When the labs look fine but nothing else does
Irregular periods. Weight that won't move no matter what you change. Energy that disappears by 2pm. Skin and hair changes you didn't expect. Cravings that feel out of your control.
These are often treated as separate problems — or as a lack of willpower. They're frequently connected, and they're frequently PCOS/PMOS, insulin resistance, or another metabolic pattern that a standard panel doesn't catch.
At Solace,
Your PCOS plan starts with understanding what’s driving your symptoms.
We start with a comprehensive visit, followed by targeted labs and imaging when appropriate, to understand your hormone patterns, metabolic health, cycle and the factors contributing to your symptoms.
From there, I build a plan around you—including nutrition based on what you’re already eating, movement and strength training, targeted supplements, and medications when appropriate.
You leave knowing what we found, what we’re working on, and exactly what to do next.
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What we look at
Menstrual cycle patterns and irregularity
Insulin resistance and blood sugar regulation
Weight changes that don't respond to diet and exercise alone
Androgen-related symptoms (acne, hair changes, hair loss)
Thyroid function
Iron, vitamin D, and other nutrient deficiencies tied to fatigue
Family history of diabetes, PCOS, or metabolic conditions
Who this is for
Women with irregular or absent periods
Women who've been told to "just lose weight" without further workup
Women with a PCOS/PMOS diagnosis who've never had a real treatment plan
Women with persistent fatigue that hasn't been fully explained
Women managing prediabetes, insulin resistance, or early metabolic concerns
How we get to the bottom of it
We don't diagnose off one ultrasound or one irregular cycle. Using the Rotterdam criteria, we build a full picture before we name what's going on - and we keep checking it over time, not just once.
Initial labs
Testosterone, DHEA-S, SHBG
LH/FSH ratio
Fasting insulin, HbA1c
Full lipid panel
Prolactin
TSH, to rule out overlapping thyroid causes
Beyond the bloodwork
Pelvic ultrasound when it's indicated
Full cycle, weight, and symptom history
Family history of PCOS/PMOS, diabetes, or metabolic disease
Ongoing re-checks of your labs to trend them - so we see where you're heading, not just where you started
Your plan: Lifestyle and medication when it is needed
Foundation
Protein-forward eating built around insulin sensitivity and satiety — targets set to your body and goals
Strength training and movement shown to improve insulin resistance
Sleep and stress support, since cortisol dysregulation worsens PCOS/PMOS
Tracking what's actually moving — weight, A1c, lipids
When indicated
Metformin or other insulin-sensitizing options
Hormonal management for cycle regulation and androgen symptoms
Targeted treatment for hair, skin, or hair loss symptoms​
Fertility specialist referral and coordination, if conceiving is a goal
Why is losing weight with PCOS difficult?
Many women with PCOS experience insulin resistance, which can make weight management more challenging. Successful treatment often involves addressing nutrition, physical activity, sleep, stress, and hormonal health together rather than focusing on one factor alone.
Do I need an endocrinologist for my PCOS?
Not necessarily. Many women receive comprehensive PCOS care through their family physician. If specialized fertility treatment or advanced endocrine care becomes necessary, referrals can be coordinated while your primary care remains consistent.
What testing is needed for PCOS?
Evaluation may include reviewing your medical history, menstrual cycles, symptoms, laboratory testing, and, in some cases, ultrasound. Testing is individualized based on your symptoms and health goals.
Can you have PCOS if you’re not overweight?
Yes. Although many women with PCOS have overweight or obesity, up to 20-30% have a normal BMI (“lean PCOS”). PCOS is diagnosed based on symptoms and hormone findings—not weight alone. Women with lean PCOS can still experience irregular periods, acne, excess facial hair, infertility, and insulin resistance.
Can you get pregnant naturally with PCOS?
Yes. Many women with PCOS become pregnant naturally. PCOS is one of the most common causes of irregular ovulation, which can make conception take longer, but it does not mean pregnancy is impossible.
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What care looks like here
Your PCOS care starts with understanding the full picture. We look at your cycle patterns, symptoms, metabolic health, labs, medications, and goals to understand what may be driving your symptoms. From there, you’ll leave with a personalized plan that brings the pieces together.
Solace Primary Care
Dr. Shehzein Khan
Board-certified family medicine physician providing personalized primary care, preventive care, women’s health, pediatric care, and chronic disease management. Solace Primary Care is a Direct Primary Care (DPC) practice offering concierge-style care with direct physician access, longer appointments, and telemedicine throughout California.
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Get in Touch
949-785-5644
1617 Westcliff Drive
Suite 207
Dr. Shehzein Khan
Board-certified family medicine physician providing personalized primary care, preventive care, women’s health, pediatric care, and chronic disease management. Solace Primary Care is a Direct Primary Care (DPC) practice offering concierge-style care with direct physician access, longer appointments, and telemedicine throughout California.
Care
Get in Touch
949-785-5644
1617 Westcliff Drive
Suite 207