question: Q:A 19-year-old woman presents with irregular menstrual cycles for the past 3 years and facial acne. Patient says she had menarche at the age of 11, established a regular cycle at 13, and had regular menses until the age of 16. Patient is sexually active with a single partner, and they use barrier contraception. They currently do not plan to get pregnant. There is no significant past medical history and she takes no current medications. Vitals are temperature 37.0℃ (98.6℉), blood pressure 125/85 mm Hg, pulse 69/min, respiratory rate 14/min, and oxygen saturation 99% on room air. Physical examination is significant for multiple comedones on her face. She also has hair on her upper lip, between her breasts, along with the abdominal midline, and on her forearms. There is hyperpigmentation of the axillary folds and near the nape of the neck. Laboratory tests are significant for the following:
  Sodium   141 mEq/L
  Potassium   4.1 mEq/L
  Chloride  101 mEq/L
  Bicarbonate  25 mEq/L
  BUN  12 mg/dL
  Creatinine  1.0 mg/dL
  Glucose (fasting)   131 mg/dL 
    Bilirubin, conjugated 0.2 mg/dL
  Bilirubin, total   1.0 mg/dL
  AST (SGOT)    11 U/L
  ALT (SGPT)        12 U/L
  Alkaline Phosphatase 45 U/L
    WBC  6,500/mm3
  RBC 4.80 x 106/mm3 
  Hematocrit  40.5%
  Hemoglobin  14.0 g/dL
  Platelet Count   215,000/mm3
    TSH    4.4 μU/mL   
  FSH   73 mIU/mL
  LH   210 mIU/mL
  Testosterone, total  129 ng/dL (ref: 6-86 ng/dL)
  β-hCG  1 mIU/mL
  Which of the following is the best course of treatment for this patient?? 
  {'A': 'Finasteride', 'B': 'Oral contraceptives', 'C': 'Clomiphene', 'D': 'Goserelin', 'E': 'Letrozole'},