Search for “PCOD ka ilaj” and you will find tablets, powders and kadhas that promise to fix it. PCOD treatment does not work like that. The 2023 international guideline on polycystic ovary syndrome (PCOS) notes that medicines used in PCOS are generally not approved specifically for it, so doctors match medicines made for other purposes to what you want to change.
PCOD is the name most Indian clinics use; doctors diagnose one condition, PCOS, now also called polyendocrine metabolic ovarian syndrome (PMOS). Our guide to PCOD and PCOS explains the names. For diagnosis, tests and the overview, see our PCOS hub on symptoms, tests and treatment.
PCOD symptoms and treatment: start with what bothers you most
Treatment follows symptoms, so name yours first. The common ones are irregular or absent periods, excess facial or body hair, acne, thinning scalp hair, weight gain, difficulty getting pregnant, and low mood or anxiety. National Health Service (NHS) also lists tiredness and dark, thick patches of skin on the neck or armpits. Our guide to PCOS symptoms in women, including skin and acne explains each one.
The guideline asks doctors to decide treatment with you, based on what matters most to you.
PCOD treatment by goal: lifestyle first, then medicines
For almost every goal, healthy eating, activity and sleep are the base: the guideline recommends them for all women with PCOS. Our PCOS diet guide with an Indian plate and PCOS weight-loss guide cover how. Medicines are added on top, not instead.
| Your goal | Lifestyle first | Medicines a doctor may consider | Main caution |
|---|---|---|---|
| Regular periods and protecting the womb lining | Regular meals and activity; at higher weight, a modest loss can make periods more frequent | Combined pill; progestogen tablets, progestogen-only pill or a hormone-releasing coil; metformin if the pill is unsuitable | Rule out pregnancy first; the pill does not suit everyone |
| Acne and excess hair | Threading, waxing, shaving or laser for hair; gentle skin care | Combined pill; acne creams or tablets; eflornithine cream; anti-androgens if the pill is not enough after 6 months | Anti-androgens need reliable contraception |
| Weight and metabolic health | A modest energy deficit with your usual food, more movement, enough sleep | Metformin; weight-loss medicines for some adults at higher weight | Metformin: stomach upset, low vitamin B12. Weight-loss injections: contraception, weight regain |
| Trying to conceive | A pre-pregnancy check of sugar and blood pressure; folic acid as your doctor advises | Letrozole first; clomiphene or metformin; hormone injections or ovarian surgery if these fail | Pregnancy must be excluded before ovulation medicines; specialist monitoring |
| Mood and sleep | Activity, a sleep routine, talking about how you feel | Talking therapy first; antidepressants for clearly persistent depression or anxiety; assessment for sleep apnoea | Thoughts of self-harm are an emergency |
Healthy habits help every row, but they cannot remove hair that has already grown, guarantee ovulation or replace treatment that protects the womb lining.
PCOD medicines: what each does, and its main caution
Generic names appear here for information only, as the guideline names them. Each needs a doctor’s prescription, and none is a recommendation for you.
The combined pill
The combined oral contraceptive pill contains an oestrogen and a progestogen. The guideline says it could be recommended for excess hair and irregular cycles (low-certainty evidence), and NHS says it may help severe acne. Its regular bleeds also protect the womb lining. Pills containing cyproterone acetate are second choice because of blood-clot risk.
Caution: NHS says the pill may not suit you if you are living with obesity, are 35 or over and smoke, or have had blood clots (or a close relative had one before 45), migraine with aura, high blood pressure or a stroke. The clot risk is small: up to 1 in 1,000 users.
Progestogens and the hormonal coil
If you cannot take the combined pill, a doctor may use a progestogen (a progesterone-like hormone): tablets for some days to bring on a bleed, the progestogen-only pill, or a hormone-releasing coil. The guideline mentions these for protecting the womb lining, not for hair or acne, with limited PCOS-specific evidence. Our guide to irregular periods and PCOS explains why long gaps matter.
Caution: pregnancy must be ruled out before any tablet to “bring on periods”.
