A 42-year-old woman presents with oligomenorrhea for two years. She has gained 30 kg of weight during the same time period, even though her diet remained unchanged. Her medical history is significant for type 2 diabetes mellitus, hypertension, and dyslipidemia for three years. While well controlled initially, these worsened over the last year. She is currently on metformin, gliclazide, telmisartan, and rosuvastatin. Her family history is significant for polycystic ovarian disease in an older sister. She drinks 1 to 2 standard drinks per week, socially. She does not smoke. A full blood count is within normal parameters, as are serum electrolyte levels, and renal and liver profiles. A thyroid profile and serum FSH, LH, testosterone, prolactin, and growth hormone levels are also normal.