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A 16-year-old girl visited a dermatologist for acne and moderate hirsutism. The patient reported experiencing menarche at age 14 followed by two menses yearly. The dermatologist initiated minocycline treatment, which improved the acne; however, the hirsutism progressed. Two years later, before starting college, the patient visited an internist, who recognized the dyad of hirsutism and oligomenorrhea. What diagnosis did the internist make? What is the first-line treatment?
Polycystic ovary syndrome (PCOS) is typically diagnosed using the Rotterdam criteria, which require the presence of two of the following three manifestations: (1) hyperandrogenism as indicated by hirsutism or elevated serum andro…