Anti-androgens for hair and skin
Anti-androgens block the effect of male-type hormones on hair and skin. NHS lists spironolactone, and eflornithine cream for facial hair. The guideline suggests anti-androgens for excess hair if at least 6 months of the pill or cosmetic treatment has not worked well enough, or if the pill is unsuitable. It says spironolactone appears to have lower risks of side effects, and higher doses of cyproterone acetate are not advised because of a raised risk of meningioma (a usually non-cancerous brain tumour).
Caution: anti-androgens can stop a male baby’s genitals developing normally. The guideline says women who could become pregnant should be strongly counselled to use effective contraception, such as a coil or the combined pill. NHS adds that spironolactone can raise potassium.
Weight-loss medicines
The guideline says anti-obesity medicines, including the glucagon-like peptide-1 (GLP-1) injections liraglutide and semaglutide, and orlistat, could be considered alongside an active lifestyle programme for adults with PCOS at higher weight, as in the general population.
Caution: effective contraception is needed when pregnancy is possible, because pregnancy safety data are lacking. Stomach side effects are common at first, and weight regain after stopping is likely.
Indian and international advice differ. Indian Council of Medical Research–National Institute of Nutrition (ICMR-NIN)’s dietary guidelines, written for the general public, say anti-obesity drugs should be avoided; the international guideline allows them for some women with PCOS under medical care. Our view: ICMR-NIN is the default for self-directed dieting, and these medicines are a doctor’s decision, never something bought online.
Letrozole and other fertility medicines
For women who do not ovulate and have no other fertility problem, the guideline says letrozole should be the first-line medicine to bring on ovulation, ahead of clomiphene, for better ovulation, pregnancy and live-birth rates. Its evidence is rated high certainty, rare in a field where most evidence is low to moderate quality. Letrozole is a breast-cancer medicine; its fertility use is off-label in many countries.
India’s own history: the government suspended letrozole for ovulation induction in 2011 and lifted the suspension in February 2017, after a review by Indian Council of Medical Research (ICMR) experts that included Indian studies. Clomiphene, metformin, hormone injections (gonadotrophins) and keyhole surgery on the ovaries are other options.
Caution: pregnancy should be excluded before ovulation medicines, and letrozole should not be given if you could already be pregnant. Clomiphene raises the chance of twins or more, so cycles may need scans. A gynaecologist or fertility specialist should guide this.
Mood and sleep
The guideline says talking therapy could come first for depression or anxiety, with antidepressants when the problem is clearly documented and persistent, or with suicidal thoughts, avoiding medicines that worsen weight gain. Treating PCOS features with the pill, metformin, laser or lifestyle change may itself lift mood. Snoring with unrefreshing sleep should be assessed for sleep apnoea.
Metformin for PCOS: what it does and does not do
Metformin is a prescription-only type 2 diabetes medicine that NHS also lists for PMOS symptoms. Our guide to diabetes medicine names covers it in diabetes.
What it can do
- For adults with a body mass index (BMI) of 25 or more, the guideline says it should be considered for weight-related and metabolic measures: insulin resistance, glucose and cholesterol. At a lower BMI it may be considered, with limited evidence.
- It could be preferred over the pill for metabolic goals, and tried for irregular cycles when the pill is unsuitable.
- For fertility it could be used alone, but the guideline says women should be told that more effective ovulation medicines exist.
What it does not do
- It is not a cure, and not a shortcut past lifestyle change: the guideline says metformin and an active lifestyle programme have similar effects.
- It is not the first choice for excess hair; the guideline prefers the pill.
- In pregnant women with PCOS, it has not been shown to prevent gestational diabetes, high blood pressure in pregnancy, pre-eclampsia or late miscarriage.
Which BMI applies in India? The guideline’s 25 is on the international scale. Indian cut-offs are lower: the 2009 Asian Indian consensus, which our BMI calculator with Indian cut-offs follows, calls 23–24.9 overweight and 25 or more obese. The guideline adds that metformin with the pill may help most in high metabolic risk groups, including high-risk ethnic groups; whether that includes you is your doctor’s judgement.
