My Dr put me on metformin. It has helped a lot and helped me to lose weight as well.

Birth control has been the opposite of help for me... haven't tried that again and don't ever plan to! People always put a negative connotation on dieting. There are some amazing cookbooks out there with recipes that you wouldn't even realize are "diets". You just gotta find em! The one I'm using right now is for The Anti-Inflammatory Diet and it's by the same woman who runs the blog What Molly Made. When my family comes over to eat, they don't even realize that it's all Gluten-free, Dairy-free, Sugar-free, etc... and I just feel so much better eating that way!

For me changing my lifestyle was super helpful in reducing PCOS symptoms. I got help from a nutritionist in changing my diet and became more active by exercising more. About the birth control - there are more options for hormonal contraception such as vaginal contraceptive rings and intra-uterine devices containing progesterone.. maybe you will prefer those treatments