PCOS

What is PCOS?

PCOS is a hormonal condition that affects how the ovaries work and how the body handles insulin. It is one of the most common causes of irregular periods and ovulatory problems in women of reproductive age.

Diagnosis is based on a combination of features, including irregular cycles, signs of excess androgens, and polycystic-appearing ovaries on ultrasound, after other causes are ruled out.

Common symptoms

Common symptoms include irregular, infrequent or absent periods, acne, unwanted hair growth on the face or body, hair thinning on the scalp, weight gain or difficulty losing weight, and sometimes ovarian cysts.

Symptoms vary widely between women, and some women have few outward signs.

Possible causes

The exact cause is not fully understood, but genetics, insulin resistance and higher-than-typical androgen levels all play a role. Insulin resistance is present in a large share of women with PCOS.

PCOS is a syndrome, meaning it is a pattern of features rather than a single disease with one cause.

How it is evaluated

Evaluation includes a detailed history of cycles and symptoms, and labs such as testosterone and other androgen markers, hormone panels, thyroid tests, glucose, A1C, fasting insulin and lipids.

Labs are completed near you or with home kits where available, depending on your state and the tests ordered.

Care options that may be considered through telehealth

Care may include cycle and symptom management, metabolic support for insulin resistance, nutrition and lifestyle planning, and, when appropriate, medications such as metformin or hormonal options discussed with your gynecologist.

Fertility planning is discussed openly, and coordination with a gynecologist or reproductive specialist is recommended when pregnancy is a goal.

Lifestyle factors

Regular activity, strength training, protein and fiber at meals, consistent sleep and stress management improve insulin sensitivity and can meaningfully improve PCOS symptoms, including cycle regularity.

When to seek urgent care

PCOS is not an emergency, and telehealth is not for emergencies. Severe pelvic pain, heavy bleeding with dizziness, or chest pain warrants immediate care: call 911 or go to the emergency room.