Conditions · PCOS

PCOS care that treats the root cause

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.

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More than “take the pill and lose weight”

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

Why “here’s the pill, come back for kids” falls short

The difference is treating the metabolic root, not just masking the symptoms.

The conventional visit

“Here’s the pill”
“Come back when you want kids”
Symptoms masked, cause untouched
Insulin rarely tested
A rushed visit

The True You approach

Test and treat the insulin and hormone drivers
Help now — cycles, weight, skin, and energy
Address the metabolic root so symptoms improve
Fasting insulin, androgens, and full hormones
Unhurried time with a physician who monitors over time

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The pill can hide PCOS symptoms without treating the insulin resistance underneath — which is why they return when it’s stopped.

Do these sound familiar?

Irregular cycles

Unpredictable, missed, or difficult periods.

Stubborn weight

Weight that resists effort, especially around the middle.

Skin & hair changes

Acne, oily skin, or unwanted hair growth.

Insulin resistance

Cravings, energy crashes, and rising blood sugar.

Our approach

Metabolic Health

Address the insulin resistance that drives so much of PCOS.

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Hormone Balance

Rebalance the hormones behind cycles, skin, and hair.

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Functional Medicine

One connected, root-cause plan across metabolism and hormones.

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What is PCOS?

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.

What drives PCOS

Several factors feed each other.

Insulin resistance

High insulin can push the ovaries to make more androgens.

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Higher androgens

Behind acne, oily skin, unwanted hair, and thinning scalp hair.

Inflammation

Low-grade inflammation that worsens insulin resistance.

Weight changes

Weight gain worsens PCOS, and PCOS makes weight harder to lose.

Sleep & stress

Poor sleep and high cortisol add to the hormone load.

Family history

PCOS and type 2 diabetes often run in families.

PCOS and long-term health

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 care at True You may help if you…

Have irregular, missing, or unpredictable periods
Struggle with weight that won’t respond to diet and exercise
Have acne, oily skin, or unwanted hair growth
Have been diagnosed with PCOS but only offered the pill
Have rising blood sugar or a family history of diabetes

PCOS testing

What we may test

Fasting insulin, glucose, and HbA1c
Testosterone and other androgens
Thyroid and prolactin, to rule out look-alike causes
A lipid panel
Vitamin D and other nutrients
Your cycle history, symptoms, and goals

How it works

PCOS treatment, step by step

A personalized plan aimed at the root.

01

Step 1

Initial appointment

An in-person visit in downtown Fredericksburg to review your cycles, symptoms, and goals.
02

Step 2

Metabolic & hormone labs

Insulin, androgens, thyroid, and more — so treatment fits your PCOS.
03

Step 3

Treat the insulin driver

Nutrition, strength training, sleep, and medication when appropriate — including GLP-1 options through our medical weight loss program.
04

Step 4

Balance hormones

Address androgens, skin, hair, and cycles with a physician-guided plan.
05

Step 5

Monitor & coordinate

Repeat labs and follow-up — many visits virtual — and coordination with your OB/GYN if fertility is a goal.

PCOS — common questions

Do I have to be trying to get pregnant to get help?

No. Whether or not fertility is a goal, addressing the insulin and hormone drivers of PCOS can improve cycles, weight, skin, and energy.

Is PCOS really about insulin?

For most people, insulin resistance is a central driver. That’s why we test and treat the metabolic picture, not just the reproductive symptoms.

Do you take insurance?

True You is a cash-based practice, so your care isn’t limited by insurance rules. We’re transparent about costs during your consultation.

Can PCOS be reversed?

PCOS can’t be cured, but symptoms can often improve significantly when insulin resistance and hormone balance are addressed. Many women see more regular cycles, better skin, and easier weight management.

Can GLP-1 medications help with PCOS?

For some women, yes — particularly when insulin resistance and weight are major factors. Whether a GLP-1 is appropriate depends on your evaluation and goals, including any pregnancy plans.

Can I have PCOS without being overweight?

Yes. PCOS occurs at every body size, and insulin resistance can be present even at a normal weight. Testing tells us what’s driving your symptoms.

Does PCOS affect fertility?

It can make ovulation less regular, which can make conceiving harder. Improving the metabolic and hormone drivers may help, and we coordinate with your OB/GYN or fertility specialist when pregnancy is the goal.

How is PCOS diagnosed?

Diagnosis is based on your cycle history, signs of higher androgens on exam or labs, and sometimes ovarian imaging — after ruling out look-alike causes such as thyroid problems. We review all of it and coordinate with your gynecologist when needed.

Can PCOS affect mood?

It can. Hormone imbalance, insulin swings, poor sleep, and the stress of living with symptoms can all affect mood and anxiety. We treat that as part of your care.

Does PCOS change after menopause?

Cycle-related symptoms change after menopause, but the metabolic side — insulin resistance and cardiovascular risk — can continue, so ongoing metabolic care still matters.

Will I have to stop birth control?

Not necessarily. Some women stay on it for cycle control or contraception while we work on the metabolic drivers. We’ll talk through your goals and coordinate with your gynecologist.

Can my follow-up visits be virtual?

Many can. Your first visit and labs are in person at our downtown Fredericksburg office, and much of the ongoing care can be virtual.

Can PCOS cause hair thinning?

Yes. Higher androgens can thin scalp hair while increasing hair growth elsewhere. Addressing the hormone and insulin drivers is part of improving it.

Can PCOS cause fatigue?

It can. Insulin swings, poor sleep, and hormone imbalance all drain energy. As the metabolic drivers improve, many women find their energy steadies too.

How do I get started?

Book an initial appointment. We’ll review your history and symptoms and order the metabolic and hormone testing that fits your situation.

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