PCOS care in San Antonio

Polycystic ovary syndrome (PCOS) is a common hormone condition that can cause irregular periods, acne, extra hair growth and trouble getting pregnant. It affects an estimated 10% to 13% of women of reproductive age, and up to 70% don't know they have it. It is a long-term condition, and treatment can ease symptoms and lower long-term health risks.

Key facts

  • PCOS is diagnosed when at least two of three features are present, after other causes are ruled out: irregular or absent ovulation, signs or blood levels of high androgens ("male" hormones), and polycystic ovaries on ultrasound.
  • You do not need to have ovarian cysts to have PCOS.
  • More than half of women with PCOS develop prediabetes or type 2 diabetes by age 40.
  • Infrequent periods over many years raise the risk of endometrial (uterine lining) cancer. Treatment can lower this risk.
  • PCOS is one of the most common causes of infertility, and it is often treatable.
  • Leticia Vargas, MD, OB/GYN, provides PCOS care in-clinic in San Antonio, with telehealth follow-ups for women located in Texas.

What are the symptoms of PCOS?

Symptoms vary a lot, and you may not have all of them:

  • irregular periods (fewer than eight a year), no periods, or very heavy periods;
  • extra hair on the face, chin, chest or belly;
  • acne or oily skin;
  • thinning hair on the scalp;
  • weight gain or trouble losing weight;
  • dark, velvety patches of skin on the neck, armpits or groin;
  • trouble getting pregnant.

PCOS can also affect mood. Anxiety, depression and body image concerns are more common in women with PCOS, and they are worth talking about at your visit.

How is PCOS diagnosed?

There is no single test for PCOS. Diagnosis is based on:

  • your period history and symptoms;
  • a physical exam;
  • blood tests for androgens, and to rule out other causes like thyroid problems, high prolactin or pregnancy;
  • sometimes a pelvic ultrasound or an AMH blood test.

If you have both irregular cycles and signs of high androgens, an ultrasound is usually not needed to diagnose PCOS in adults. In teens, PCOS is diagnosed more carefully, because irregular periods and ovary changes are normal in the first years after periods start.

Once PCOS is diagnosed, international guidelines recommend checking blood sugar, cholesterol and blood pressure, and screening for mood and sleep problems such as sleep apnea.

PCOS treatment options

Treatment depends on your symptoms and whether you want to get pregnant now. A plan may include:

  • Healthy eating and regular activity. Recommended for all women with PCOS. For women who have extra weight, losing about 10% of body weight may help periods become more regular.
  • Hormonal birth control. Can make periods more regular, lower the risk of endometrial cancer, and improve acne and unwanted hair.
  • Metformin. A diabetes medicine that may help with insulin resistance and, in some women, ovulation. It is not FDA-approved for PCOS (off-label use).
  • Anti-androgen medicines, such as spironolactone. May reduce unwanted hair, acne and scalp hair loss. They are not FDA-approved for PCOS and can cause problems in pregnancy, so reliable birth control is needed.
  • Hair and skin care. Hair removal methods and prescription creams can help with unwanted hair and acne.

Every medicine has side effects. Dr. Vargas will go through the benefits and risks with you.

PCOS and fertility treatment

Many women with PCOS can get pregnant, sometimes with help to ovulate. The 2023 international PCOS guideline recommends letrozole as the first medicine to try for ovulation in most women with PCOS. Letrozole is not FDA-approved for this use in the U.S. Clomiphene is another option. If these don't work, a fertility specialist can discuss other treatments, such as injectable medicines or IVF.

Dr. Vargas can talk through your options, help you prepare for pregnancy, and refer you to a fertility specialist when needed. Read more in our guide to PCOS and fertility.

PCOS and weight

Insulin resistance is common in PCOS, which can make weight harder to manage. Weight is not your fault, and PCOS affects women of every size. If weight is a concern for you, we can talk about a medical weight loss plan as part of your care.

What to ask your clinician

  • Do my symptoms fit PCOS, or could something else be causing them?
  • Which tests do I need, and how often should we repeat them?
  • What is my risk of diabetes, and how do we watch for it?
  • Which treatment fits me if I don't want to get pregnant right now?
  • What are my options if I want to get pregnant?
  • How can we treat acne or unwanted hair?

FAQs

Does PCOS go away with treatment? No. PCOS is a long-term condition, but treatment can control symptoms and lower long-term risks. Symptoms often change over a woman's life.

Do I have to have cysts on my ovaries to have PCOS? No. Many women with PCOS have normal-looking ovaries on ultrasound. Diagnosis needs two of three features, and ovary changes are only one of them.

Can I get pregnant with PCOS? Many women with PCOS do get pregnant, some with help from medicines that support ovulation. A visit before trying can help you plan.

Does birth control treat PCOS? It doesn't make PCOS go away, but it can make periods regular, protect the lining of the uterus and improve acne and hair growth.

Does PCOS go away after menopause? Periods may become more regular as you near menopause, but the hormone differences and the risks of diabetes and heart disease remain. Ongoing checkups still matter.

Book a visit

Book a PCOS visit with Leticia Vargas, MD, OB/GYN. Call (210) 903-1030 or book a visit. In-clinic in San Antonio • Telehealth for women located in Texas Yaso Wellness Health Clinic, 1907 Goliad Rd, San Antonio, TX 78223

About the clinician: Leticia Vargas, MD, OB/GYN, founder of Yaso Wellness Health Clinic. About Dr. Vargas

Sources

Education only, not medical advice or a diagnosis. In an emergency, call 911.