Main cautions
- Stomach upset: nausea, loose motions, tummy pain or a changed taste. The guideline says these are usually dose-related and settle, and starting low and increasing slowly helps.
- Vitamin B12 can fall. The guideline suggests monitoring if you have risk factors such as diabetes, past weight-loss surgery, pernicious anaemia or a vegan diet.
- Not for everyone. NHS says it may not suit people with liver or kidney problems, heart failure, a severe infection or heavy drinking, and that vomiting, diarrhoea or fever risk dehydration.
- Review it. Long-term use appears safe, but the guideline asks doctors to check whether you still need it.
No “PCOD tablet” from the chemist: safety rules
- No prescription medicine without a prescription. Hormone pills, metformin, spironolactone, letrozole and weight-loss injections all need a doctor. Do not buy a “PCOD tablet” over the counter, copy a friend’s prescription or follow doses from social media.
- Rule out pregnancy first. Tablets to bring on a period and ovulation medicines need pregnancy excluded; anti-androgens and weight-loss injections need reliable contraception. A home pregnancy test is the first step.
- Ayurvedic, herbal and “PCOS powder” products only with your doctor. In a 2008 study in the Journal of the American Medical Association, about one in five Ayurvedic medicines bought online, whether made in the US or India, contained detectable lead, mercury or arsenic. Our guide to seed cycling and PCOS supplements covers the evidence.
- Inositol is a supplement, not a medicine. The guideline says it could be considered if you prefer it, with limited clinical benefit and no recommended type or dose. Tell your doctor about every supplement you take.
- Do not stop or switch on your own. If side effects bother you, ask your doctor.
How long PCOD treatment takes, and why it is not a cure
There is no cure. NHS says treatments and lifestyle changes can help symptoms, and the guideline suggests the diagnosis can be considered lifelong. Our guide to whether PCOS can be cured or reversed explains what “reversal” claims mean.
Goals move at different speeds. Excess hair is slowest: the guideline waits at least 6 months on the pill or cosmetic treatment before adding an anti-androgen, and women with PCOS may need more laser sessions than other women. A regular bleed on the pill comes from the pill, so it does not show whether PCOS itself has changed.
The guideline asks doctors to monitor hair, acne and hair loss during treatment and adjust it if needed; a diary of periods, skin, weight and mood helps.
When to see a doctor
The hub has the full list of PCOS warning signs.
Emergency: get help now (call 112)
- Bleeding that soaks through a pad soon after you put it on, or heavy bleeding with dizziness or fainting.
- If you could be pregnant: severe or one-sided lower tummy pain, shoulder-tip pain or fainting.
- On the combined pill: pain and swelling in one leg with breathlessness or chest pain.
- On metformin: vomiting, stomach pain, muscle cramps and breathing problems with severe tiredness, or a swollen throat or tongue.
- Thoughts of harming yourself. Call 112 or Tele Mental Health Assistance and Networking Across States (Tele-MANAS), the Government of India’s mental-health helpline.
Prompt review: within days to a few weeks
- A missed period or positive pregnancy test while taking an anti-androgen, letrozole or a weight-loss injection.
- Throbbing pain and swelling in one leg on the pill, without breathlessness: the same day.
- Yellowing of the skin or eyes, or side effects that stop you taking a medicine.
- No period for three months or more when you are not pregnant, or rapidly worsening facial hair or a deepening voice.
Routine review
- You have taken metformin for a long time with B12 risk factors and no B12 test.
- You are planning a pregnancy while on any PCOS medicine.
- You want to review whether a medicine is still working or still needed.
How Disha can help
Disha is an AI health coach that chats and calls in Hindi, English and Hinglish. It helps with the daily habits under every treatment goal: meals with your own food, movement, sleep and stress. Disha does not diagnose, prescribe, choose or change medicines, or provide emergency care, and it does not replace your doctor. Read how Disha coaching works.
