Does Vaginal Delivery of Combined Hormonal Contraception Affect the Risk of Metabolic Syndrome in Overweight/Obese Women With PCOS

Inclusion Criteria: * Diagnosis of PCOS according to Rotterdam criteria, with at least 2 of 3 of the following criteria: oligomenorrhea (≤8 periods per year), clinical or biochemical hyperandrogenism, and polycystic ovaries on ultrasound * Body mass index ≥25 and ≤45 kg/m2 * In good general health according to the investigators' discretion * Willing to avoid pregnancy for the duration of the study Exclusion Criteria: * Current pregnancy or desire for pregnancy during course of study * Current breastfeeding * Second-trimester pregnancy within four weeks prior to initiation of NuvaRing or third-trimester pregnancy within 6 months prior to initiation of NuvaRing * Use of hormonal contraception within four weeks prior to initiation of NuvaRing * Diagnosis of metabolic syndrome. Metabolic syndrome will be defined according to the updated Adult Treatment Panel III as 3 or more of the following criteria: blood pressure ≥130/85 mm Hg, waist circumference \>35 inches, fasting glucose ≥110 mg/dL, TG ≥150 mg/dL, HDL-C \<50 mg/dL. * Contraindications to NuvaRing use: * Age ≥ 35 plus tobacco use * Current or past deep vein thrombosis or pulmonary embolism * Cerebrovascular disease * Coronary artery disease * Thrombogenic valvular or rhythm diseases of the heart (such as subacute bacterial endocarditis with valvular disease or atrial fibrillation) * Inherited or acquired coagulopathy * Headaches with focal neurological symptoms or migraine headaches with aura * Age ≥ 35…