Figure 1.

Treatment strategy. Patients were started with 1 of 2 treatment strategies selected and asked to return every 6 months. Patients who were not treated could over time start in of the 2 treatments. The target of antiandrogen treatment was a reduction of grooming frequency and or the stabilization of hair thinning. The target of insulin-sensitizing treatment was the restoration of menstrual cyclicity with titration of metformin dose every 6 months on the basis of patient tolerance and response. A lifestyle plan was presented and discussed at each visit. OCP = oral contraceptive.