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Patient Briefing · 2026 · Barrie, ON
ORIENTATION PRESENTATION

Cycle & Hormone Care

Dedicated care for women's cycles & hormones, local in Barrie — for PCOS, PMS, endometriosis, adenomyosis, irregular periods, acne, and symptoms that aren't yet explained.

Led by
Nurse Practitioner
Program
12 weeks
Bloodwork
OHIP-covered
Patient in the Optimal waiting lounge
Optimal · Barrie
WHY WE BUILT THIS PROGRAM

Cycle & hormone symptoms are common —
and commonly dismissed.

Millions of women live with PCOS, endometriosis, adenomyosis, PMDD and cycle disorders for years before anyone connects the dots. We built this program to shorten that path.

10–13%
Of reproductive-aged women

Estimated share of reproductive-aged women affected by PCOS/PMOS — one of the most common hormonal conditions there is.

2023 International PCOS/PMOS Guideline

≈10%
Live with endometriosis

Roughly 1 in 10 reproductive-aged women — an estrogen-driven condition behind painful periods and pelvic pain.

World Health Organization, 2023

70%
May not know they have it

Up to 70% of women with PCOS worldwide may be undiagnosed — symptoms dismissed as "normal" for years.

2023 International PCOS/PMOS Guideline

2+ yrs
Waiting for a diagnosis

In a 1,385-person PCOS survey, about one-third of women reported waiting more than two years for a diagnosis.

PCOS diagnosis experience survey (n = 1,385)

WHAT'S DRIVING YOUR SYMPTOMS

The biology behind your symptoms.

Five systems work in concert across your cycle. PCOS, PMS/PMDD, endometriosis, adenomyosis, irregular periods — or symptoms no one has explained yet — usually trace back here.

SYMPTOMS LIKELY DRIVER Irregular or absent periods unpredictable cycles Hormonal acne jawline & chin Unwanted hair growth face & body Scalp hair thinning Premenstrual mood symptoms PMS · PMDD Heavy or painful periods endometriosis · adenomyosis Weight & blood-sugar changes Fatigue & low energy Androgens ↑ PCOS/PMOS · acne · unwanted hair Estrogen & progesterone Cycles · PMS/PMDD · endometriosis Insulin & metabolic PCOS · weight & energy Thyroid (TSH) Thyroid conditions · fatigue · mood Iron & ferritin Heavy periods · fatigue
Androgens ↑
The classic PCOS/PMOS pattern — acne, hair growth, thinning.
Estrogen & progesterone
Ovulation, PMS/PMDD — and estrogen-driven endometriosis & adenomyosis.
Insulin & metabolic
Central in PCOS — drives weight, energy and cycle changes.
Thyroid (TSH)
Mimics cycle and mood symptoms — checked, not assumed.
Iron & ferritin
Heavy periods deplete iron — fatigue and hair changes follow.
Sources: 2023 International PCOS/PMOS Guideline · ESHRE Endometriosis Guideline 2022 · ACOG premenstrual disorders · NICE NG88
Is this protocol right for you?

This protocol could be for you
if you recognise yourself here.

  • You're roughly 18–45 and still having periods — or should be.
  • Your cycles are irregular, absent, heavy or painful — or something feels off.
  • You're dealing with hormonal acne, unwanted hair growth or hair thinning.
  • You suspect PCOS, endometriosis, adenomyosis or PMS/PMDD — or have no diagnosis at all. You don't need one to start.
  • No referral needed — and you don't need a family doctor to enrol.
Optimal Clinic waiting area
Optimal · Barrie

What brought you here

6 concerns
Cycle pattern
  • Irregular, absent, heavy or painful
PCOS / PMOS
  • Suspected or diagnosed
PMS / PMDD
  • Cycle-linked mood & physical symptoms
Skin & hair
  • Acne
  • Hair growth
  • Hair thinning
Pelvic pain
  • Endometriosis
  • Adenomyosis
Not sure yet?
  • Most people start here
What we treat

Start with what you're
experiencing.

The symptoms no one connects

7 categories · 25 symptoms
Cycle pattern
  • Irregular cycles
  • 60-day gaps
  • Absent periods
  • Unpredictable bleeding
Pain & bleeding
  • Very heavy bleeding
  • Painful periods
  • Chronic pelvic pain
  • Pain with sex
  • Pain with bowel movements
Skin & hair
  • Hormonal acne
  • Unwanted facial or body hair
  • Scalp hair thinning
  • Oily skin
Cycle-linked mood
  • Premenstrual mood swings
  • Irritability before periods
  • Symptoms that lift once bleeding starts
Metabolic
  • Weight or blood-sugar concerns
  • Sugar cravings
  • Energy crashes
Fertility
  • Trouble ovulating
  • Trouble conceiving
  • Absent ovulation signs
General
  • Fatigue
  • Sleep disruption
  • Headaches around your period

Tap any that feel familiar — they're noted on your PDF record.

