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PCOS guide

PCOS support online in Virginia and West Virginia

Metformin ER for insulin resistance and cycle regularity, and a withdrawal-bleed plan when months go by without a period — not for pregnancy or trying-to-conceive care, rapid virilization, or severe kidney disease, which need in-person clinicians.

Start online

Start a $59 online review for PCOS support.

PCOS affects roughly 1 in 10 women of reproductive age, and many wait years between appointments that actually move the plan forward. Online review can carry a meaningful part of that plan — metformin for insulin resistance and cycle regularity, a withdrawal-bleed course when indicated, and honest routing to the right lane for everything else, from acne treatment to lab workups.

If treatment is appropriate, your physician can send a non-controlled prescription to your pharmacy and provide portal instructions for the next step.

Start this visitSee response windows

Quick facts

  • You must be physically in Virginia and West Virginia at the time of request
  • Starts at $59
  • No insurance needed
  • No app download
  • Physician review around the clock
  • Non-controlled prescriptions can be sent to your pharmacy when appropriate
  • A work or school note can be included when medically appropriate
  • Response windows: 24/7, every day

Common symptoms

  • Irregular, infrequent, or missed periods
  • Weight gain or difficulty losing weight
  • Acne or unwanted facial and body hair that built up gradually
  • A prior PCOS diagnosis that has drifted without a plan

May fit online care

  • Adults 18 and older
  • A prior PCOS diagnosis, or irregular cycles you want worked up properly
  • Not pregnant and not trying to conceive this cycle
  • No rapid changes like a deepening voice or quickly spreading coarse hair
  • Kidney function normal or only mildly reduced (metformin safety)

Look for another care setting

  • Pregnant, possibly pregnant, or trying to conceive this cycle (your OB or a fertility clinician leads there)
  • A deepening voice, quickly spreading coarse hair, or clitoral enlargement over weeks to months (needs an in-person endocrine workup)
  • Severe kidney disease (eGFR under 30) or dialysis
  • Heavy or unusual bleeding that has never been examined

What to have ready

  • Your cycle pattern over the last 12 months, as best you can describe it
  • Any prior PCOS diagnosis or workup — photos of labs help if you have them
  • Your medication list, including metformin if you've taken it before
  • Your metabolic history — blood sugar, blood pressure, cholesterol, sleep apnea

What happens next

Standard

$59

Within 6 hours

Priority

$99

Within 3 hours

Rush

$149

Within 1 hour

Start the request on the website, answer the fit questions, and choose the response window you want. If the concern still fits this service, a physician reviews it and sends a secure update after sign-in. When appropriate, non-controlled prescriptions can be sent to your pharmacy, and a basic work or school note can be included at physician discretion.

Your physician

Every visit is personally reviewed by Ankur Fadia, MD — board-certified, cardiology-fellowship-trained, and Alpha Omega Alpha. Recognized with the Act Fast Award for the fastest physician stroke-treatment times (2019–2022) and as the most efficient, highest-rated physician in the HCA LewisGale Alleghany emergency department (2018). Licensed in Virginia and West Virginia — your care is never handed off.

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What can this visit actually prescribe for PCOS?

The centerpiece is metformin ER, titrated slowly for insulin resistance and cycle regularity, plus a short norethindrone course to bring on a period after months without one, when that's appropriate. Acne and unwanted-hair treatment run through the spironolactone visit, and daily-pill cycle regulation through the birth-control visit — so each medication gets its own proper safety screening.

I've never been formally diagnosed. Can I still start here?

Yes — and the visit is designed to do it right. A few conditions can mimic PCOS, so for a new or never-worked-up presentation the physician usually recommends a small lab panel (total testosterone, TSH, prolactin) through the lab test ordering visit. That protects you from carrying the wrong label for years.

What if I want to get pregnant?

That's a genuinely hopeful place to be — PCOS is one of the most treatable causes of difficulty conceiving. Care around conception belongs with your OB or a fertility clinician rather than this visit, and the intake will route you there rather than starting treatment that would need to change immediately.

Why does the intake ask about voice changes and hair growth speed?

PCOS symptoms build slowly over years. Changes that appear or accelerate over weeks to months — a deepening voice, coarse hair spreading quickly, clitoral enlargement — follow a different pattern that can signal a hormone-producing tumor, and that needs an in-person endocrine evaluation. The intake treats those as a firm stop, because getting that right matters more than convenience.