I have pcos, and possible endometriosis. I have insulin resistance, but I think that has improved a lot due to weight loss, interval training, weight lifting, and eating low carb.
The biggest problem, and the one I most want to fix, is severe pain intermittently throughout my cycle. The pain is worst for 2-3 days at the end of my period, then intermittently from ovulation to my period starting. I've gone from 5-week cycles to 4-week ones, with paleo, which is a big sign that hormones are improving. I don't get cramps, but my periods are very heavy.
I currently eat low-carb: green veg, meat (primarily pork, beef, some salmon & shrimp), eggs, nuts (1 - 2 oz almonds or cashews per day), coconut oil, butter, some avocado, and some dark chocolate. I have one large coffee in the morning, and I drink black tea and herbal teas as well. I also take vitamin d, magnesium, and omega-3 supplements.
cut out the every-few-weeks wheat "cheat" (I think this one is a no-brainer. I've never noticed a problem from it, but it's a likely culprit)
add organ meats (this seems totally doable)
add bone broth (this seems doable too)
cut out dairy (I don't eat a lot, just cheese on things, and not daily) - many say this is helpful for their endometriosis
cut out eggs (I don't particularly like eggs, but they are currently a large part of our diet. They tend to "sit in my stomach", which maybe is trying to tell me something?)
cut out nuts (I eat 1-2 oz of almonds and cashews a day) - they could be contributing to inflammation
cut out coffee (this would be hard to do!) - there is conflicting info as to whether caffeine is helpful or harmful for endo
cut out dark chocolate (this would be very hard)
I'm torn because on the one hand, I recognize it can take months to see if changes are going to make a difference to complex hormone problems. In that regard I'd like to cut out all the potential problems, and give it 6 months.
On the other hand, if it's too many changes, and I fail at it and eat worse, then where am I going to be. Cutting out everything but meats, green veg, and coconut oil & butter would give me an answer, but I don't think I could stick to it for months at a time. Maybe I'm missing something, though.
If I can't stick to it that strictly, I'm not sure what the safest foods to add are. I want to say berries, but then fructose isn't great for hormone issues. Potatoes and sweet potatoes have the same "sit in my stomach" problem. Oats? Rice?
I have endo (but not pcos) as well and was bleeding a lot all the time. I went to an acupuncturist who prescribed "moxbustion" on the SP-1, KID-1, and ST-36 points. I stopped bleeding in 3 applications.
I also use progesterone cream which helped at first but hasn't done much for me lately. I still take it though.
Have you ever met with a naturopath? Or gotten a consult from a paleo/primal nutrition specialist? Might be worth it. I have a lot of the same issues you do, and a fear that if I eliminate too much, I'll fail. My ND has helped me identify likely culprits that contribute to my health issues. If you've not done an elimination diet, it could be helpful. I found that unfortunately I can't do dairy and that chocolate and nuts are only ok in small amounts. Googling paleo autoimmune protocol will give you a lot of info. Practical Paleo also has a great section on it as well and a menu plan to go along with it.
Stefani from Paleo for Women has a protocol and book for PCOS sufferers. Perhaps it will be helpful for you. http://www.paleoforwomen.com/pcos-unlocked-the-manual/
Be patient! You will definitely need 6 months to a year to see changes with hormone balance. I like your "definite" changes and would do them for 3 months before making any other "possible" changes.
Also, get your Vitamin D3 level checked & sun/supplement to 60-80 ng/ml. You won't know if you are supplementing enough without a test. More info at www.vitamindcouncil.org
D3 is a hormone precursor & deficiency is going to impact your Progesterone levels which will affect your PCOS & endo.
More suggestions on my blog posts on fertility (fertility is largely about hormonal balance!)
It is better to cut one thing at a time, to see what makes a difference. For me (I have endo) the biggest change was cutting the dairy. Consider adding b-complex vitamin supplement. Homemade ginger tea usually eases my pain.