Conditions · PCOS
Irregular cycles, stubborn weight, acne, unwanted hair, and fertility worries — PCOS is hormonal and metabolic at its core. In Fredericksburg, VA, we address the insulin and hormone drivers, not just the symptoms. Start with an initial appointment.
Polycystic ovary syndrome (PCOS) is driven largely by insulin resistance and hormone imbalance — which is why it shows up as irregular cycles, weight gain, acne, and unwanted hair growth all at once, and why symptom-only management so often falls short.
At True You, Dr. Hoff addresses the metabolic and hormonal roots with a personalized, physician-guided plan — so the symptoms improve because the cause does.
Why the pill isn’t the whole answer
The difference is treating the metabolic root, not just masking the symptoms.
The conventional visit
The True You approach
The pill can hide PCOS symptoms without treating the insulin resistance underneath — which is why they return when it’s stopped.
Unpredictable, missed, or difficult periods.
Weight that resists effort, especially around the middle.
Acne, oily skin, or unwanted hair growth.
Cravings, energy crashes, and rising blood sugar.
Polycystic ovary syndrome (PCOS) is one of the most common hormone conditions in women of reproductive age. It’s typically diagnosed when at least two of three features are present: irregular or absent ovulation, signs of higher androgens (such as acne or unwanted hair growth, or elevated levels on labs), and polycystic-appearing ovaries on imaging.
Despite the name, PCOS isn’t really about cysts. It’s a hormonal and metabolic condition — and insulin resistance sits at the center of it for many women. That’s why PCOS often affects weight, energy, and long-term metabolic health, not just cycles.
Several factors feed each other.
High insulin can push the ovaries to make more androgens.
Learn moreBehind acne, oily skin, unwanted hair, and thinning scalp hair.
Low-grade inflammation that worsens insulin resistance.
Weight gain worsens PCOS, and PCOS makes weight harder to lose.
Poor sleep and high cortisol add to the hormone load.
PCOS and type 2 diabetes often run in families.
PCOS affects more than cycles and skin. Because insulin resistance is so often involved, it raises the long-term risk of type 2 diabetes, high cholesterol, and cardiovascular problems, and irregular cycles can affect the uterine lining over time. Addressing the metabolic side early helps how you feel now and lowers those risks later — whether or not pregnancy is part of your plans.
Who it’s for
PCOS testing
How it works
A personalized plan aimed at the root.
Step 1
An in-person visit in downtown Fredericksburg to review your cycles, symptoms, and goals.
Step 2
Insulin, androgens, thyroid, and more — so treatment fits your PCOS.
Step 3
Nutrition, strength training, sleep, and medication when appropriate — including GLP-1 options through our medical weight loss program.
Step 4
Address androgens, skin, hair, and cycles with a physician-guided plan.
Step 5
Repeat labs and follow-up — many visits virtual — and coordination with your OB/GYN if fertility is a goal.
Explore related care
The metabolic root driving most of PCOS — tested and treated directly.
Learn more
Rebalance the hormones behind cycles, skin, and hair.
Learn more
Physician-guided, metabolic weight loss for the stubborn weight PCOS brings.
Learn more
One connected, root-cause plan across metabolism and hormones.
Learn moreBook an appointment with Dr. Hoff’s team in Fredericksburg, VA.
From the blog
Hormone Therapy & BHRT
Plan hormone optimization costs in Fredericksburg by separating evaluation, testing, treatment, follow-up, monitoring, and payment.
Read article
Hormone Therapy & BHRT
How much does hormone therapy cost in Fredericksburg? Compare evaluation, labs, treatment, follow-up, payment, and reimbursement.
Read article
Hormone Therapy & BHRT
Review hormone replacement therapy drugs list categories, forms, risks, monitoring questions, and cost drivers before a clinician visit.
Read articlePatient reviews
Rated 4.7 from 46 Google reviews
“The people at True You helped save my life . They have been so supportive from the very first call. Dr. Hoff found the underlying issue that was affecting my health. I had bounced from one primary care office to another and from specialist to specialist, wasting money on copays along the way! I walked into their office with genuine concern about where my health was headed and what the rest of my life would look like. I now feel better than I have in over 20 years! I take any health concern to Dr. Hoff first. My biggest concern used to be whether I would be able to live well enough to remain an active part of my family. Now, my only concern is whether they can keep up with me! Thank you, Dr. Hoff and Tina Hoff! Not only will I get to enjoy watching my grandkids grow up, but I'll also be able to get around and chase them down, too! God bless you both!”
“Dr Hoff goes above and beyond to listen to you and respond with a program that can truly change your life. He’s very down to earth, easy to talk to, a wealth of knowledge, and genuinely cares about improving your life experience. I wish I would’ve found him and his staff sooner. I would give six stars if it were possible, thank you!”
“Dr. Hoff has truly changed my life in less than six months. I went from waking up every morning feeling miserable and constantly bloated to now feeling healthy, energized, and excited to take on each new day and experience life again. More importantly, I genuinely believe he is helping save my life in the long run by focusing not only on treating symptoms, but on improving my overall health and quality of life. Dr. Hoff is exceptionally knowledgeable and highly skilled in his field, but what truly sets him apart is the genuine care and compassion he shows his patients — something that has become far too rare in healthcare today. I’m also incredibly grateful for the entire staff and everyone there for creating an environment where patients feel heard, supported, cared for, and truly valued.”
Reviews shown as published on our Google Business Profile.
