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These intersecting mechanisms suggest that PCOS-related ER impairment arises from a broader metabolicinflammatoryendocrinemicroecological network rather than isolated defects [9, 14]

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Common Side Effects When side effects occurred, they were typically mild, transient, and similar in frequency to placebo groups: Reported Adverse Effects Most Common (occurring in small percentage of participants): Mild to moderate headaches (most frequently reported, often resolving with continued use) Injection site reactions (minor redness, swelling, or irritation at injection site) Gastrointestinal effects (particularly at higher oral doses: mild nausea, diarrhea, flatulence) Fatigue (reported occasionally during initial adaptation period) Rare Events: One case of chest tightness was deemed possibly related to treatment in safety trials

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