I went to an endocronologist to test and help me understand it all. Personally, I have a few things affecting my acne (high-normal IGF-1, sensitivity to androgens, etc.)but the endocronologist said that unless it is extreme not much can be done for these kinds of things because the treatment side effects outweigh the advantages. That said, my derm has me on Spironolactone for the androgen sensitivity.
Both told me the key to controlling acne is changing how the pores function. Then it doesn't matter what is happening with the hormones, etc. To do this often requires a multi-prong approach, especially with adult acne. I now have almost 100% clear skin due to the regime below. I guess what I'm trying to say is that there is no way to control everything the hormones do. Some tweaking can be done for specific ailments like your wife has but even then it is virtually impossible to understand how everything is affecting everything else.
I am a researcher and, like you, spent much time trying to figure it all out...changing this and tweaking that, getting lots of testing. But after a certain point realized I couldn't control all the variables.
I hope this helps. Feel free to message me if you want to talk more in depth about this. Personally, I think there is a middle ground to the task of trying to find causative agents for acne. It helps to a point and then there is the realization that for many of us there is no magic bullet cure as it were...just the boring task of keeping on doing a regime that keeps the pores functioning better. I am older (62) and have been dealing with this since age 15 so I know what it is like to keep on trying to find something that explains the ongoing problem!
It's great you've taken on the task and are helping your wife try to figure this out. My husband is also very supportive and stood by me as I tried and tried to control the problem. He was a lifesaver and I couldn't have made it without his support. I'm sure your wife is very appreciative!