Soru

A $26$-year-old woman comes to the office due to the absence of menstrual periods for the past $7$ months. Previously, she had regular $28$-day cycles with normal bleeding. Over the same $7$-month period, she has noticed worsening acne, increased thick hair growth on her face and abdomen, and a deepening of her voice. She has no significant past medical history and takes no medications. A urine pregnancy test obtained in the clinic is negative. Vital signs are temperature $36.8^\circ\text{C}$, blood pressure $122/78 \text{ mmHg}$, pulse $76/\text{min}$, and respirations $14/\text{min}$. BMI is $24 \text{ kg/m}^2$. Physical examination reveals temporal hair thinning and terminal hair on the upper lip, chin, and linea alba. Pelvic examination shows clitoromegaly and a normal-sized, mobile uterus. Adnexae are difficult to palpate. Which of the following is the most appropriate next step in management?