--- title: "PCOS treatment options" description: "How hormone treatments, metformin and other options fit different PCOS goals, and the limits of the evidence on inositol." url: "https://myruva.co/learn/pcos-treatment-options" language: "en-GB" topic: "PCOS" published: "2026-10-18" updated: "2026-10-19" author: "Ruva team" reading_minutes: 5 --- # PCOS treatment options How hormone treatments, metformin and other options fit different PCOS goals, and the limits of the evidence on inositol. *Written and reviewed by the Ruva team · Updated 2026-10-19 · PCOS* ## Key points - The right treatment depends on your symptoms, your health and your plans for pregnancy. - The combined pill can help irregular periods and extra hair. Metformin mainly helps with how your body handles sugar. - If you could get pregnant, you need reliable contraception while taking anti-androgens. - Inositol has few proven benefits, and as a fertility treatment it is still experimental. PCOS treatment depends on which symptoms or health risks you want help with, your overall health and your plans for pregnancy. A treatment that helps with unwanted hair may do little for the reasons behind a blood sugar check. There is no cure, but symptoms can be treated. PCOS now has a new name: polyendocrine metabolic ovarian syndrome (PMOS). Both names mean the same condition. This article uses PCOS because it’s the name you may already know. ## Begin with the aim of treatment Ask what each treatment is meant to help with. The Office on Women’s Health describes plans based on your symptoms, whether you want a pregnancy in future, and longer-term risks such as diabetes and heart disease. WHO recommends making these decisions with your clinician, taking what matters to you into account. Some treatments are prescribed off-label. This means using a medicine for PCOS when it isn’t officially approved for that use. It can still be based on evidence. The guideline asks clinicians to explain the evidence, any concerns and side effects. NICHD notes this is common in US PCOS care. ## Hormonal options for bleeding and hair growth The combined pill can help with irregular cycles and extra hair growth, and may also improve acne. Talk with your clinician about your health risks and possible side effects to decide whether it suits you. The international guideline doesn’t name one type of pill for everyone with PCOS. When periods are far apart, protecting the womb lining is another aim of treatment. The guideline includes making cycles more regular and progestogen treatment among the ways to do this. Progestogen-only pills may be considered to protect the lining, though there’s little evidence specific to PCOS. The NHS also lists the hormonal coil (IUS) for irregular periods. Ask your prescriber what the method would do for you. If you want a pregnancy now or later, bring that up before you choose a treatment. Some PCOS treatments prevent pregnancy or can harm a developing baby. ## What metformin is used for Metformin mainly helps with the metabolic side of PCOS, such as how your body handles insulin and blood sugar. It may also help cycles or ovulation for some people. It usually does little for acne or extra hair on the face and body. Your doctor can tell you whether it fits the problem being treated. It can upset your stomach or bowels. Metformin is also linked to low vitamin B12, especially in people with other risk factors. The guideline says checks may be considered in these cases. Ask which side effects to report and whether you need any checks. ## Anti-androgens and hair treatment Anti-androgen medicines reduce the effects of androgens (hormones such as testosterone). They may help with extra hair, acne or hair loss on the scalp. But there’s little evidence on treating scalp hair loss in PCOS specifically. The NHS lists spironolactone among the options for reducing hair growth. The international guideline considers anti-androgens when other options haven’t helped enough. If you could get pregnant, you need reliable contraception, because these medicines can harm a developing baby. Ask the prescriber to explain your contraception plan and what to do if you could become pregnant. ## What the evidence says about inositol The guideline includes inositol as a supplement you might choose to consider. It may improve some measures of metabolism. But its real benefits for ovulation, hair growth and weight are limited. The evidence isn’t strong enough to recommend a particular type or mix. For infertility, the guideline is more cautious. Inositol is still