Please Share This Episode

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This Podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, other professional health care services, or any professional practice of any kind. Any reliance on the information provided in this Podcast is done at your own risk and Sarah Fechter Fitness LLC expressly disclaims any and all liability or responsibility for any direct, indirect, incidental, special, consequential or other damages arising out of any individual use of, reference to, reliance on, or inability to use, this Podcast or the information presented in this Podcast. All contents and design for this Podcast are owned by Sarah Fechter Fitness LLC. Always consult your professional team before beginning any exercise or nutrition program.

Today I want to talk about the point where most women quit. Not in the beginning when motivation is high and we're stacking quick wins and definitely not later on when results are much easier to see.

I'm talking about the messy middle, the point where the scale stops moving. Your frustration starts building, and the brain immediately wants to assume something must be wrong with the game plan.

This is the moment where a woman starts questioning everything, including her coach.

She's hitting her numbers, tracking her macros. She's training consistently, going for walks, focusing on recovery, doing her cardio. She is consistent and instead of seeing the scale reward her effort, she feels like she's doing all of this work for nothing.

That is the fork in the road, because this is where most women begin to panic and negatively start speaking about their process.

They write stories in their brain. This is where she wants to cut calories even lower. Add more cardio. Question her coach. Take control of the steering wheel and rewrite the coach's plan. This is where more pressure gets piled on to a system that was already stressed to begin with.

And inside the SF Coaching Method, this is also the exact point where our coaches do not panic. This is where we educate, we manage expectations, and we keep building the foundation instead of reacting emotionally to a temporary stall.

So today I want to give you an inside look at one of those moments a real client, a real plateau, and a real coaching decision that most people and many coaches often get wrong.

Time Stamps:

(1:24) When Women Start Questioning Everything

(2:40) Client Case Study

(4:30) The Result

(19:15) Weight Gain Being Part Of The Process

(21:05) Dieting vs Coaching

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This Podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, other professional health care services, or any professional practice of any kind. Any reliance on the information provided in this Podcast is done at your own risk and Sarah Fechter Fitness LLC expressly disclaims any and all liability or responsibility for any direct, indirect, incidental, special, consequential or other damages arising out of any individual use of, reference to, reliance on, or inability to use, this Podcast or the information presented in this Podcast. All contents and design for this Podcast are owned by Sarah Fechter Fitness LLC. Always consult your professional team before beginning any exercise or nutrition program.

We're sticking with the theme of client case studies for the entire month of April, I'll be providing an inside look at a variety of real client case studies inside the SF Coaching Method.

In today's episode is one I've been really looking forward to recording, because we're going to unpack a real client case study that sits at the intersection of PCOS, perimenopause, fat loss, and hormone health.

And before I even get into her story, I want to zoom out for a second here because one of the biggest problems women are facing right now isn't just symptoms, it's where the nuance gets lost.

There's a massive amount of information online about hormones, PCOS, perimenopause, insulin, and of course, fat loss. And a lot of it is either oversimplified, taken out of context, or just not applicable to real life.

So what that does is it creates a constant feeling of, am I doing this right? Should I be doing more? Why isn't this working for me? And what I want to do in this episode is give you a clearer lens in a better understanding of what's happening.

We're going to talk through what's happening physiologically in PCOS and perimenopause, why fat loss can feel more complex in this phase. How metabolism, stress and hormones are all interacting.

And I'll walk you through the real case study of how this played out over the course of about nine months with my current client.

Time Stamps:

(0:57) Client Case Study I'm Excited To Dive Into

(2:35) Defining Perimenopause

(7:18) Insulin

(9:49) Energy and Stress

(14:18) My Client's Background and Lifestyle

(17:02) TPO Antibodies

(21:27) Changes In Months 3 and 4

(28:36) The SF Coaching Method

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This Podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, other professional health care services, or any professional practice of any kind. Any reliance on the information provided in this Podcast is done at your own risk and Sarah Fechter Fitness LLC expressly disclaims any and all liability or responsibility for any direct, indirect, incidental, special, consequential or other damages arising out of any individual use of, reference to, reliance on, or inability to use, this Podcast or the information presented in this Podcast. All contents and design for this Podcast are owned by Sarah Fechter Fitness LLC. Always consult your professional team before beginning any exercise or nutrition program.

