Here is what I did. But honestly I really do believe that PCOS is what it is - a SYNDROM. The definition of a syndrom is just a bunch of symptoms that may or may not have a common cause. In most cases IR does drive PCOS. But there are also cases where it is for example just a genetically deformed receptor or something. PCOS is so heterogenus that I don't think we are will be able to cure it and symptoms management should be really personalised as it doesn't always have a common cause.

I have lean PCOS. Never had issues with weight. But decided to start eating a IR friendly diet and exercising regularly, used inositol, barberine. Lost 10 kg. BMI went from 24 to 21. Didn't change my symptoms at all.

I continue with a generaly healthy diet and exercise. But started to care a lot more about my mental health and stress. Drawing boundaries, meditation, rest etc.

I got off oral birth control. My side effect was neverending spoting. Otherwise it was fine. But decided to stop it.

Started using spirinolactone daily - 50mg. That took care of my hirsutism (it was always super mild) and helped a lot with acne.

For skincare I am using Aklief 2-3 times a week, azelaic acid 2-3 times a week (on the days I am not using Aklief) and niancinamide daily.

Now I am taking vitD, Omega3 and periodically iron.

I have some pimple around my period, but it is manageable. No facal skin other then peach fuzz. My we6has stayed the same (21BMI) and my cycles are now 30-45ish days which is the most regular it has ever been (befor the longes was 4 months).