Ms Adrian had a 26-year history of PCOS, characterized by oligomenorrhea or amenorrhea, hirsutism, hyperandrogenism, and polycystic ovaries, confirmed by several laboratory tests and ultrasound. Twenty years ago, her gynaecologist suggested lifestyle changes such as exercises, nutritional guidance, low doses of oral contraceptive pills, cosmetic therapy and laser therapy for hirsutism. With the use of oral contraceptive pills, she experienced an improvement in her menstrual cycles, although she continued to have mood swings, irritability, and severe headaches, which were extremely distressing. She was switched to several oral contraceptive pills, but all showed severe side effects. She discontinued all oral contraceptive pills after a few months of use.