What to Know About Telehealth for Polycystic Ovary Syndrome (PCOS)

Telehealth is health care provided remotely using technology, including live video chats, mobile health apps (also called mHealth), online visits, and secure messaging via text or email.

Many conditions can be diagnosed and/or managed through telehealth, including polycystic ovary syndrome (PCOS)—a common condition in people of childbearing age involving hormone imbalances, metabolic problems, and the development of ovarian cysts.

When to Use Telehealth for PCOS

Because telehealth uses technology that includes video, audio, or email (or a combination), healthcare providers can assess and treat conditions that do not require a physical exam.

As PCOS is a chronic condition that usually involves ongoing care, telehealth is advantageous in many ways for people living with PCOS.

Some instances where telehealth may be used for PCOS include:

• Diagnosis
• Treatment
• Follow-up and monitoring
• Treating comorbid conditions
• Receiving referrals

Diagnosis

For a diagnosis of PCOS, a person must experience at least two of the following:

• Irregular menstrual cycles
• An imbalance of androgen hormones such as testosterone, as determined by a blood test and/or symptoms of this imbalance such as hirsutism (increased body or facial hair), skin problems like acne, or other symptoms associated with increased androgen
• Polycystic ovaries (enlarged ovaries with many small, fluid-filled cysts)

While determining the presence of polycystic ovaries requires an ultrasound, irregular menstrual cycles and symptoms of hormonal imbalance can be discussed via telehealth, and a diagnosis of PCOS can sometimes be made based on symptoms alone.

Treatment

There is no cure for PCOS, only symptom management. PCOS is primarily treated with medication and with lifestyle changes such as improved diet and exercise.

In most cases, medication can be prescribed via telehealth. The healthcare provider may send the prescription to a pharmacy to be filled and then picked up by the patient, or they may send it to a medication delivery program to be sent to the patient by mail.

Lifestyle changes can be discussed and monitored through telehealth. The healthcare provider can help the person with PCOS:

• Plan healthy meals
• Develop an exercise plan
• Make other necessary changes

Follow-Up and Monitoring

Someone diagnosed with PCOS can keep ongoing appointments via telehealth to:

• Track weight: Weight loss in people with PCOS who are above average in weight is associated with a reduction of symptoms. A person with PCOS can keep a record of their weight using a home scale and use telehealth appointments to check in with their healthcare provider about their progress.
• Discuss medication: Medication adjustments and refills can usually be accommodated through telehealth as well, assuming a physical exam is not needed.

Comorbid Conditions

People with PCOS are at a higher risk for:

• Insulin resistance
• Diabetes
• High blood pressure
• Unhealthy cholesterol
• Sleep apnea
• Depression and anxiety
• Infertility
• Weight gain/difficulty losing weight
• Heart disease
• Stroke
• Endometrial cancer

While not everyone with PCOS will experience these, people with PCOS should be monitored for signs of their development.

If present, these conditions may require treatment in addition to the treatment for PCOS.

People with PCOS who need to can monitor their blood sugar and blood pressure at home and consult with their healthcare provider using telehealth.

The healthcare provider can also order tests and prescribe medications for these conditions if necessary.

Referrals

Difficulties with fertility can be a problem experienced by people with PCOS.

This can often be treated with medication and/or lifestyle changes provided by your gynecologist or primary healthcare provider with expertise in this area, but sometimes requires a referral to a fertility specialist or reproductive endocrinologist.

People with PCOS who experience health problems associated with their condition may need to see specialists such as:

• OB/GYN
• Endocrinologist
• Sleep specialist
• Dietitian
• Cardiologist
• Psychiatrist
• Therapist

A telehealth appointment with a primary healthcare provider can provide a referral to specialists, and appointments with specialists can often be conducted through telehealth as well.

You should seek immediate/emergency in-person medical attention if you are experiencing:

• Signs of a heart attack, including chest pain
• Signs of a stroke, including one-sided weakness or facial drooping
• Seizures
• Changes in mental state such as confusion or incoherent/jumbled speech
• Fainting
• Significant or uncontrolled bleeding, suspected broken bones, or anything else that requires immediate or emergency attention

Benefits and Challenges of Telehealth

Benefits

The use of telehealth has several advantages, for the patient, for the provider, and for the healthcare system, including:

• Convenience: Telehealth allows people to connect with their healthcare provider from wherever they are. This can mean from the comfort of their own home in their pajamas, during a break at work which would otherwise have required time off, or anywhere else the person chooses.
• No need for transportation: Transportation can be costly and inconvenient. Public transportation exposes a contagious person to others.
• Accessibility: For people who have problems with mobility or otherwise find it difficult to leave the house, telehealth makes health care more accessible.
• Cost: Telehealth is often at least partially covered through insurance or programs like Medicaid and Medicare. Some providers offer telehealth at comparable or lower cost than in-person appointments. Telehealth also reduces or eliminates the cost of transportation and missed work.
• Fewer missed appointments: Ohio State Wexner Medical Center noted a drop in missed appointments with the increased use of telehealth.
• Flexibility: With telehealth, people are not limited to the care providers in their immediate area. This means a better opportunity to find a care provider that is a good fit, the ability to access appointment times outside of fixed office hours, and faster availability of appointment times.
• Asynchronous options: Healthcare providers and their patients do not always have to communicate in real-time. Documentation, photos, videos, and other information can be sent, received, and reviewed at the provider's and the patient's convenience. This can also be helpful for people with social anxiety or who have difficulty communicating verbally.
• Lowered exposure to contagions: With telehealth, there is no waiting room or public travel in which people are exposed to others who might make them sick.

