Reference no: EM133723499

A 28-year-old nulliparous woman presents for evaluation of irregular menstrual cycles for the past year. They occur on average only once every 2 or 3 months, and she has gone as long as 4 months without a cycle. Currently, she states her last cycle occurred 11 weeks ago. Her cycles have been "mostly" regular, usually occurring every 30 days. Her menarche occurred at age 13, and she has never been on hormonal contraception. She does not smoke, does not drink alcohol, and does not exercise. She is sexually active in a monogamous relationship with a male partner who uses condoms for contraception. On review of systems, she reports a 30-lb weight gain in the past 18 months but denies other constitutional symptoms. On examination, she is noted to be obese, with a body mass index of 36 kg/m2, and her other vital signs are within normal limits. She has fine hair growth on her face and a velvety thickening of the skin on her neck. Her general physical examination is unremarkable. A pelvic examination reveals normal external genitalia, no vaginal or cervical discharge, no cervical motion tenderness, and no uterine or adnexal masses.

Questions

What is the most likely diagnosis?