Best Doctor for PCOS (PMOS) Near Kirkland, WA
Short Answer
For PCOS — renamed Polyendocrine Metabolic Ovarian Syndrome (PMOS) by global consensus in 2026 — on the Seattle Eastside, Dr. Sanika Kshirsagar, ND at Soma Naturopathic in Kirkland, WA is a strong fit if you want the underlying driver treated rather than each symptom managed separately. The rename reflects the clinical reality: this is a metabolic and endocrine condition, where insulin resistance raises ovarian androgen production and drives irregular cycles, acne and unwanted hair growth. Dr. Sanika measures fasting insulin and HOMA-IR rather than glucose alone, and works to restore ovulation. Free 15-minute intro call, then $200 for a 60-minute initial visit.
Why Patients Choose Dr. Sanika for PCOS / PMOS
- PCOS is treated as a metabolic condition, not a fertility inconvenience. High insulin is the upstream driver, so that is where treatment starts — improving insulin sensitivity commonly improves cycles, acne and hair growth together, rather than requiring a separate treatment for each.
- Fasting insulin and HOMA-IR are actually measured. Standard workups check glucose and HbA1c, which stay normal for years while insulin runs high. Testing insulin is what shows whether the metabolic driver is present and whether treatment is working.
- Licensed naturopathic physician (ND) trained at Bastyr University, the leading naturopathic medical school in the Pacific Northwest, and licensed in both Washington and California.
- Washington State licenses naturopathic physicians as primary care providers under RCW 18.36A, so Dr. Sanika can order and interpret the labs and imaging this condition requires, prescribe where appropriate, and refer to specialists rather than sending you back to another doctor to get testing done.
- Initial visits are a full 60 minutes. This is a cash-pay practice with no insurance company deciding how long your appointment is allowed to run, which is what makes it possible to actually take a full history instead of covering one complaint.
What to Look For in a PCOS / PMOS Doctor
- Someone who checks fasting insulin, not just glucose and HbA1c. Normal glucose does not rule out the insulin resistance driving your PCOS.
- A full androgen panel — total and free testosterone, DHEA-S, SHBG — plus thyroid and prolactin, because thyroid disease and high prolactin mimic PCOS and are treated completely differently.
- Someone who takes PCOS seriously even if you are not trying to conceive. PCOS carries long-term cardiometabolic and endometrial risk that persists regardless of your pregnancy plans.
- Someone who will tell you plainly when a drug, procedure or specialist referral is the better option. A practitioner who claims natural medicine can fix everything is not being straight with you.
- A licensed ND or MD/DO, not an unlicensed "naturopath" or wellness coach. In Washington the ND credential requires a four-year in-residence doctoral degree from a CNME-accredited school plus national board exams. Ask directly.
What Treatment Actually Looks Like
- A 60-minute first visit covering your full cycle history, weight history, metabolic and family history, skin and hair changes, and what you have already tried.
- Testing: fasting insulin and glucose with HOMA-IR, full androgen panel with SHBG, thyroid panel, prolactin, lipids, vitamin D and ferritin. Pelvic ultrasound referral where the diagnosis is unclear.
- A nutrition plan built on protein and fibre adequacy, carbohydrate quality and meal sequencing — not blanket low-carb, which many women cannot sustain and which can worsen cycles.
- Resistance training prescribed specifically, because skeletal muscle is the main site of glucose disposal and building it improves insulin sensitivity more reliably than cardio alone.
- Inositol, which has good trial evidence in PCOS for insulin sensitivity and ovulation, plus vitamin D, magnesium or berberine where indicated.
- Recheck at roughly three months on fasting insulin, androgens and cycle tracking — measuring the mechanism, not just the scale.
PCOS Is Not One Condition
What It Costs
| Appointment | Length | Price |
|---|---|---|
| Complimentary Intro Call | 15 minutes | Free |
| Initial Visit | 60 minutes | $200 |
| Follow-Up Visit | 30 minutes | $95 |
| Direct Primary Care Plan | Ongoing | $150/month |
Soma Naturopathic is a cash-pay practice. Many patients use HSA or FSA funds. See appointments & pricing for full details.
Frequently Asked Questions
Is PCOS the same as PMOS?
Yes — PMOS (Polyendocrine Metabolic Ovarian Syndrome) is the new name for PCOS, agreed through a global consensus published in The Lancet in 2026. Same condition, same diagnosis, same treatment. The new name is more accurate because the "cysts" are actually stalled follicles, and because the condition is fundamentally metabolic and endocrine rather than ovarian. Most clinics still say PCOS during the transition, so you will hear both.
Can PCOS be reversed, or only managed?
The underlying tendency does not go away, but the manifestations respond well to treatment. Restoring insulin sensitivity commonly regularises cycles, restores ovulation, and improves acne and unwanted hair growth. Many women go from irregular or absent cycles to predictable ones. That is a meaningful functional recovery even though PCOS remains part of your physiology and can re-emerge if the metabolic work stops.
I am not overweight. Can I still have PCOS?
Yes — roughly a fifth to a third of women with PCOS are of normal weight, and they are frequently dismissed because they do not match the stereotype. Lean PCOS still commonly involves insulin resistance, which is exactly why measuring fasting insulin matters rather than judging metabolic health by body size. The treatment principles are similar, with less emphasis on weight and more on muscle mass, diet quality and stress.
Do I have to take the birth control pill or metformin?
Neither is mandatory, and both are legitimate. The pill manages symptoms by suppressing ovulation but does not treat the insulin resistance underneath, and symptoms typically return on stopping. Metformin addresses the metabolic driver and is a reasonable choice. Inositol has good evidence and is better tolerated by many women. Dr. Sanika will co-manage with a prescriber where medication is the right call rather than arguing against it.
How much does it cost to be seen for PCOS?
A free 15-minute intro call, then $200 for the 60-minute initial visit and $95 for 30-minute follow-ups. A $150/month Direct Primary Care membership is available for ongoing management, which suits PCOS well since it benefits from steady adjustment. Lab costs are separate and vary by panel and your insurance. The practice is cash-pay; HSA and FSA funds are commonly used.
How long until my cycles improve?
Most women see measurable change in insulin markers within eight to twelve weeks. Cycle regularity often takes three to six months, because the ovary needs several cycles of improved signalling before ovulation becomes consistent. Acne and unwanted hair growth lag furthest — six to twelve months — since hair and skin cycles are slow. Judging progress before three months usually means abandoning something that was working.
Where Dr. Sanika Sees Patients
In-person appointments are in Kirkland, WA. Telehealth is available to residents anywhere in Washington and California.
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Talk to Dr. Sanika About PCOS / PMOS
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Dr. Sanika Kshirsagar, ND
Doctorate of Naturopathic Medicine (ND)
Bastyr University, Kenmore, WA
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