Mapped to the 2023 International PCOS/PMOS Guideline, ESHRE Endometriosis Guideline (2022), ACOG premenstrual-disorder guidance and NICE NG88.

Your 12-week journey

What happens, and when.

Included twice in every program

InBody scan.

A 30-second body-composition scan — muscle, fat, visceral fat and water, by region. Baseline at your orientation visit, repeated at week 12 so you see what actually changed.

30 sec
Scan 1 · Week 1
Scan 2 · Week 12
InBody body composition scanner
Medical-grade
The full path · 6 steps
Step 01 · Week 0
Cycle Check + intake call
3-minute online check, then our care coordinator calls to confirm fit.
3 min
Step 02 · Week 1
Orientation visit in Barrie
30-min orientation, InBody scan #1, and your cycle-timed lab requisition.
In-clinic
Step 03 · Weeks 1–6
Bloodwork + symptom tracking
LifeLabs or Dynacare, OHIP-covered — some tests drawn on specific cycle days.
Off-site
Step 04
60-min NP consultation
Full review of labs & InBody, working diagnosis, personalized plan.
60 min
Step 05 · Week 6
Follow-up #1
Symptom check, cycle-tracking review, adjustments. Virtual or in-person.
30 min
Step 06 · Week 12
Follow-up #2
Repeat InBody, program wrap-up, and handoff to Ongoing Care.
30 min
Your care team

The people looking after you.

Chantelle Oostwoud, MN, PHC-NP
Chantelle Oostwoud
MN, PHC-NP · Our Clinician
  • Your dedicated clinician for this program
  • Master of Nursing, Athabasca University
  • A decade in emergency, critical & remote care
  • Small panel — more time, more answers
Cheryl Cairns, Care Coordinator
Cheryl Cairns
Care Coordinator
  • The first person most members meet
  • Onboarding & care navigation
  • Coordinates your consults and follow-ups
  • Your first call for scheduling & results
Lab work & optional add-ons

Your panel is OHIP-covered, with three
add-ons worth considering.

Optional add-ons
SHBG
$69
Sex-hormone binding globulin

Shows how much of your testosterone and estradiol is active, so we can calculate free (bioavailable) levels — a sharper read than totals alone.

Vitamin D
$54
25-Hydroxy

A common, correctable driver of fatigue, low mood and aches that overlap with cycle symptoms — testing separates deficiency from hormone-driven complaints.

AMH
≈$82
Anti-Müllerian hormone · fertility only

Estimates ovarian reserve. Offered only if you're interested in fertility planning — it may or may not be useful for you, so it's entirely optional.

All three are uninsured, paid directly at LifeLabs or Dynacare. Pelvic ultrasound — if endometriosis or adenomyosis is suspected — is OHIP-covered.

Your complete lab panel

24 tests · 5 systems
Hormones & Ovulation
  • FSH
  • LH
  • Estradiol
  • Progesterone (cycle-timed)
  • Prolactin
  • AMH (fertility only)
  • Cortisol AM
Androgens
  • Total Testosterone
  • Free Testosterone
  • DHEAS
  • 17-OH Progesterone
  • SHBG
Thyroid
  • TSH
  • Free T4 (when indicated)
  • Thyroid antibodies (when indicated)
Metabolic & Glucose
  • Glucose — Fasting
  • HbA1C
  • Insulin (fasting)
  • Lipid Assessment
General Health
  • CBC
  • Ferritin
  • B12
  • Liver & Kidney Function
  • Vitamin D (25-OH)
Optional add-on (uninsured) — every other test is OHIP-covered. Some draws are timed to specific cycle days; your requisition will say which.
Understanding your options

Options chosen with you.

Cycle, bleeding & pain

Cycle regulation
& pain relief

  • Progesterone — cyclic or continuous
  • Progestogens, incl. for endometriosis & adenomyosis
  • Combined hormonal contraception
  • Hormonal IUD
  • NSAIDs, tranexamic acid & iron repletion
Skin & hair

Acne, hair &
androgens

  • Anti-androgen therapy (e.g. spironolactone)
  • Topical & oral acne treatments
  • Hair-growth treatments
  • Dermatology referral when appropriate
Energy & weight

Metabolic
health

  • Insulin-sensitizing medication (e.g. metformin)
  • Inositol, where evidence supports it
  • Nutrition & movement support
  • InBody tracking through the program
Mood & beyond

PMS / PMDD
& referral

  • Symptom tracking (2–3 cycles) to confirm the pattern
  • SSRIs — continuous or luteal-phase
  • Sleep & stress support
  • Pelvic ultrasound & gynecology, endocrinology or fertility referral
Care Coordinator Support

Dedicated, personalized administrative support throughout your care journey.

Secure Patient Portal

Messaging, lab results & treatment-plan delivery via our encrypted system.

