I need to go read up on the mechanisms in females (because, stereotypes aside, women are several orders of magnitude more complicated than men) but PCOS is a result of the feedback loops associated with androgen sensitivity/regulation getting severely broken....in part because of all the oestrogen floating around....if I was to grossly oversimplify, the normal state is 1:25 TES/OES and because you're a fat fuck you've got 1:50 TES/OES then your body will try to find ways to being the ratio in line. In guys if T is too high (through steroids more than anything) you get conversion of T into OES and downregulation of the hormones (FSH/LH) that stimulate the testes to produce T. So in women I can only guess that if they can't produce more T (lacking testes) then whatever T they do produce isn't bound up in SHBG leaving it free to act on receptors...as testosterone is one hell of a drug this is why you get femayos rocking facial hair that looks like Freddy Murcury and a marshmellow had a telepod accident. As to why they don't use it to get in better shape...women don't want to get 'too bulky' because lifting more than pink dumbelles will turn them into She-Hulk*....despite already occupying the same cubic volume as Ronnie Coleman. *No disrespect to the ladies here that wearing flats/heels can mean a decision between Converse/Adipowers.