<p>Polycystic ovary syndrome (PCOS) is one of the most common disorders encountered in daily gynaecological practice. In addition to addressing fertility issues, the main focus is in general on the treatment of hyperandrogenism, menstrual cycle regulation and the prevention of endometrial hyperplasia/cancer. However, attention must also be paid to issues such as overweight, obesity, and metabolic aspects of PCOS, including associated problems. The heterogeneity of the syndrome requires complex treatment strategies, which may also necessitate treatment with drugs that are not approved for this indication. Combined oral contraceptives (COCs) have become the established standard treatment for women with PCOS. In cases of increased cardiovascular or thromboembolic risk, the following options may be considered after assessing the individual benefits and risks: oestrogen-free ovulation inhibitors; cyclic progestogen administration; or the prescription of a&#xa0;levonorgestrel-releasing intrauterine device. Depending on the situation, additional medications may be used alongside therapy, such as metformin, off-label. However, metformin monotherapy may also be an option.</p>