1.General treatment For patients with obese polycystic ovary syndrome, diet should be controlled and exercise should be increased to reduce weight and waist circumference, which can increase insulin sensitivity and reduce insulin and testosterone levels, thus restoring ovulation and fertility function. 2. Drug treatment (1) Regulation of menstrual cycle: It is very important to apply drugs regularly and reasonably to counteract the effects of estrogen and control the menstrual cycle. 1) Oral contraceptives: combined estrogen and progestin cycle therapy. Progestin inhibits abnormally high secretion of pituitary LH through negative feedback, reduces the production of androgens by the ovaries, and can act directly on the endometrium to inhibit excessive endometrial hyperplasia and regulate the menstrual cycle; estrogen can promote the production of sex hormone binding globulin (SHBG) by the liver, leading to a decrease in free testosterone. Commonly used oral short-acting contraceptives, taken periodically, the course of treatment is usually 3 to 6 months and can be repeated. It can effectively inhibit hair growth and treat acne. 2) Post-progestin semi-cycle therapy: It can regulate menstruation and protect the endometrium. It has the same inhibitory effect on LH overproduction. It can also achieve the effect of restoring ovulation. (2) Lowering blood androgen levels 1) Glucocorticoid steroids: For polycystic ovary syndrome where the excess androgens are of adrenal origin or of mixed adrenal and ovarian origin. The commonly used drug is dexamethasone, 0.25 mg orally each night, which can effectively inhibit dehydroepiandrosterone sulfate concentration. The dose should not exceed 0.5mg daily to avoid excessive inhibition of pituitary-adrenal axis function. 2) Cyproterone: 17-hydroxyprogesterone derivative, with strong anti-androgen effect, can inhibit the secretion of pituitary gonadotropin and reduce the level of testosterone in the body. It is effective in reducing hyperandrogenemia and treating hyperandrogenic signs when combined with ethinyl estradiol to form oral contraceptives. 3) Spironolactone: It is a competitive inhibitor of aldosterone receptors. The anti-androgen mechanism is to inhibit the synthesis of androgens in the ovaries and adrenal glands, to enhance androgen breakdown, and to compete for androgen receptors in the hair follicles. The anti-androgen dose is 40-200 mg daily, and the treatment of hirsutism requires 6 to 9 months of medication. In case of irregular menstruation, it can be combined with oral contraceptives. (3) Improve insulin resistance: Insulin sensitizers are commonly used in patients who are obese or have insulin resistance. Metformin (metformin) can inhibit hepatic glucose synthesis and increase the sensitivity of peripheral tissues to insulin. By lowering blood insulin to correct the patient’s hyperandrogenic state, it improves ovarian ovulation function and enhances the effect of ovulation promotion therapy. The commonly used dose is 500mg per oral dose, 2 to 3 times daily. (4) Ovulation induction: For patients with fertility requirements, ovulation induction therapy is administered after basic treatment such as lifestyle adjustment, anti-androgen and improvement of insulin resistance. Clomiphene is the first-line ovulation-inducing drug, and second-line ovulation-inducing drugs can be given to clomiphene-resistant patients. Ovarian hyperstimulation syndrome is prone to occur when ovulation is induced, so close monitoring is needed to strengthen preventive measures. 3. Surgical treatment (1) laparoscopic ovarian perforation: better results in those with elevated LH and free testosterone. Laparoscopic perforation of polycystic ovaries with electroacupuncture or laser, 4 perforations per side of ovary is appropriate, 90% ovulation rate and 70% pregnancy rate can be obtained. (2) Ovarian wedge resection: removing 1/3 of each ovarian wedge can reduce the androgen level, alleviate the symptoms of hirsutism and improve the pregnancy rate. The incidence of postoperative periovarian adhesions is high and is no longer commonly used clinically.