experimental, because its benefits and risks are too uncertain to recommend it as a fertility treatment. The quality and regulation of supplements can also differ from medicines. Ask your pharmacist or doctor before adding a product to your care. ## Medicines for higher weight The guideline allows weight-loss medicines to be considered alongside lifestyle support, following general prescribing rules. These include GLP-1 receptor agonists such as semaglutide or liraglutide. They aren’t an automatic treatment for everyone with PCOS. Talk with your prescriber about side effects and the chance you may need them long term. This includes putting weight back on after you stop. If you could get pregnant, reliable contraception is advised, because there isn’t enough safety information for pregnancy. Ask your prescriber how this applies to the medicine you’re considering. This advice changed recently. In January 2026, the MHRA strengthened its warnings about acute pancreatitis (sudden inflammation of the pancreas) with these medicines. Get urgent medical help now from your GP or NHS 111 (UK), or your doctor or an urgent medical service (US or elsewhere), if you use a GLP-1 medicine and get severe tummy pain that won’t go away, especially if it spreads to your back, with or without feeling sick or vomiting. Ask the clinician who sees you what to do about your medicine. ## Reviewing the plan with your clinician Book a GP appointment in the UK, or see your doctor in the US or elsewhere, if symptoms still affect daily life or what you want from treatment has changed. Ask what benefit to look for, when to review how it’s going and who to contact about side effects. Talk to your clinician before changing any prescribed treatment. If you’re planning a pregnancy or are pregnant, don’t stop a prescribed medicine without talking to your doctor. Arrange a review of your medicines instead. ## When to get help - **Same day:** Get urgent medical help now from your GP or NHS 111 (UK), or your doctor or an urgent medical service (US or elsewhere), if you use a GLP-1 medicine and get severe tummy pain that won’t go away, especially if it spreads to your back, with or without feeling sick or vomiting. - **Book an appointment:** Book a GP appointment (UK), or see your doctor (US or elsewhere), if symptoms affect daily life or you want to look again at what you want treatment to do. ## Where you live Services and advice differ between countries. - **UK:** The NHS lists hormone treatments, metformin and treatments for hair, skin and weight. A GP can talk through a plan that suits you. - **US:** NICHD explains that many treatments aren’t FDA-approved for PCOS itself but may be offered for its symptoms. - **Elsewhere:** WHO recommends making decisions together that reflect what matters to you. The international guideline describes the benefits and limits of each option. ## Sources 1. [What are the treatments for PCOS?](https://www.nichd.nih.gov/health/topics/pcos/conditioninfo/treatments), NICHD 2. [Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polyendocrine Metabolic Ovarian Syndrome](https://www.asrm.org/practice-guidance/practice-committee-documents/recommendations-from-the-2023-international-evidence-based-guideline-for-the-assessment-and-management-of-polyendocrine-metabolic-ovarian-syndrome-2023/), American Society for Reproductive Medicine 3. [Polyendocrine metabolic ovarian syndrome (PMOS)](https://www.nhs.uk/conditions/polyendocrine-metabolic-ovarian-syndrome-pmos/), NHS 4. [Polycystic ovary syndrome](https://womenshealth.gov/a-z-topics/polycystic-ovary-syndrome), Office on Women's Health 5. [Polycystic ovary syndrome](https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome), World Health Organization 6. [Medicines in pregnancy](https://www.nhs.uk/pregnancy/keeping-well/medicines/), NHS 7. [GLP-1 receptor agonists and dual GLP-1/GIP receptor agonists: strengthened warnings on acute pancreatitis, including necrotising and fatal cases](https://www.gov.uk/drug-safety-update/glp-1-receptor-agonists-and-dual-glp-1-slash-gip-receptor-agonists-strengthened-warnings-on-acute-pancreatitis-including-necrotising-and-fatal-cases), Medicines and Healthcare products Regulatory Agency 8. [When to use NHS 111 online or call 111](https://www.nhs.uk/nhs-services/urgent-and-emergency-care-services/when-to-use-111/), NHS --- This guide is general information to help you keep and use your own records. It isn’t medical advice. If you’re worried about a symptom, or something changes suddenly, talk to a doctor, nurse or pharmacist.