This is not medical advice. This page is general education for adults (18+), not a diagnosis or treatment plan, and naming a medicine is not a recommendation to take it. Do not start, stop or change any medicine, including contraception, because of it. If you are pregnant, trying to conceive, breastfeeding, or have a current or past eating disorder, get individual advice. In an emergency, call 112.
Frequently asked questions
Which is the best PCOD medicine?
There is no single best one. Treatment depends on your goal: the combined pill or a progestogen for periods, the pill and sometimes an anti-androgen for hair and acne, metformin or weight-loss medicines for metabolic health, and letrozole for ovulation. The guideline asks doctors to choose with you. The best medicine is the one your doctor prescribes for your goal and that you can take safely.
Is there a PCOD problem treatment medicine I can buy without a prescription?
No. Every medicine used for PCOD, including hormone pills, metformin, spironolactone and letrozole, needs a doctor’s prescription. Several must not be taken if you could be pregnant, and the combined pill does not suit women with some health conditions. Do not buy a “PCOD tablet” over the counter or copy someone else’s prescription. A gynaecologist can match treatment to your goal.
Should I take metformin for PCOS if I do not have diabetes?
Only if your doctor advises it. The international guideline says metformin should be considered for adults with PCOS and a BMI of 25 or more, mainly for insulin resistance, glucose and cholesterol, and may be considered at lower weight with limited evidence. It says metformin and an active lifestyle programme have similar effects. Stomach upset and low vitamin B12 are the main cautions.
Do I have to take birth control pills for PCOD?
No. The combined pill is one option for irregular periods, excess hair and acne, but not the only one. If it does not suit you, a doctor may use a progestogen or a hormone-releasing coil to protect the womb lining, metformin for irregular cycles, or cosmetic treatment for hair. If you are trying to conceive, the pill is not the treatment; ovulation medicines are.
Which medicine helps with getting pregnant with PCOS?
For women who do not ovulate and have no other fertility problem, the 2023 guideline says letrozole should be the first-line medicine, ahead of clomiphene. Metformin, hormone injections and ovarian surgery are other options. Pregnancy must be excluded before each course. In India, letrozole for this use was suspended in 2011 and allowed again in 2017. A fertility specialist should guide and monitor treatment.
Are ayurvedic or herbal medicines safe for PCOD?
Use them only with your doctor’s knowledge. A 2008 study found detectable lead, mercury or arsenic in about one in five Ayurvedic medicines bought online, whether made in the US or India. We found no herbal product among the 2023 international guideline’s recommendations, and it encourages women to tell their doctor about complementary therapies. Do not stop a prescribed medicine to try one.
Can PCOD be treated permanently with medicines?
No. There is no cure, and the guideline suggests PCOS can be considered lifelong. Medicines control symptoms while you take them: a regular bleed on the pill comes from the pill. Symptoms can improve a lot with treatment and healthy habits, and they change with age. Keep regular checks of glucose, blood pressure and mood, even when you feel well.
What are the main PCOS symptoms and treatment options?
The main symptoms are irregular periods, excess facial or body hair, acne, thinning scalp hair, weight gain, difficulty getting pregnant and low mood. Treatment is matched to the symptom that bothers you most: healthy habits for all, then the combined pill or progestogens for periods, anti-androgens for hair, metformin or weight-loss medicines for metabolic health, and letrozole for ovulation.
Sources
- Teede HJ, Tay CT, Laven JJE, Dokras A, Moran LJ, Piltonen TT, Costello MF, Boivin J, Redman LM, Boyle JA, Norman RJ, Mousa A, Joham AE. Recommendations From the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. Journal of Clinical Endocrinology and Metabolism, 2023. Supports: medicines generally not approved specifically for PCOS (off-label); shared decision-making; lifestyle for all; the combined pill for hirsutism and irregular cycles, dose and cyproterone acetate points; progestin-only options for endometrial protection; metformin indications by BMI, similar efficacy to lifestyle, pill versus metformin, combination in high-risk groups, side effects, B12 risk factors, long-term review, and pregnancy outcomes it does not prevent; anti-obesity medicines, contraception, dose escalation and regain; anti-androgens after 6 months, contraception and undervirilisation, spironolactone and cyproterone cautions; inositol; laser sessions; letrozole first-line (high certainty), clomiphene twins and monitoring, gonadotrophins and ovarian surgery, pregnancy exclusion, prenatal vitamins and folate; psychological therapy, antidepressants and sleep apnoea; monitoring hyperandrogenism; evidence mostly low to moderate quality; lifelong diagnosis.
