02/22/2026
1. Irregular periods that aren't "that irregular"
Cycles every 35-45 days? That's irregular. In my clinical experience, many providers dismiss this if you're not TTC. But early intervention prevents metabolic progression.
2. Chin hair you manage in secret
That daily plucking routine? The pre-date shave? Hirsutism often starts subtly in the 20s. I hear "it's just my genetics" constantly—until we check androgens.
3. Acne that won't quit (especially jawline)
Topicals provide temporary relief. Pattern matters: hormonal acne clusters around jaw, chin, neck. Often worsens premenstrually. This distribution suggests androgen excess.
4. Weight gain that defies explanation
"I eat less than my friends, exercise more, but the scale won't budge." Sound familiar? Insulin resistance can precede abnormal glucose by 5-10 years. I catch this early with fasting insulin testing.
5. Fatigue that's not "just being busy"
Not tired—exhausted. Paired with mood swings or anxiety? In practice, I've seen this resolve when we address the metabolic-hormonal root, not just prescribe antidepressants.
The expanded workup I order
• Fasting insulin + glucose + HbA1c
• DHEAS, free & total testosterone, SHBG
• AMH, 17-OH progesterone (to rule out NCAH)
• Vitamin D, TSH, free T4, prolactin
• Lipid panel, CMP
Save this for your next appointment. If your provider won't order these, find one who will. You deserve answers, not "come back when you want babies."
P.S. I offer comprehensive PCOS evaluations with 60-minute visits—link in bio