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Patients should also consider whether the product fits their health needs

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J.et al (2018a)

For symptomatic or persistent cysts , or those with concerning features on imaging, surgical intervention may be necessary: Laparoscopic cystectomy : Removal of the cyst whilst preserving the ovary (preferred for younger women) Oophorectomy : Removal of the affected ovary in cases of large, complex, or potentially malignant cysts In women with PCOS , treatment focuses on managing the underlying metabolic and hormonal dysfunction: Lifestyle modification : Weight loss of 510% can restore ovulatory function Metformin : First-line pharmacological treatment for insulin resistance in PCOS Ovulation induction : Letrozole (often used first-line though off-label) or clomifene citrate for women trying to conceive Anti-androgens : Such as co-cyprindiol for severe hirsutism and acne when other treatments have failed (note: co-cyprindiol carries an increased risk of venous thromboembolism) [1] Urgent referral to gynaecology is warranted if there is sudden, severe abdominal pain (suggesting rupture or torsion) or signs of internal bleeding