Your NP walks through what fits — based on your labs, symptoms, and full medical history. Never chosen for you.

Why Optimal

Not all hormone care is
the same.

Nurse practitioner in conversation with a patient in an Optimal exam room
"In 12 weeks, know what's driving your symptoms — and have a plan you understand."
The Foundation Program promise
Typical referral clinic
Optimal
First visit
20–30 minute visits
60-minute, whole-person assessment
Continuity
Rotating providers
The same NP every visit
Wait time
6–18 months on referral waitlists
Seen within days — no referral
Body composition
Not included
InBody at visit 1 and week 12
Follow-up
Varies by availability
Built-in 12-week protocol

Comparison reflects typical Ontario referral pathways; individual timelines and experiences vary.

Safety & risk information

Our safety-first approach.

We prioritize appropriate patient selection, evidence-informed prescribing, and ongoing monitoring. Every treatment class carries a distinct and manageable risk profile, which your NP reviews with you — benefits, risks and alternatives, side by side — before any prescription is made.

Class 01

Hormonal options

For cycle regulation, heavy or painful periods, endometriosis and adenomyosis — chosen around your history and plans.

Considerations
  • Breakthrough bleeding or spotting, especially early on
  • Mood sensitivity in some patients
  • Clot risk varies by formulation, age & health profile
  • Your history guides which options are appropriate
01
Class 02

Anti-androgens & acne therapy

For hormonal acne, unwanted hair growth and hair thinning — results build gradually over several months.

Considerations
  • Spironolactone requires reliable contraception
  • Blood-pressure & potassium monitoring where indicated
  • Skin dryness or irritation with some topical treatments
  • Dermatology referral when appropriate
02
Class 03

Metabolic support

For insulin resistance and the metabolic side of PCOS — paired with nutrition, movement and InBody tracking.

Considerations
  • Metformin: GI side-effects that usually settle with time
  • Inositol: evidence-informed dosing — quality matters
  • B12 monitoring with longer-term metformin
  • Nutrition & movement support throughout
03
Class 04

Mood support

For PMS and PMDD once symptom tracking confirms a cycle-linked pattern.

Considerations
  • SSRIs: continuous or luteal-phase, chosen together
  • Early side-effects reviewed at follow-up
  • Never stopped abruptly — tapered with your NP
  • Written escalation plan for mood changes
04
When to seek urgent care

Call 911 or go to the ER
immediately if you experience:

Severe or sudden headache, or visual changes.

Calf pain or swelling, chest pain, or shortness of breath.

Bleeding that soaks a pad or tampon every hour for several hours, or with dizziness.

Severe pelvic pain, especially with a possible pregnancy.

Severe allergic reaction, fainting, severe muscle weakness, or a racing or irregular heartbeat.

Significant mood deterioration or thoughts of self-harm.

Appendix

A couple
of notes.

Two quick housekeeping details before we wrap — purely for expectation-setting. Nothing here needs action today.

Optimal Clinic reception
Optimal Clinic treatment hallway
Before your consultation

Certain lab results may put your
consultation on hold.

Occasionally, bloodwork reveals something unrelated that deserves attention first. Here's exactly what happens if it does.

YOUR CARE PROGRAM YOUR FAMILY PHYSICIAN
Step 1

Results reviewed

Your NP reviews your complete panel first.

Step 2

Incidental finding

Something unrelated needs attention before care begins.

Step 3

NP notifies you

Your NP will give you a quick call to notify you.

Program on hold

Routed to your FP

Your family physician takes over, with a full copy of your results.

Step 5

You return

Resolved — you continue right where you left off.

Prefer a refund?

We provide a pro-rated refund minus $150, covering your bloodwork analysis and initial onboarding.

A friendly reminder

Your bloodwork keeps everything on time.

The sooner your labs are done, the sooner your NP can build your plan. Here's how timing works from the day you register.

SWEET SPOT WK 1WK 3WK 4 WK 5WK 6WK 7 $
Day 0 · Registration

You're enrolled

Requisition in hand — LifeLabs or Dynacare, any day that suits.

Weeks 1–2 · Priority

First in line

Labs done in this window mean your NP consult is booked within about a week of your results arriving.

Weeks 2–8

We'll still see you

No problem at all — though one-week scheduling is no longer guaranteed once results arrive.

Week 8

A $100 admin fee applies

If bloodwork isn't complete by week 8, the fee covers re-coordinating your program.

Life gets busy — we understand. Running behind? Call us and we'll keep you on track. (437) 370-0291

Pricing & immediate next steps

Let's get you started.

Option A · Pay in full
Best value
One-time payment
$895+ HST
Paid at your orientation appointment.

Everything in the 12-week program — booked as separate visits: $1,075+.

OPTION B · MONTHLY INSTALMENTS
New
Spread over three months
$325/ mo × 3
Total $975 + HST · first payment at orientation.

Same 12-week program — paid in equal monthly instalments.