Soru

A 19-year-old female university student visits the clinic seeking a reliable method of birth control. She reports that her menstrual periods have been unpredictable since menarche at age 13, often occurring every 3 to 4 months. She also notes worsening facial acne and excess dark hair on her upper lip. Her body mass index is $32 \text{ kg/m}^2$. Blood pressure is $118/76 \text{ mmHg}$ and heart rate is $78/\text{min}$. A urine pregnancy test obtained in the clinic today is negative. During the interview, the patient mentions suffering from severe headaches that are consistently preceded by flashing lights and blind spots. The physician strongly suspects an underlying endocrinopathy but must first address her request for contraception and endometrial protection. Which of the following is the most appropriate next step in the management of this patient?