As an older woman with PCOS, my issues have probably been different from younger folks, but here's my story: 50 years of PCOS, undiagnosed, until I found myself at an endocrinologist for pre-diabetes. Yes, you still have PCOS even after the ovaries are gone!. Lost 30 pounds very slowly with metformin and Victoza and intensive nutritional counseling, but finally made the decision to go for gastric sleeve, in face of increasing health issues.
At 2 months post surgery and down 20 more pounds, I was able to discontinue 6 RXs, including all the blood pressure and diabetes meds. Also discontinued spironolactone because my BP dropped so low I was dizzy.
I've had a few hormonal issues after surgery that you might watch for, annoying, but not disabling. Rapid weight loss releases the estrogen bound to the fat tissue - I got menopausal symptoms of hot flashes and mood swings. These have diminished over time. Without spironolactone, I've had increased facial hair growth and thinning of my scalp hair- very upsetting, of course.
Since then, I'm finding my BIG hunger, down a lot after surgery (but not gone), and slowly diminishing even more as my blood sugar is normal and I'm more active. I'm continuing to lose about a pound a week, but finding I have to work pretty hard to keep losing. All in all, I'm very pleased. And size 14 is not too shabby, for now.