A 30-year-old obese patient presents with irregular menses every 6-12 weeks, acne on her face and back, coarse dark hair on her lower abdomen, and a report of an inability to become pregnant despite unprotected intercourse for the past 3 years.
Your workup, including thyroid-stimulating hormone, urine pregnancy test, total testosterone, dehydroepiandrosterone sulfate, 17-hydroxyprogesterone, and pelvic ultrasound, is normal. A progesterone challenge test results in 3 days of uterine bleeding.
The patient states she has decided not to attempt pregnancy at the present time because she just split from her long-time partner and she does not need contraception.
Which of the following best describes how you should counsel this patient?
- She should take oral contraceptive pills (OCPs) to regulate her menstrual cycle.
- She should take oral contraceptive pills (OCPs) for pregnancy prevention even if she does not have a current sexual partner.
- She does not need any interventions at this time.
- She should take oral contraceptive pills (OCPs) or cyclic progesterone to protect her endometrium.
- She is clearly infertile based on her history and should seek immediate fertility treatments.
This question appears in Med-Challenger OBGYN Exam Review with CME
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