[18F] Experiencing migraines, nausea, back pain, sweating, and unusual vaginal bleeding

Patient Description

An 18-year-old female has been experiencing daily severe migraines (9/10) for the past week, with sensitivity to light and worsening nausea during and after the migraines. The migraines are located at the front of her head, resembling sinus pain, and she has been taking Excedrin to alleviate the pain. The nausea has been persistent, especially when active or in a car, and she vomited a few days ago. She also reports back pain that started in the lower back and has spread to the upper back, feeling very tense. Additionally, she has been sweating significantly, both during sleep and throughout the day. Today, she noticed unusual vaginal bleeding that was red and creamy, with drops of blood in her urine and underwear, unsure if it's spotting, discharge, or the start of her period. This is the first time she has experienced such bleeding. Her sleep has been irregular, waking up in the middle of the night, and she has noticed some mood swings. She mentioned that her last two periods were affected after taking Plan B in January. She is not currently on any medications and has no known pre-existing conditions.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible explanations for your symptoms include:

  • Migraine: A neurological condition that can cause multiple symptoms. It's frequently characterized by intense, debilitating headaches. Symptoms may include nausea, vomiting, difficulty speaking, numbness or tingling, and sensitivity to light and sound. Migraines are often accompanied by other signs and symptoms.

    • Treatment typically includes pain relieving and preventive medications.
  • Premenstrual Syndrome (PMS): A combination of symptoms that many women get about a week or two before their period. Symptoms can include migraines, back pain, mood swings, and changes in sleep patterns.

    • Treatment can involve lifestyle changes, such as regular physical exercise, a healthy diet, and adequate sleep. Over-the-counter pain relievers can help with back pain and headaches. If symptoms are severe, a healthcare provider may recommend other treatments.
  • Urinary Tract Infection (UTI): An infection in any part of your urinary system — your kidneys, bladder, ureters, and urethra. Most UTIs are caused by bacteria, but some are caused by viruses and fungi. UTIs are among the most common infections in humans.

    • Treatment usually involves antibiotics to kill the bacteria causing the infection.
  • Stress or Anxiety: Physical symptoms can include headaches, sleep disturbances, and changes in appetite. Stress can also affect mood and cause mood swings.

    • Treatment can involve a combination of lifestyle changes, therapy, and medication.

Please note that this is not an exhaustive list and other conditions could also explain your symptoms.

What you can do

  1. Make an appointment with your healthcare provider to discuss your symptoms. They may want to perform some tests to help determine the cause of your symptoms.
  2. Keep a symptom diary. This can help you and your healthcare provider identify patterns that might not be apparent otherwise.
  3. Try to maintain a healthy lifestyle. This includes eating a balanced diet, getting regular exercise, ensuring you get enough sleep, and managing stress.
  4. Drink plenty of fluids and avoid irritants such as caffeine and alcohol to help manage your migraines and nausea.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe headache or migraine that doesn't improve with medication
  • Fever or severe back pain, which could indicate a kidney infection
  • Increased frequency or urgency of urination, or pain or burning when you urinate
  • Persistent or worsening mood swings or changes in sleep patterns

Please remember that while I strive to provide accurate and helpful information, I am an AI and not a doctor. Always consult with a healthcare provider for a formal diagnosis and treatment.

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9 mo ago

People Also Ask


What are common symptoms of migraines and how can they be managed?

Common symptoms of migraines include intense headaches, nausea, vomiting, and sensitivity to light and sound. Management often involves pain relief medications, preventive treatments, and lifestyle changes such as stress management and avoiding known triggers.


How can Plan B affect menstrual cycles and what should be expected?

Plan B can cause changes in menstrual cycles, such as irregular periods, spotting, or heavier bleeding. These effects are usually temporary, but if irregularities persist, it's advisable to consult a healthcare provider.


What are the signs of a urinary tract infection (UTI) and how is it treated?

Signs of a UTI include a strong urge to urinate, a burning sensation when urinating, cloudy or strong-smelling urine, and pelvic pain. Treatment typically involves antibiotics prescribed by a healthcare provider.


How can stress or anxiety manifest physically and what are some management strategies?

Stress or anxiety can cause physical symptoms like headaches, sleep disturbances, and mood swings. Management strategies include regular exercise, relaxation techniques, therapy, and sometimes medication under the guidance of a healthcare provider.


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Brian#4030

9 mo ago

Do you take any abortive or pro-phylactic medication? I get migraines once in a while and the standard off-the-shelf pills at CVS work pretty well but I know that if you have them often your doctor can prescribe you some anti-epileptic or beta blocker medication that work for headaches too.

My dr said the gold-standard abortive medication for more intense migraines is called sumatriptan, not sure if you've tried that

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