Q96
Single choice
A 16-year-old woman comes to see you for a yearly physical examination. Her only concern is that her periods are very irregular, and she desires oral contraceptives to regulate them. She relates that menarche was at 12 years, of age and that her periods have always been irregular. On examination, she is a markedly obese woman with a body mass index of 35 and with normal linear growth. She has some coarse facial hair down both of her checks as well as cystic acne along her hairline. On the nape of her neck she is noted to have acanthosis nigricans. She has tanner 4 breast development as well as tanner 4 pubic hair.
Her urinalysis in the office is normal.
What would be the best intervention to achieve the best long-term outcome in this woman?