Today I'm walking you through a real case study from a client inside the SF coaching method.

This client didn't call me because Fat loss stopped working for her. She came back because she was scared. She was waking up fifteen to twenty times per night, drinking three gallons of water a day and still couldn't quench her thirst.

Doctors told her what she was imagining and the symptoms she was experiencing were all in her head. Just because her lab values fell within the normal Western range.

So this is where coaching changes your experience. This is no longer a fat loss or a transformation conversation.

This becomes a systems root cause conversation.

A conversation of advocacy.

And today I'm going to walk you through this case. How I'm thinking about it, what stands out and what this teaches us about fat loss shortcuts.

Time Stamps:

(1:45) Who This Episode Is For

(3:38) Beth's Case Study

(6:40) Retatrutide, Weight Loss, and Weight Regain

(11:05) How I Look At This Case As A Functional Health Coach

(16:45) GLP-1's, Peptides, and Fat Loss Tools

(24:28) Rebuilding Predictability

(30:30) The SF Coaching Method

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This Podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, other professional health care services, or any professional practice of any kind. Any reliance on the information provided in this Podcast is done at your own risk and Sarah Fechter Fitness LLC expressly disclaims any and all liability or responsibility for any direct, indirect, incidental, special, consequential or other damages arising out of any individual use of, reference to, reliance on, or inability to use, this Podcast or the information presented in this Podcast. All contents and design for this Podcast are owned by Sarah Fechter Fitness LLC. Always consult your professional team before beginning any exercise or nutrition program.

This is part two of a conversation I started last week that, quite honestly, I felt compelled to have because if you've been paying attention to culture lately, you've probably noticed something happening again.

Bodies are getting smaller, celebrity frames are shrinking, and the language around women's bodies is starting to sound a lot like it did in the late nineties and early two thousand. The skinny era is back, and I'll be honest with you, it pisses me off.

Not because women are losing weight, but because we are watching the same cycle repeat itself without the education that women actually deserve about what these trends can do to their bodies over time.

In last week's episode, we started unpacking the physiology behind chronic under fueling. We talked about energy availability, metabolic adaptation, thyroid downregulation, and stress physiology.

In other words, what actually starts happening inside the body when calorie intake drops too low for too long? If you haven't listened to that episode yet, I highly recommend going back and starting there because it lays the foundation for everything we're going to talk about today, because today we're going to keep going.

We're going to move deeper into what chronic under-eating can do to the female body. And we're starting with something that almost no mainstream dieting conversation talks about the menstrual cycle specifically and female hormone signaling.

Because when energy availability, aka calories, stays too low, the body doesn't just slow metabolism, it begins adjusting reproductive physiology as well.

And that's where the conversation gets really important for women.

Time Stamps:

(0:40) Part 2 Of Our Conversation

(2:55) The Menstrual Cycle

(6:24) Muscle Mass Considerations

(15:30) Energy Balance and Availability

(21:48) Micronutrient Considerations

(34:18) The Cultural Pendulum

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This Podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, other professional health care services, or any professional practice of any kind. Any reliance on the information provided in this Podcast is done at your own risk and Sarah Fechter Fitness LLC expressly disclaims any and all liability or responsibility for any direct, indirect, incidental, special, consequential or other damages arising out of any individual use of, reference to, reliance on, or inability to use, this Podcast or the information presented in this Podcast. All contents and design for this Podcast are owned by Sarah Fechter Fitness LLC. Always consult your professional team before beginning any exercise or nutrition program.