A 21-year-old college student (straight A's, accounting) presents with a five year history of irregular bleeding (45-180 days), increasing hair growth (facial, chest, arm, thighs), and weight gain. She exercises daily yet has gained 25 pounds in the last year. Her family is rather hairy and they all have had irregular cycles. One sister attempting pregnancy has been placed on a fertility drug to try and help her to ovulate.
Her physical examination reveals terminal hairs on the chin, nose, face, chest, arms, abdomen and inner thighs. She is 5 foot 4 inches tall and weighs 175 pounds. Her excess weight is trunkal. She has no striae. The remainder of her examination is within normal limits.
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