What is the preferred initial treatment for polycystic ovary syndrome (PCOS)?

The preferred initial treatment for polycystic ovary syndrome (PCOS) is lifestyle modification. This approach emphasizes the importance of weight management, dietary changes, and increased physical activity, particularly for individuals who are overweight or obese. Lifestyle modifications can help improve insulin sensitivity, regulate menstrual cycles, and alleviate symptoms associated with PCOS, such as hirsutism and acne.

In many cases, these changes can lead to significant improvements in metabolic health and reproductive function. The evidence supporting lifestyle modifications is strong, as it addresses the underlying risk factors associated with the condition, such as obesity and insulin resistance, rather than just the symptoms.

While hormonal contraceptives, metformin, and surgery are also valid treatment options for managing specific symptoms or complications of PCOS, they are generally considered after lifestyle changes have been implemented, particularly if lifestyle modifications alone are insufficient to control symptoms. Hormonal contraceptives are effective for menstrual regulation and managing acne and hirsutism, and metformin can help with insulin resistance, but they do not address the foundational issues as directly as lifestyle changes do. Surgery is rarely a first-line treatment option for PCOS and is usually reserved for specific cases, such as in the management of ovarian hyperstimulation or if there are