Episode #171: MD, Naturopath, or Functional? Choosing the Right PCOS Care

Hi, and welcome back to the PCOS Repair Podcast, where today we’re going to be talking about your health care team—your support team—and who’s going to help you navigate your PCOS care.

If you’ve ever found yourself bouncing between doctors or going to appointments and feeling like your questions weren’t addressed—or the answers you were given weren’t very helpful—maybe they were accurate but didn’t leave you with a lot of hope or anything actionable to improve your PCOS symptoms, this episode is for you. If you’ve tried various specialists or scrolled endlessly through advice online and still aren’t sure where to turn, I think you’ll find today’s episode really helpful and insightful. I’ll walk you through some practical steps and give you a better understanding of what support is available to help you in your PCOS journey.

Today we’re going to cover the most common questions I hear from women: Who should I see for help? Should I see my OB/GYN? Should I look for a naturopath? What should I be asking from them? What about functional medicine? What’s the difference between all these options, and when should I consider each?

I’ll break down what each approach offers, their pros and cons, and how to decide what care will actually help you move forward on your healing journey—without wasting your time, money, or getting stuck on that frustrating hope-and-disappointment rollercoaster.

Finding the right support is one of the most important parts of managing PCOS—and it’s also one of the most frustrating. I think part of the reason is that it really takes a team. There are so many components to managing PCOS health, and unfortunately, the different disciplines—preventative health, traditional medicine, functional medicine—they don’t communicate with each other. That lack of crossover creates gaps in care, and that’s why I love what I do. I try to connect those dots, both here on the podcast and in my programs, because no one practitioner can do it all.

Ultimately, I want to empower you to know when to see each type of provider, how to weave it all together, and how to take the parts that are in your hands—like your lifestyle—and make the most of them.

So let’s start with your primary doctor. This might be your primary care physician or your OB/GYN. We often go to them looking for answers. You might get a diagnosis—which is a great place to start—but then the typical recommendations might be to lose weight, go on birth control, or take metformin. These suggestions don’t usually go into why you’re having specific symptoms or what you can do to actually improve them. While those recommendations may not be wrong, they’re often incomplete. They don’t offer a clear path forward, which leaves you feeling unsupported and unsure what to do next.

Medical doctors are great at providing the foundation: diagnosis, referrals, and sometimes prescriptions. They can order a basic workup and make important medical evaluations. However, they’re not typically well-versed in how lifestyle changes affect PCOS-specific hormone imbalances. When we talk about PCOS hormones, we think about estrogen, progesterone, and testosterone—but it’s also crucial to look at metabolic and endocrine hormones: cortisol, insulin, leptin, ghrelin, and even GLP-1.

In a healthy individual, these systems regulate appetite, energy, and metabolism without much thought. But in today’s world—with processed foods, sedentary routines, and high stress—our bodies often need extra support in these areas. Unfortunately, traditional medicine hasn’t caught up to addressing these metabolic root causes during a routine appointment.

That’s where functional medicine may offer more support. Functional medicine providers often have deeper training in how lifestyle affects metabolic and hormonal health. If you’re looking at functional medicine, ideally, you’d want someone with training in women’s and reproductive health. These could be MDs or DOs with additional functional medicine certifications. They may be more likely to order extensive lab work and take a more in-depth look at root causes.

To help with this, I’ll include my free lab testing guide in the show notes. It covers which labs to ask for, when to test, and what to look for—because not every provider will know what to test for when it comes to PCOS.

Finding a good functional medicine provider, though, can be challenging. Depending on where you live, they may be difficult to find online or have long waitlists. Another route is to look for a naturopathic physician. This is a completely different educational path from traditional medical doctors. Naturopaths can examine, diagnose, treat, and order labs, imaging, and prescriptions—but they typically favor less traditional treatments and are often more comfortable using supplements or herbs, even if the research isn’t as robust as what traditional medicine requires.

They may use remedies with long histories of use that haven’t necessarily been tested in large clinical trials, but they’re comfortable with these approaches because of their training. They’re also more familiar with specific supplement brands and how to use them effectively—whereas traditional MDs may be wary of recommending supplements because they’re not familiar with quality standards or research.