- NHS. Polyendocrine metabolic ovarian syndrome (PMOS). Current patient guidance. Supports: PMOS as the new name for PCOS; symptoms including tiredness and acanthosis nigricans; no cure; medicines (combined pill, progestogen-only pill or IUS, clomifene, spironolactone, eflornithine, weight-loss medicines, metformin, acne creams or tablets); laparoscopic ovarian drilling; hair removal options.
- NHS. Metformin. Current medicine guidance. Supports: use for PMOS symptoms; prescription only; common side effects including B12 deficiency; dehydration with vomiting, diarrhoea or fever; lactic acidosis and anaphylaxis symptoms; who it may not suit; hepatitis with yellowing skin.
- NHS. Who can take the combined pill, Side effects and risks of the combined pill and DVT (deep vein thrombosis). Current patient guidance. Supports: who the pill may not suit; help with PMOS and severe acne; clot risk up to 1 in 1,000; leg pain and swelling as clot symptoms, urgent review, and emergency care with breathlessness or chest pain.
- NHS. Spironolactone. Page last reviewed 6 May 2026. Supports: prescription only; not usually recommended in pregnancy; raised potassium; liver problems with yellowing.
- ICMR–National Institute of Nutrition. Dietary Guidelines for Indians. 2024. Supports: “Approaches of rapid weight loss and use of anti-obesity drugs should be avoided.”
- Shankar R. Health ministry revokes ban on drug letrozole, for induction of ovulation in anovulatory infertility. Pharmabiz, 1 March 2017 (reporting the Gazette of India notification of 17 February 2017). Supports: suspension of letrozole for ovulation induction on 12 October 2011; revocation in 2017 after an ICMR systematic review and meta-analysis including Indian studies and a Drugs Technical Advisory Board recommendation.
- Saper RB, Phillips RS, Sehgal A, Khouri N, Davis RB, Paquin J, Thuppil V, Kales SN. Lead, Mercury, and Arsenic in US- and Indian-Manufactured Ayurvedic Medicines Sold via the Internet. JAMA, 2008. Supports (laboratory survey of 193 products): 20.7% contained detectable lead, mercury or arsenic, with no significant difference between US- and Indian-made products.
- Misra A, Chowbey P, Makkar BM, Vikram NK, Wasir JS, Chadha D, Joshi SR, Sadikot S, Gupta R, Gulati S, Munjal YP, for Consensus Group. Consensus Statement for Diagnosis of Obesity, Abdominal Obesity and the Metabolic Syndrome for Asian Indians. Journal of the Association of Physicians of India, 2009. Supports: BMI 23.0–24.9 as overweight and 25 or more as obese for Asian Indians.
Related reads
- PCOS in India: symptoms, tests, treatment and daily care: the hub. It covers diagnosis, tests and red flags, and gives treatment only in overview.
- PCOS symptoms in women: each symptom explained, including skin changes and acne.
- Can PCOS be cured or reversed?: what “remission” and “reversal” claims mean.
- Why weight loss feels harder with PCOS, and what actually helps: the lifestyle side of the weight goal, and medicines in more detail.
- PCOS diet in India: a practical plate for every meal: the Indian plate and example days that sit under every treatment.
- Diabetes medicine names explained: metformin in diabetes, including kidney checks.
- All PCOS articles: every Disha guide on PCOS in one place.
- BMI calculator with Indian cut-offs: a screening number, not a test for PCOS.
