But prior to considering medical treatment, a very important component of PCOS therapy is weight management in case of overweight and obese patients: a combination of alimentary diet and exercise is one of the cornerstones of PCOS treatment.

A 3rd option is a drug called metformin: the recommendation is to use metformin in women with PCOS

who have type 2 diabetes, or evidence of impaired glucose tolerance "IGT" who fail to improve after following lifestyle modification.

IGT is a condition where blood glucose is raised beyond normal levels, but not high enough to warrant diagnosis of full-fledged diabetes. In IGT, blood glucose reaches 7.8 mmol/L or more but less than 11.1mmol/L after a 2-hour oral glucose tolerance test (OGTT), which is a blood test where you are asked to take a sugary drink; your blood glucose is measured before and at intervals after the sugary drink is taken.

There is a permanent medical treatment used to control symptoms of PCOS women with hyperandrogenism (acne, hirsutism etc...). The typical treatment is a specific type of Oral Contraceptive Pills.

For PCOS patients with infertility there is no permanent medical treatment.

Metformin shoud be used only in patients with glucose intolerenec i.e. predisposition to Diabetes. Otherwise metformin in PCOS patients might work  to releive symptoms and to stimulate ovulation but the evidence for or against it is controversial.

The evidence says that the best medication to stimulate ovulation in PCOS patients is Clomid.