What is the most appropriate initial diagnostic study for a young woman with symptoms indicative of polycystic ovarian syndrome?

The most appropriate initial diagnostic study for a young woman with symptoms indicative of polycystic ovarian syndrome (PCOS) is measuring free testosterone levels. PCOS is characterized by symptoms related to hormonal imbalance, including signs of hyperandrogenism such as hirsutism, acne, or alopecia. Elevated free testosterone levels can indicate the presence of androgens that are often elevated in women with PCOS, making it a crucial part of assessing this condition.

In addition to free testosterone, the clinical presentation may lead to further investigations, but starting with this hormone level helps to establish the hyperandrogenic component of the syndrome, which is essential for diagnosis. Testing for other hormone levels or conducting imaging studies may follow based on the results and clinical findings, but assessing free testosterone is key to confirming the suspicion of PCOS.