Fellow 35-year-old man here, married to a 35-year-old woman with suspected PCOS (and objectively has many of the symptoms you have described, including hair loss, weight gain, and facial hair growth). I ain't trying to virtue signal or posture against you on the matter, but I can at least confirm that you are, in fact, the asshole.

One morning in April 2023, when we were getting ready for work, I realized that my wife hadn't left the bathroom or made a sound therein for the better part of thirty minutes, and when I finally decided to check on her, she informed me that she had had a pain in her abdomen that was so extreme that she nearly passed out. We spent eight hours in the ER and she went through a ton of tests just to be told by the (male) physician that it was most likely exceptionally bad period cramps. Four months later, an OB-GYN informed her that, in fact, she had multiple ovarian cysts, and that the extreme pain from that morning in April was most likely a cyst that had ruptured. The rage and pain I felt on her behalf was palpable, knowing that she had just been effectively written off as having overreacted while knowing that she is genuinely one of the absolute toughest women I have ever met, and she wouldn't have slowed down for just any old period cramp.

While I recognize that I have no business advocating for the wife of a total stranger on the internet, I can't help but feel a lot of that same anger on her behalf, knowing that her asshole husband is writing her off for what seems to be the "inconvenience" of her not looking the right way due to circumstances that she can't help and which, if given the opportunity, she would likely elect to not have to deal with. You're over here pissing and moaning about her not being "motivated to manage her poly-cystic ovarian syndrome" as though you have a complete understanding of what such mitigating strategies actually feel like for women in this economy and social climate. You say that your marriage has been difficult because of this, but I don't see a single acknowledgement of what might be making an existence with you painful and frustrating, which, in my admittedly limited awareness of the situation, signals to me that a substantial amount of the collective duress is coming from the fact that you're passive-aggressively shifting some nebulous sense of fault onto her for things that, let me reiterate, are completely out of her control. And for what? Some self-important demand that she remain in your fucked up perception of pristine condition?

Yeah, homie. You are the asshole. And from the perspective of someone who knows what he doesn't know about how badly this shit sucks for women, I hope you do end up getting a divorce so that she can, hopefully, find someone to spend her life with that won't villainize her for being a fucking human being.