Polycystic ovary syndrome (PCOS), a common condition that interferes with how the ovaries work, affects 6 percent to 13 percent of women of reproductive age, according to the World Health Organization (WHO). PCOS can cause symptoms such as irregular periods, acne, weight gain, unwanted hair growth on the face or body, and trouble getting pregnant.

There’s no cure for PCOS, but many treatment options can help manage symptoms and protect long-term health. With the right care plan, you can feel better, have more regular cycles, and reduce your risk of other medical issues, such as diabetes and heart disease.

This article covers nine of the most common ways to treat PCOS. Each works in a different way, so talk to your healthcare provider about which options might be best for you.

1. Lifestyle Changes

For many people, the first step in managing PCOS involves changes to daily habits. Your doctor may recommend:

• Healthy eating — A balanced diet rich in vegetables, whole grains, lean protein, and healthy fats can help keep blood sugar steady and reduce inflammation. Limiting processed foods and sugary snacks can be especially helpful.
• Regular exercise — Physical activity helps your body more effectively use insulin (a hormone that helps remove sugar from your blood into your cells, where it’s used for energy) and can support a healthy weight. Activities like walking, biking, or dancing can also improve your mood, energy, and hormone balance.
• Weight loss — Losing 5 percent to 10 percent of your body weight may restore ovulation (the release of an egg), help regulate menstrual periods, reduce acne and unwanted hair growth, and improve your chances of getting pregnant.

2. Combination Birth Control Pills

Birth control pills that contain both estrogen and progestin are a common treatment for PCOS in people who aren’t trying to conceive (get pregnant). Combination pills can help by:

• Regulating periods — Combination birth control pills can make your cycle more regular, reduce heavy bleeding, and lower the risk of endometrial hyperplasia (thickening of the uterine lining that, if untreated, can lead to cancer).
• Lowering levels of androgens — These sex hormones are usually higher than normal in people with PCOS, leading to irregular periods, acne, and unwanted facial or body hair. Reducing androgen levels can help improve these PCOS symptoms.

Options like progestin-only pills are discussed further below.

3. Antiandrogens

If birth control pills don’t fully help with acne or extra hair growth, your doctor might add an antiandrogen medication. These drugs work by blocking the effects of androgens.

Spironolactone

Spironolactone (Aldactone, Carospir) is commonly prescribed off-label (outside its approved use) to block androgen activity, reducing unwanted hair growth and improving acne. Because it may cause birth defects, spironolactone must be used with a reliable form of birth control if there’s any chance of getting pregnant.

Other Options

In some cases, doctors may suggest other off-label treatments for hair symptoms, such as:

• Eflornithine (Vaniqa) — A topical cream (applied to the skin) that helps reduce facial hair growth over time
• Finasteride (Propecia, Proscar) — A pill that may slow hair growth

For longer-term hair reduction, laser hair removal and electrolysis may be options.

4. Metformin

Metformin, a medication for type 2 diabetes, is commonly prescribed off-label for PCOS, especially for people with insulin resistance. This means the body isn’t using insulin properly. Metformin can help make your body more sensitive to insulin, which may lower androgen levels and encourage ovulation. This medication can also help regulate the menstrual cycle and support weight loss when combined with healthy eating and regular exercise.

Although metformin isn’t officially FDA-approved for PCOS, it’s widely used and backed by research.

5. Progestin Therapy

If you can’t take combination birth control pills, progestin-only therapy is another option to help manage PCOS. This type of treatment triggers a period every month or two, which protects the uterus and lowers the risk of endometrial hyperplasia. Progestin options include:

• Pills such as medroxyprogesterone
• Medroxyprogesterone injections (Depo-Provera)
• Hormonal intrauterine devices (IUDs) like levonorgestrel-releasing intrauterine system (Mirena)

Although progestin therapy doesn’t improve acne or hair symptoms, it’s a reliable way to reduce the risk of endometrial (uterine) cancer.

6. Fertility Treatments

Many people with PCOS don’t ovulate regularly, making it harder to conceive. Several fertility treatments can help trigger ovulation.