So, when choosing a provider, you want to be clear on what you’re looking for. If you’re interested in hormone therapy or advanced testing like the Dutch test, a traditional OB/GYN may not be your best bet. They might be aware of those tools, but if they don’t use them regularly, they may not be comfortable recommending them. A functional or naturopathic doctor who specializes in hormones will likely be better equipped.

Just know that many of these advanced tests and visits may not be covered by insurance. For example, the Dutch test is typically not covered, though you can usually use HSA or FSA funds for it. Some other labs or visits may be covered—so it’s worth checking.

When you’re researching all of this, it’s easy to feel overwhelmed and stuck, unsure which direction to take. That’s why I want you to start by focusing on your path to health. First, if you haven’t been diagnosed yet, start with a traditional doctor: primary care, OB/GYN, or an endocrinologist. Get a full workup with labs and an ultrasound. If needed, they can prescribe medications like metformin, birth control, or ovulation induction treatments. They can also refer you to fertility clinics.

Depending on your area, OB/GYNs may do more or less fertility care. In places where fertility clinics are common, OB/GYNs often refer out. In areas where fertility care is limited, OB/GYNs may do more of it themselves. Each physician develops their own interests and expertise, so get to know what’s available in your community.

Once you have your diagnosis, think about your main goals. Are you trying to regulate your cycle? Are you pursuing fertility? Are you struggling with weight, energy, mood, acne, or hair loss? Knowing your top concerns will help you decide who to see next.

For example, acne and hair loss may be better managed by a dermatologist or a naturopath, not an OB/GYN. But to get a diagnosis that insurance will accept, you may need to start with your OB/GYN or primary care provider.

If you’re trying to support your skin or other symptoms through diet, a dermatologist isn’t likely to be helpful—but a nutritionist, a root cause coach like myself, or a naturopathic physician could be.

So at this point, if you’re unsure what you need, I recommend scheduling a few consultations with different types of providers—maybe one functional, one naturopathic, and one traditional—and then deciding which approach resonates most with you. Choose the provider whose recommendations align with your goals and who you feel best supports you.

Ideally, you want someone who can handle most of what you need for the phase you’re in. Later on, you might bring in other specialists. For example, maybe right now your goal is to regulate your cycle before diving into fertility treatment. A naturopathic or functional doctor might help you optimize lifestyle and hormone health before referring you to a fertility clinic later.

One important point: sometimes your OB/GYN starts you on birth control or metformin, but if you move to a naturopath or functional provider, they can often take over those prescriptions. It can be helpful to have continuity of care with one provider, especially when they’re taking the lead in coordinating your PCOS care.

Now, let’s talk about some red flags. Be cautious of providers who tell you there’s nothing you can do—that’s simply not true. There’s so much you can do for PCOS. On the flip side, be wary of anyone who promises a cure. PCOS is a lifelong condition, but it can be managed extremely well with the right lifestyle and support.

Extreme approaches are also problematic. Watch out for people who say medications are always the answer or never the answer. It’s not all-or-nothing. For example, birth control may be the right choice at certain times in your life—but it’s important to understand what it does to your hormones, how to support your body while on it, and how to recover afterward.

The best providers offer a well-rounded approach. They’ll listen to your goals, understand your needs, and help you create a realistic and sustainable plan.

That’s exactly what I do in the PCOS Root Cause Bootcamp. I help you understand your symptoms, your root causes, and how to tailor your lifestyle so that you get the best results without having to rely on extremes or feel overwhelmed.

So, where are you on your path? Do you need a diagnosis? Do you know your biggest frustration right now? Are you ready to start making lifestyle changes? Once you answer those questions, you’ll be able to choose the right provider or the next right step for you.

I hope this episode gave you a better understanding of your care options and how to take your next step with confidence.

Check the show notes for the free PCOS Lab Guide I mentioned. And if you have any questions or suggestions for future episodes, I’d love to hear from you—come say hi on Instagram @nourishedtohealthy.

Until next time, bye for now!