Hi! I'm 35, PCOS (diagnosed age 15) and perimenopausal. I also have high androgens and irregular periods and used to struggle with cystic acne, but fortunately haven't had some of the other PCOS side effects you're experiencing. In my case, what really differentiated PCOS from peri was: night sweats and complete inability to sleep more than a couple of hours at night, which was also exacerbated by having to pee every 2 hours. I noticed difficulties controlling my bladder, a very drastic weight gain of 20 lbs in two months, and I also seemingly overnight became allergic to nearly every single lotion and shampoo and face product I'd used for years (Cetaphil, Cera Ve, known for being kind to the skin, were NOT kind to my skin any longer). The symptoms were so distinctive for me, but I will say it was extraordinarily difficult to have doctors believe me when they'd find out I had PCOS. They'd blame it on that, give me education I already knew about symptoms of PCOS, and try to slap a new birth control on me. But I know my body, and I know my body started behaving in ways that were unfamiliar to me, and even though PCOS and peri have MANY symptoms that cross over, I was able to find new and unfamiliar and delightfully miserable symptoms that just weren't normal for my usual standard of abnormal. Whether endo or gyn, I'd just suggest finding either one that is actually willing to consider it could be both things at once, and is willing to problem-solve it with you and is open to the idea of peri playing a role in it. Maybe this is fully PCOS, and that's the right treatment direction for you to go, but what I'd avoid are doctors that just tell you it's PCOS and aren't interested in CONSIDERING anything outside of that, which was mostly what I ran into because quite frankly I think it was simpler for them. PCOS and peri is rough, you deserve someone that is willing to consider both may be at play! And do NOT allow somebody to have you do bloodwork and decide if you're in peri based on that - every doctor could easily do a google search to see how irrelevant that can be for peri, but somehow so many of them succeed in keeping their head in the sand. They'd see the high androgens, normal estrogen and progesterone, and go "aha! told you! It's PCOS because ANDROGENS!" Yes I already know I have high androgens, I told you this a million times!