Letrozole (Femara) is usually the first medicine doctors try. Studies show that for people with PCOS, letrozole works better than older drugs like clomiphene (Clomid). Other options include hormone injections (called gonadotropins) and, in some cases, in vitro fertilization (IVF). These treatments are usually prescribed by a fertility specialist, who can create a plan that fits your specific needs.

With the right support, many people with PCOS go on to have healthy pregnancies. Working with a healthcare provider who understands PCOS-related infertility can make all the difference.

7. Weight-Loss Medications and Bariatric Surgery

For people with severe obesity (a medical classification of high body weight) and related health conditions, weight-loss medications or surgery may help improve PCOS symptoms.

GLP-1 Drugs

New weight-loss medications called GLP-1 receptor agonists may help the body respond better to insulin and support weight loss, as well as improve menstrual cycles and reduce testosterone levels. These drugs may be prescribed off-label for PCOS and are usually taken by injection or pill. GLP-1 drugs include:

• Dulaglutide (Trulicity)
• Exenatide (Byetta, Bydureon BCise)
• Liraglutide (Saxenda, Victoza)
• Semaglutide (Ozempic, Rybelsus, Wegovy)
• Tirzepatide (Mounjaro, Zepbound)

Bariatric Surgery

Bariatric (weight-loss) surgery may be recommended for people with a body mass index (BMI) over 35 who haven’t been able to lose weight with other methods. It’s a big decision, but these procedures can lead to major improvements in PCOS symptoms, including better fertility, as well as overall health.

These treatments should be considered only with a doctor’s guidance and are usually tried after lifestyle changes.

8. Mental Health Support

PCOS affects more than just your body — it can also take a toll on your emotions. Your mental health matters just as much as your physical health, and it’s an important part of PCOS treatment.

Therapy

Talking with a therapist or counselor can help if you’re feeling overwhelmed, anxious, or concerned about body image or self-esteem. One option, cognitive behavioral therapy (CBT), has been shown to benefit many people with PCOS. CBT focuses on changing unhelpful thought patterns and building coping skills.

Support Groups

Connecting with others who live with PCOS — through a support group or online community — can also make a big difference. Sharing your story and hearing from others who understand can help you feel less alone and more empowered.

9. Gynecological Surgery

Most people with PCOS respond well to lifestyle changes and medications, but surgery may be considered when symptoms are severe or other treatments haven’t worked. Procedures include the following:

• Ovarian drilling is a minor surgery in which a doctor makes small holes in the ovaries to lower testosterone levels and help restart ovulation. This procedure is usually tried if fertility medications don’t help, but it’s not a cure and doesn’t help everyone.
• Endometrial ablation destroys the lining of the uterus to reduce heavy menstrual bleeding, but it doesn’t treat the underlying PCOS. This procedure may make pregnancy unsafe or unlikely, so it’s only for people who don’t want to get pregnant in the future.
• Dilation and curettage (D&C) removes tissue from inside the uterus and may be used to help manage heavy bleeding, especially if endometrial hyperplasia is a concern. D&C isn’t a common treatment for PCOS alone.
• Hysterectomy (removal of the uterus) and oophorectomy (removal of the ovaries) are rarely used for PCOS. These permanent surgeries lead to infertility and, if the ovaries are removed, bring on menopause.

Surgery is not a cure for PCOS but may be helpful in specific situations. Always discuss risks, benefits, and alternatives with a healthcare provider before deciding on surgery.

What Is the Best Way To Manage PCOS?

The best way to manage PCOS depends on you. Your symptoms, goals, and overall health all play a part. There’s no one-size-fits-all answer, but there are many options, including lifestyle changes, medications, and fertility treatments.

The most important step: Talk with your doctor. Together, you can create a plan that fits your needs, supports your long-term health, and helps you feel your best.

Talk With Others Who Understand

MyPCOSTeam is the social network for people with polycystic ovary syndrome and their loved ones. On MyPCOSTeam, more than 72,000 members come together to ask questions, give advice, and share their stories with others who understand life with PCOS.

Have you wondered what treatments are available for PCOS? Which have you tried, and how did they work for you? Share your experience in the comments below, or start a conversation by posting on your Activities page.