How I Approach a First Consultation
The first appointment is not where a treatment plan is confirmed — it is where we work out what the right plan even is. Here is how I think, and why the appointment is built the way it is.
The question I’m most often asked
Before someone has even met me, the message often reads: “How do you treat PCOS? What’s your protocol for PCOS?”
I understand the question — but it contains an assumption I have to gently take apart. It treats the diagnosis as though it were the problem itself: as if “PCOS” were a single thing that happened to a person, and treatment were a matter of matching that label to the right protocol, the way a key matches a lock.
That is not how the body works. A diagnosis is a name we give to a pattern — it is not the cause of the pattern. Two women who both carry a diagnosis of PCOS (or PMOS, as the 2026 Lancet consensus now frames it — polyendocrine metabolic ovarian syndrome, a name that finally puts the metabolism where it belongs) can arrive at that same label by very different routes. One may be profoundly insulin-resistant; another may have a thyroid or adrenal picture driving the same downstream appearance; a third may be lean, stressed, and under-eating. The ovaries look similar on a scan. The terrain underneath could not be more different.
If I handed all three the same “PCOS protocol,” I would be treating the name, not the woman. At best it would help one of them.
Why the label is a starting point, not an answer
Every person who comes to me carries a diagnosis or a label. That label is where the conversation begins, not where it ends. My job in the first appointment is to ask the question the label skips over: why has this particular body produced this particular pattern?
So I put on the detective’s hat. I work to understand your picture — what has led you to where you are now, which systems are under strain, what is missing, what is quietly compensating, and where the meaningful points of leverage actually lie. The diagnosis tells me what to call it. The consultation tells me why it’s there — and why is the only thing worth treating.
What the consultation actually involves
The initial consultation is a structured, in-depth clinical assessment. It is cognitively demanding — for both of us. It typically covers:
- Thorough history-taking — not just reproductive history, but metabolic, digestive, immune, endocrine and lifestyle history
- Review of all prior investigations — blood results, imaging, previous consultations, any prior treatment responses
- Systems assessment — fertility difficulty is rarely an isolated reproductive problem; it is often the visible consequence of a systemic issue that has not yet been named
- Identification of missing information — if critical data is absent, I will say so clearly, so the gap is filled before anything is built on it
- Framework-building — by the end of the appointment, you should understand your situation more clearly than when you arrived, with a coherent map of what we are working with and why
On supplements and testing
I do not prescribe supplement stacks as a default, and I do not recommend laboratory testing unless I have a specific clinical question that the test can answer. Where testing is indicated, I explain exactly what I am looking for and why. Where it is not, I will tell you that too.
Essential nutrition principles
Regardless of individual findings, all patients receive core nutritional guidance grounded in the evidence for reproductive and metabolic health. Baseline requirements are shared rather than bespoke: balanced macronutrients, adequate micronutrients, and nutrient-dense whole food that is easy to digest and assimilate. The aim is food that supplies the raw material the body builds from, keeps blood glucose steady, and supports oxidative metabolism. Nutritional targets are met with food first, before any supplement is considered.
What happens after
All recommendations — whether acupuncture, herbal medicine, nutritional therapy, or further investigation — follow directly from what we find and agree on together during the initial consultation. Nothing is added without a clear reason that connects back to your individual picture.
This is what I mean by appropriate medicine: not a protocol matched to a label, but a response fitted to a person. It’s the same instinct that runs through how my practice found fertility, and it’s why I treat conditions as ‘the body of the diseased’, not ‘diseases of the body’.
Ready to begin?
If this is the kind of care you’ve been looking for, the first step is an initial consultation. Here’s what to expect at your first visit.