Functional Medicine Consultations: A Root-Cause Approach to Women’s Health

Many of the women I see in my functional medicine clinic have a particular story in common. They have seen multiple doctors. They have had blood tests that came back normal. They have been told there is nothing wrong. And yet they feel profoundly unwell — exhausted in a way that sleep does not fix, hormonally disrupted despite treatment, mentally foggy, bloated, anxious, and unable to find answers. They have been patient, persistent, and often quietly desperate.

I hear them. And I want to offer a different kind of conversation.

Functional medicine does not ask “what is your diagnosis?” as its first question. It asks “why are you feeling this way?” It is a framework that takes seriously the idea that your symptoms are real, that “normal” reference ranges do not always mean optimal, and that the body’s systems — hormonal, immune, metabolic, digestive, neurological — are deeply interconnected. Addressing one without considering the others is often the reason conventional treatment falls short.

What is functional medicine?

Functional medicine is not alternative medicine, and it is not a rejection of conventional science. It is an evidence-informed, systems-biology approach to healthcare that sits firmly within the medical mainstream while looking further and asking more questions. It recognises that the same diagnosis — say, hypothyroidism or PCOS — can have very different underlying drivers in different women, and that a truly personalised treatment plan requires understanding those drivers rather than simply responding to the label.

Where conventional medicine excels at diagnosis and acute treatment, functional medicine complements this by investigating the conditions that created illness and the factors that are preventing recovery. This means longer consultations, more comprehensive testing, and a plan that addresses lifestyle, nutrition, the microbiome, hormonal balance, stress physiology, and environmental factors alongside any medication or medical treatment.

My training in functional medicine is an addition to, not a replacement for, my conventional gynaecological expertise. I bring both to every consultation.

Who this is for

I find functional medicine consultations particularly valuable for women who:

• Experience persistent, unexplained fatigue that affects their daily functioning
• Have ongoing hormonal symptoms — irregular cycles, worsening PMS, perimenopausal symptoms — despite conventional treatment
• Have received a diagnosis of PCOS, endometriosis, thyroid disease, or an autoimmune condition and want a more comprehensive management approach
• Struggle with gut symptoms alongside their hormonal problems — bloating, IBS-like symptoms, food intolerances
• Experience brain fog, poor concentration, or mood dysregulation that does not respond well to standard treatment
• Have been told their blood tests are “normal” despite feeling unwell
• Struggle with weight despite genuinely eating well and exercising regularly
• Have a tendency to recurrent infections or suspect their immune function is compromised
• Are approaching perimenopause and want to optimise their health before, during, and beyond the transition

Advanced testing available

One of the distinguishing features of a functional medicine approach is the depth of investigation. In addition to standard medical tests, I have access to a range of advanced diagnostics that provide a much more complete picture of what is happening in your body.

• Comprehensive hormonal panel: Moving beyond the basic FSH, LH, and oestradiol to include progesterone (timed to cycle phase), testosterone (total and free), SHBG (sex hormone binding globulin), DHEA-S, and where indicated, prolactin and AMH
• Detailed thyroid panel: TSH alone is insufficient for many women. I routinely assess free T3, free T4, reverse T3, and thyroid antibodies (anti-TPO and anti-thyroglobulin) to identify subclinical hypothyroidism, Hashimoto’s thyroiditis, and conversion problems that a standard NHS panel will miss
• Adrenal and cortisol function: The DUTCH (Dried Urine Test for Comprehensive Hormones) provides a detailed cortisol curve across the day, revealing HPA axis dysregulation, adrenal fatigue patterns, and cortisol metabolite profiles that cannot be assessed from a single morning blood test
• Comprehensive metabolic and inflammatory markers: Including fasting insulin, HbA1c, full lipid profile with particle sizing, CRP, homocysteine, and liver function as indicators of metabolic health and systemic inflammation
• Nutrient status: Vitamin D (25-OH), B12, ferritin and full iron studies, folate, zinc, magnesium (RBC), and omega-3 index — micronutrient deficiencies are extremely common and directly implicated in hormonal, neurological, and immune symptoms
• Gut microbiome assessment: Comprehensive stool analysis to evaluate microbiome diversity, the presence of pathogenic bacteria, parasites, yeast overgrowth, and markers of intestinal permeability and inflammation
• Food sensitivity testing: IgG-mediated food reactivity panels to identify potential dietary triggers for inflammation and gut symptoms, interpreted alongside clinical history
• Genetic SNP analysis: Where relevant, assessment of polymorphisms in genes relevant to hormone metabolism (such as COMT and CYP1B1), methylation (MTHFR), and detoxification pathways

Key areas addressed

Hormonal balance beyond oestrogen

Women’s hormonal health involves a complex interplay of oestrogen, progesterone, testosterone, DHEA, and cortisol. In my practice, I see many women in whom progesterone insufficiency — often missed on standard panels — is driving symptoms including anxiety, insomnia, and heavy periods. Testosterone in women is frequently overlooked; it plays a vital role in energy, libido, muscle strength, and cognitive function. And DHEA, the adrenal precursor to sex hormones, often reflects the impact of chronic stress on the entire hormonal system.

