Soru

A 20-year-old woman comes to the clinic because of irregular menstrual periods and increased facial hair. Her menarche occurred at age 13. Her periods were initially regular but have become increasingly irregular over the past two years, now occurring every 3 to 4 months. She has also noticed coarse, dark hair growing on her chin and chest, and she has struggled with severe acne that has not responded to over-the-counter topical treatments. She takes no medications and has no other medical conditions. Vital signs show a blood pressure of 122/78 mmHg, pulse of 76/min, and a BMI of 31 kg/m². Physical examination reveals hirsutism on the face and chest and moderate inflammatory acne on the back. There is no clitoromegaly or deepening of the voice. Pelvic examination is unremarkable. A urine pregnancy test is negative. Initial laboratory studies show a normal serum thyroid-stimulating hormone (TSH) level and a normal serum prolactin level. Which of the following is the most appropriate next step in the evaluation of this patient?