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Hyperinsulinemia resulting from insulin resistance stimulates excessive androgen production by the ovaries and adrenal glands, exacerbating hyperandrogenemia and ovulatory dysfunction ( e.g ., diet and exercise) and pharmacological treatments ( e.g ., metformin, GLP-1 receptor agonists) can ameliorate insulin resistance and improve metabolic outcomes in PCOS ( 2.3 Hormonal imbalance Hyperandrogenemia is a defining feature of PCOS, characterized by elevated serum testosterone, androstenedione, and dehydroepiandrosterone (DHEA) levels, leading to clinical manifestations such as hirsutism, acne, and alopecia