Conditions
PCOS: symptoms, tests and treatment by video
PCOS (polycystic ovary syndrome) is a hormone imbalance that causes irregular periods, acne, extra hair growth and insulin resistance. It is common and treatable. By video, the doctor evaluates you, gives you a lab order for hormones, blood sugar and cholesterol, and explains your options. If appropriate, the doctor prescribes and we send your prescription to your pharmacy. We see you anywhere in Puerto Rico.
Is it an emergency? Call 911.
Is this an emergency?
This is not an emergency service. Call 911 or go to the nearest emergency room if you have:
- Bleeding that soaks a pad or tampon every hour for 2 hours or more, or with dizziness or fainting
- Severe belly pain, bleeding or fainting with a positive pregnancy test
- Thoughts of harming yourself: call or text 988 or Línea PAS 1-800-981-0023
Help lines
At a glance
Polycystic ovary syndrome (PCOS)
Common symptoms
- Irregular periods that come and go, or stop
- Acne on the face, chest or back
- Extra hair on the face, chest or belly
- Hair loss
- Weight gain and insulin resistance
- Dark, thick skin on the neck, armpits or groin
- Trouble getting pregnant
- Anxiety, depression or sleep problems
- Other names
- PCOS · Polycystic ovaries · Polyendocrine metabolic ovarian syndrome (PMOS)
- Usual test
- Blood tests for hormones, blood sugar, cholesterol and thyroid; sometimes a pelvic ultrasound
- Treatment
- Routine changes; hormonal birth control or metformin, only when the medical evaluation calls for it
- Possible complication
- Type 2 diabetes and heart disease
On this page(9)
What is PCOS?
MedlinePlus describes it as a hormone imbalance that can raise the risk of diabetes and heart disease. It affects the hormones that control ovulation and periods, testosterone (a male hormone women also make) and insulin, which regulates blood sugar. That is why ovulation often doesn’t happen every month.
It is usually diagnosed in your 20s or 30s, but it also affects teens, and symptoms can start with the first periods. Often a mother or sister has similar symptoms. Despite the name, many women with the syndrome have no cysts on their ovaries. MedlinePlus now calls it polyendocrine metabolic ovarian syndrome (PMOS), a new name for the same condition.
How we treat PCOS by video
You see Dr. Diana Nieves Castro, MD, a Puerto Rico–licensed general practice physician with several years of emergency-department experience, in English or Spanish. She asks about your periods, acne, hair growth, mood, sleep, family history of diabetes and the medicines you take.
We evaluate, diagnose and treat. We give you a lab order for a lab near you and go over the results with you. If you need a pelvic ultrasound, we refer you and tell you where to go. If appropriate, the doctor prescribes and we send your prescription to your pharmacy. If you are trying to get pregnant and it isn’t happening, we refer you to gynecology.
If you are under 21, your parent or legal guardian must be on camera for the whole visit and show photo ID.
Your doctor
Dr. Diana Nieves Castro, MD
General practice physician
Several years of emergency-department experience.
Founding Executive Director of The Health Initiative.
Your visit in 3 steps
Request a visit online 24/7 — we confirm your time by email or text.
Request your visit.
Book a visit and choose "Doctor visit". You pay by card when you request it.
See the doctor by video.
We send you a secure video link. It works on your phone, tablet or computer.
Get your plan.
If needed, you get a lab order or a referral. If appropriate, the doctor prescribes and we send your prescription to your pharmacy.
What the visit costs
A PCOS evaluation is a US$79 doctor visit, with no membership. If you already use a treatment and only need a prescription refill, that is a US$49 follow-up visit. You pay by card when you request the visit, and you get a full refund if the visit can’t take place. We do not bill insurance; the lab and the pharmacy charge separately.
PCOS symptoms
They vary a lot from person to person, and some people have very few. According to MedlinePlus, the most common are:
- Irregular periods that come and go, or stop
- Acne on the face, chest or back
- Extra hair on the face, chest or belly
- Hair loss
- Weight gain and insulin resistance
- Dark, thick skin on the neck, armpits or groin
- Trouble getting pregnant
- Anxiety, depression or sleep problems
Tests and treatment
Tests. MedlinePlus lists blood tests for hormones (testosterone, FSH, LH, prolactin), thyroid, fasting blood sugar or hemoglobin A1c, cholesterol and a pregnancy test, and sometimes a pelvic ultrasound. The doctor picks the ones your case needs, because other conditions, such as thyroid problems, can cause similar symptoms. See also irregular periods, acne treatment and acanthosis nigricans, the dark, thick skin on the neck or armpits.
Changes to your routine. MedlinePlus calls them an important tool: eating healthy, exercising regularly and getting support for anxiety or depression.
Medicines. According to MedlinePlus, birth control pills help regulate periods and, over a few months, improve acne and hair growth; a hormonal IUD can also help. Metformin, a diabetes medicine, can make periods regular and help prevent type 2 diabetes. The doctor explains which option fits you and, if appropriate, prescribes it. See also birth control online.
PCOS, diabetes and heart health
According to MedlinePlus, women with the syndrome have a higher risk of type 2 diabetes, heart disease, fatty liver, sleep apnea and cancer of the lining of the uterus. That is why it is worth checking blood sugar and cholesterol even if you feel fine.
This matters more in Puerto Rico: according to a CDC analysis, 14.4% of adults had diagnosed diabetes in 2021, the highest of any US state or territory. See prediabetes.
When to go to the ER
For your safety, go to the emergency room or call 911 if you have:
- Bleeding that soaks a pad or tampon every hour for 2 hours or more, or with dizziness or fainting
- Severe belly pain, bleeding or fainting with a positive pregnancy test
- Thoughts of harming yourself: call or text 988 or Línea PAS at 1-800-981-0023
How we care for you
We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you.
We see adults and children of all ages. Patients under 21: a parent with patria potestad (parental authority) or a legal guardian is on camera for the whole visit and shows photo ID.
Real-time video visit. We send you a secure video link. It works on your phone, tablet or computer.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy. We do not prescribe controlled substances.
You must be physically in Puerto Rico during the visit (visitors, tourists and cruise passengers are welcome).
In an emergency, call 911.
Frequently asked questions
How do I know if I have PCOS?
Can PCOS be cured?
Can I get pregnant with PCOS?
Can I get metformin for PCOS by video?
About this page
Author: The Health Initiative
Medical care provided by Dr. Diana Nieves Castro, MD (PR license 24027)
Disclosure: Founding Executive Director of The Health Initiative
Published: 2026-10-02 · Updated: 2026-10-02
Sources (3)
- Polyendocrine metabolic ovarian syndrome (MedlinePlus, NIH) (opens in a new tab) (accessed 2026-10-02)
- Absent menstrual periods – secondary (MedlinePlus, NIH) (opens in a new tab) (accessed 2026-10-02)
- CDC, Preventing Chronic Disease 24_0221: prevalence of diagnosed diabetes among adults by state and territory, 2021 (opens in a new tab) (accessed 2026-10-02)