PCOS Explained: What It Is, How It's Diagnosed, and How I Treat It in Plano, TX

PCOS, polycystic ovary syndrome, is one of the most common conditions I diagnose and manage in my practice, yet it’s also one of the most misunderstood. Patients often come in after years of being told their irregular periods, acne, or stubborn weight gain are “just how their body is,” without ever being screened for the underlying cause. PCOS affects an estimated 1 in 8 women, more than 170 million women worldwide, which makes it one of the most common hormonal conditions of reproductive age.

As a board-certified Internal Medicine physician in Plano, TX, I want to walk you through what PCOS actually is, how it’s diagnosed, what’s changing in how the medical field talks about it, and how I approach treatment.

What PCOS Actually Is

Despite the name, PCOS isn’t primarily a disease of the ovaries. It’s a metabolic and endocrine condition that happens to show up with reproductive symptoms. Three features tend to drive the condition:

• Insulin resistance — your cells don’t respond to insulin as efficiently as they should, so your body produces more of it. Elevated insulin, in turn, can drive up androgen production.
• Androgen excess — higher-than-typical levels of male hormones like testosterone, which can cause acne, excess hair growth, and hair thinning.
• Ovulatory dysfunction — irregular or absent ovulation, which shows up as irregular, infrequent, or missing periods.

These three pieces interact with each other, which is exactly why PCOS is now understood as a whole-body metabolic and endocrine condition, not a purely gynecological one.

A New Name Is Being Introduced: PMOS

In May 2026, an international consensus group, led by researchers at Monash University alongside the International Androgen Excess and PCOS (AE-PCOS) Society, and endorsed by more than 50 patient and professional organizations including the Endocrine Society, published a recommendation in The Lancet to rename PCOS to polyendocrine metabolic ovarian syndrome (PMOS). The change followed a 14-year global consultation process with patients and clinicians, and it’s meant to better reflect that this is a metabolic and endocrine condition, not a disease defined by ovarian cysts (the “cysts” seen on ultrasound aren’t true cysts at all, but immature follicles).

Here’s what matters for you as a patient: this is a real, formally adopted name change, but it isn’t replacing “PCOS” overnight. A three-year transition period is underway, with full incorporation into the next update of the International Guideline expected in 2028. You’ll continue to see “PCOS” on your labs, records, and insurance paperwork for the foreseeable future, and that’s completely normal. I’ll use both terms with you so the connection is always clear.

How PCOS Is Diagnosed: The Rotterdam Criteria

PCOS is diagnosed using the Rotterdam criteria, which require two of the following three findings, after we’ve ruled out other conditions that can mimic PCOS (like thyroid disease, elevated prolactin, or adrenal disorders):

1. Ovulatory dysfunction — irregular or absent ovulation
2. Clinical or biochemical hyperandrogenism — signs like acne, excess hair growth, or elevated androgen levels on labs
3. Polycystic ovarian morphology — seen on ultrasound (12 or more small follicles in an ovary, or increased ovarian volume)

Under the 2023 International Evidence-Based Guideline for PCOS, an anti-Müllerian hormone (AMH) blood test can now be used as an alternative to ultrasound for the third criterion. And if you already have both irregular cycles and signs of hyperandrogenism, a diagnosis can often be made without imaging or AMH testing at all.

This matters because PCOS is frequently underdiagnosed or diagnosed late. If you have irregular periods and any signs of androgen excess, that’s enough for a conversation and appropriate lab work, not something to wait out.

How I Manage PCOS at My Practice

Because PCOS is a metabolic condition at its core, treatment goes well beyond the reproductive symptoms that usually bring patients in. My approach includes:

• Metabolic evaluation — bloodwork to assess insulin resistance, blood sugar, and lipid levels, since PCOS increases long-term risk for type 2 diabetes and cardiovascular disease
• Hormone testing — androgens and other relevant markers to confirm the diagnosis and track your response to treatment
• Weight and metabolic health management — for many patients, improving insulin sensitivity through nutrition, activity, and, when appropriate, medical weight management meaningfully improves cycle regularity and symptoms
• Targeted treatment — this may include metformin for insulin resistance, medications to manage androgen-related symptoms, or a personalized plan built around your specific goals, whether that’s symptom relief, fertility, or long-term metabolic health

PCOS looks different in every patient I see, so I don’t treat it with a one-size-fits-all protocol. Some patients need help with cycle regulation. Others are more concerned with skin and hair symptoms, or with the metabolic risks down the road. We build the plan around what matters most to you, informed by the full clinical picture. If PCOS is part of a broader pattern of symptoms you’re trying to make sense of, this often starts as part of your regular primary care visit.

If irregular periods, unexplained weight changes, acne, or excess hair growth have you wondering whether PCOS could be behind it, let’s find out together. Schedule a consultation and we’ll build a diagnostic and treatment plan around your specific picture.

Sophia Rahman MD is located at 1212 Coit Rd, Suite 105, Plano, TX 75075. Accepting new patients in Plano, Frisco, McKinney, Allen, Murphy, and the surrounding Collin County area.