Thyroid optimisation

Subclinical hypothyroidism — where TSH is elevated but within the “normal” range, or free T3 is low-normal — is far more common than is often acknowledged, particularly in women. Hashimoto’s thyroiditis, an autoimmune thyroid condition, is the most common cause of hypothyroidism in women and requires a specific management approach including attention to the immune component. The conversion of T4 to the active thyroid hormone T3 can be impaired by nutrient deficiencies, inflammation, and chronic stress — a problem that is entirely invisible on a standard TSH test.

The gut-hormone axis

The gut microbiome plays a direct role in hormonal regulation through the oestrobolome — the collection of gut bacteria that metabolise and regulate oestrogen recycling. Disrupted gut flora can lead to excess oestrogen recirculation, contributing to conditions such as endometriosis, heavy periods, and PMS. Intestinal permeability (“leaky gut”) promotes systemic inflammation, which in turn drives hormonal disruption. For many women I see, addressing the gut is a foundational part of addressing the hormones.

Nutritional medicine

Micronutrient deficiencies are far more prevalent than is commonly assumed, even in women who eat healthily. Magnesium deficiency is implicated in PMS, anxiety, and poor sleep. Iron deficiency — even without frank anaemia — causes fatigue and cognitive impairment. Vitamin D insufficiency affects immune regulation, mood, and metabolic health. Zinc is essential for progesterone production. I approach nutrition not as a lifestyle add-on but as a core component of hormonal medicine, with targeted supplementation guided by testing rather than guesswork.

Stress and the HPA axis

Chronic psychological and physiological stress dysregulates the hypothalamic-pituitary-adrenal (HPA) axis — the body’s central stress response system. This has profound downstream effects on the reproductive hormones: cortisol competes for the same precursor molecule as progesterone (“pregnenolone steal”), and chronic HPA activation suppresses thyroid function, impairs insulin sensitivity, and disrupts the menstrual cycle. Addressing stress physiology is not soft medicine — it is biochemistry.

My approach

The first functional medicine consultation lasts 90 minutes. I take a comprehensive personal, medical, and family history; conduct a thorough functional health assessment; and work with you to design a targeted testing plan. This may include blood tests, urine testing, stool analysis, or a combination, depending on your symptoms and history.

The follow-up consultation, typically two to three weeks later once results are available, lasts 60 minutes. We review all findings in detail — I explain what each result means in plain language — and I present a personalised therapeutic plan. This plan may include dietary and lifestyle recommendations, targeted nutritional supplementation, hormone optimisation, and, where indicated, conventional medical treatment or specialist referral.

Ongoing support is available as needed. For many women, the journey to feeling well is not linear; I am here for the duration.

What to expect: the consultation journey

Here is what your functional medicine journey with me typically looks like:

1. First consultation (90 minutes): A detailed conversation covering your complete health history, current symptoms, diet, sleep, stress, exercise, relationships, and goals. A functional health assessment. Together we agree on a testing plan tailored to your presentation
2. Testing phase (1–3 weeks): You complete the agreed tests, which may involve a blood draw at a local clinic, a urine sample collection at home, or a stool test. I will guide you through exactly what is required
3. Results consultation (60 minutes): A thorough review of all results with clear explanations. I present your personalised therapeutic plan in written form, covering nutrition, supplementation, lifestyle, hormonal optimisation, and any medical treatment recommended
4. Implementation and follow-up: You begin your plan with my written guidance. Follow-up appointments are scheduled according to your needs — typically at 6–8 weeks — to review progress, adjust the plan, and repeat any relevant tests

When functional medicine adds value

1. You have been told your tests are normal, but you feel persistently unwell
2. You have a chronic hormonal condition — PCOS, endometriosis, fibroids, thyroid disease — and conventional treatment alone has not resolved your symptoms
3. You are experiencing the perimenopause and want a proactive, whole-body approach rather than purely symptomatic management
4. You struggle with unexplained fatigue, brain fog, or mood symptoms despite normal mental health screening
5. You have gut symptoms that appear connected to your hormonal health but have not been investigated in that context
6. You want to understand your own biology in depth and take an informed, active role in your health
7. You have a family history of autoimmune disease, metabolic syndrome, or hormonal cancers and want to optimise your preventive health
8. You feel that previous consultations have been too brief to properly address the complexity of what you are experiencing

I believe that women deserve medicine that takes them seriously — that devotes the time and depth of investigation to truly understand what is happening in their bodies. Functional medicine is not for everyone, and I will always be honest about when conventional treatment is the right first step. But for the many women who have fallen through the gaps of standard care, it can be the beginning of a genuinely different relationship with their health.