Which statements reflect core components of PCOS management?

• A. Weight loss, combined oral contraceptives, metformin, and antiandrogens if needed
• B. Surgical removal
• C. High-dose steroids
• D. Insulin as monotherapy

Answer: (A)

Managing PCOS relies on a multimodal approach that targets weight, menstrual regulation, androgen effects, and insulin resistance. Weight loss through diet and exercise improves insulin sensitivity, lowers ovarian androgen production, and can help restore regular ovulation in many overweight individuals. Combined oral contraceptives regulate the menstrual cycle and reduce hyperandrogenic symptoms such as acne and hirsutism by suppressing ovarian and adrenal androgen production. Metformin addresses insulin resistance and can improve ovulatory function, particularly when there is glucose intolerance or metabolic risk; it’s often used alongside lifestyle changes. Antiandrogens are added if hair growth or acne persists despite OCP therapy, helping directly counteract androgen effects. Other options like surgical removal or high-dose steroids aren’t standard PCOS treatments, and using insulin as a sole therapy isn’t the typical approach unless there’s coexisting diabetes—addressing underlying insulin resistance and hormonal regulation remains the goal.