PCOS

PCOS care in Miami.

Polycystic ovary syndrome is a metabolic condition as much as a gynecological one, and treating only the cycle misses most of it.

The options

How this is approached here

  1. 01

    Diagnosis on the Rotterdam criteria

    With the bloods and ultrasound needed to exclude what mimics it.

  2. 02

    Metabolic workup

    Glucose tolerance, lipids and blood pressure, because insulin resistance is the part that matters long term.

  3. 03

    Cycle regulation where that is the goal

    With the options and their trade-offs written out.

  4. 04

    Ovulation induction where pregnancy is the goal

    And referral to reproductive endocrinology when that is the better route.

  5. 05

    Coordination with endocrinology rather than sending

    You away to arrange it yourself.

Symptoms

The pattern that brings most people in

Cycles longer than thirty-five days

Or fewer than eight periods a year.

Acne that persists past the teenage years

Particularly along the jaw.

Hair growth on the face

Chest or abdomen in a male pattern.

Thinning hair at the crown

Weight that climbs despite no change in habits

Concentrated around the middle.

Difficulty conceiving

Which is often the symptom that finally prompts a visit.

What the workup covers

Beyond confirming the diagnosis

  1. 01

    Androgens

    LH and FSH, prolactin and thyroid function — the last two because they mimic PCOS and are treated differently.

  2. 02

    A two-hour glucose tolerance test rather

    Than a fasting glucose, because fasting values miss most insulin resistance.

  3. 03

    Lipids and blood pressure

    Since cardiovascular risk is the part of PCOS that matters over decades.

  4. 04

    Pelvic ultrasound where it will change the answer

    In adolescence it usually will not, and is often omitted.

  5. 05

    A conversation about mood

    Depression and anxiety are markedly more common with PCOS and routinely go unasked about.

Treatment by goal

What you are treating for decides what we use

If the goal is a regular

Cycle and endometrial protection: hormonal contraception or cyclical progestogen.

If the goal is pregnancy

Letrozole first line, with metformin where insulin resistance is present, and referral to reproductive endocrinology if that does not work.

If the goal is hair or acne

Anti-androgen treatment, which takes six months before it is fair to judge.

If the goal is metabolic

Weight, activity and sometimes metformin or a GLP-1 agonist, coordinated with endocrinology rather than managed at a distance.

PCOS: common questions

Do I have to be overweight to have PCOS?
No. Lean PCOS is common and frequently missed for exactly that reason.
Will I be able to get pregnant?
Many women with PCOS conceive, with or without help. The workup tells us which is likely for you rather than guessing.
Is the pill the only treatment?
No. It is one option among several and it suits some goals and not others.
Does PCOS go away?
The underlying tendency does not, but cycles often become more regular in the late thirties and forties, and the symptoms that bother you most can change over a lifetime.
Do I need to be on the pill forever?
No. It is one tool for one goal. If the goal changes, the treatment should change with it.
Does PCOS mean I will get diabetes?
It raises the risk substantially, which is why the glucose tolerance test is part of the workup and repeated periodically. It is not a certainty, and the risk is modifiable.

Know before you book.

Vireo opens in 2027. Until then the plan list, panel status and first-available wait for every office are published on this site and kept current. Questions can go to the practice office on (305) 555-0180.

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