Challenges

There are some ways in which telehealth is not always advantageous:

• Lack of access to equipment: Not everyone has the access or ability to use the technology necessary for telehealth. They may also lack equipment such as a blood pressure monitor, a blood sugar monitor, a home scale, and other items that make consultations for people with PCOS possible from home. This discrepancy in accessibility creates inequity in health care.
• Missed observations: Healthcare providers use more than just questions and examinations to make diagnoses and suggest care. During an in-person appointment, a healthcare provider may notice nonverbal cues, sensory perceptions such as smell, and other things that might be missed during a telehealth appointment.
• Technical problems: Technology is unpredictable and often unreliable. Dropped calls, failed Wi-Fi connections, and other technical problems can prevent or interrupt a telehealth visit.
• Limited options for examination: While many aspects of PCOS can be discussed and examined via telehealth, the hands-on examination and diagnostic testing that is sometimes necessary is only available in person.
• Continuity of care: Not all primary healthcare providers offer telehealth. If a person's regular provider does not do telehealth appointments, a new provider will be needed for telehealth. This might mean switching care providers or having different care providers based on the type of appointment.

How to Prepare for a Telehealth Visit for PCOS

Some preparation is needed to ensure a successful telehealth appointment.

Before Booking an Appointment

• If you have a regular healthcare provider, check if they offer a telehealth option. If they do not, or you do not have a regular provider, check online for telehealth clinics that are available to you, or ask people you know if they have one they like. Vet them as you would an in-person doctor.
• Check with your insurance or health coverage provider in terms of what is covered for telehealth, what is not, and if there are any requirements such as a video call versus audio or email.

When Booking an Appointment

• Determine if you will be speaking with a doctor, nurse practitioner, or other healthcare professional, and confirm their name.
• Discuss the mechanism of the appointment—will it be a video conference, a phone call, something else?
• Ask if you need to download any programs or use a specific device such as a laptop versus a phone.
• Write down the time of the appointment.
• If the appointment involves a video or audio call, verify that they will call you (or if you need to call them) and what name or identifier will appear on the display when they call.
• Make sure they have a current and accurate phone number at which to reach you if you get disconnected during the appointment.

Before the Appointment

• Check that you have the necessary equipment. That will usually mean a device that supports the type of telehealth appointment you have (including a microphone and webcam if necessary), and a strong internet connection. Headphones or earphones are helpful for better hearing and for privacy if you need or want it.
• Decide where you will take the appointment. It should be a quiet, well-lit spot if possible.
• Test your equipment and the programs you will be using.
• Write down any questions, observations, concerns, or information you have for your healthcare provider, including if you have been keeping track of things like blood pressure or blood sugar readings.
• Be ready about 10 to 15 minutes before your appointment to make sure you are able to connect on time.

During the Appointment

• Wear comfortable clothes that allow accessibility to areas your healthcare provider may need to see.
• Speak as clearly as possible and at a comfortable volume. Don't be afraid to let your provider know if you are having difficulty hearing or seeing them.
• Refer to your notes and take your time.
• Have a paper and pen handy to take notes during the appointment.
• Ask for clarification if there is something you are unsure of or unclear about.

What Happens During the Visit

Generally speaking, the healthcare provider will call the patient, by phone or by video conference, at the predetermined time.

The telehealth visit is often very similar to an in-person visit, just without being in the same room.

The healthcare provider may:

• Ask for the reason for the visit
• Discuss symptoms the person is experiencing
• Ask about health and family history, or request other information that is applicable
• Ask to see any observable concerns such as a bump, rash, mark, behavior, etc. via the video call, or ask the person to take and email photos for a closer look
• Respond to any questions or concerns the person has
• Issue a referral to a specialist, or book an in-person visit if needed
• Order tests, if indicated
• Provide a diagnosis, if appropriate
• Determine treatment options, if possible and necessary
• Prescribe medication if needed
• Discuss follow-up plans, such as booking further appointments, obtaining prescription refills, or any necessary monitoring

A Word From Verywell

While telehealth has become more utilized during the COVID-19 pandemic, it has been available for a number of years and will continue to be useful after the pandemic is over. It is particularly helpful for chronic conditions like PCOS that can often be monitored and managed from home.

If you are experiencing symptoms of PCOS, or are looking to make a treatment and management plan, consider booking a telehealth appointment and receiving care from the comfort of your own home.