Lifestyle modification is the first line treatment. PCOS is the most common endocrine (hormones) syndrome affecting women of reproductive age. It is more prevalent in obese women (28%) than those who are lean. The effects of PCOS manifest via deranged hormonal profiles, excess of circulating androgen (free testosterone) , increase LH, decrease FSH, Insulin resistance, decrease SHBG (sex hormone binding globulin is a glycoprotien that binds to the two sex hormones:androgen and estrogen). Obesity induced insulin resistance causes an exacerbation of all the symptoms of PCOS. Lifestyle modification, including a minimum of 30 min of moderately intense exercise at least 3 days per week and dietary interventions is the first line treatment. A weight loss of 5–10% has been shown to decrease testosterone concentrations, increase SHBG, normalize menses and improve fertility in women with PCOS. Prevention of excess weight gain should be emphasized in all women with PCOS with