[19F] Experiencing heavy irregular periods with clotting and severe cramps

Patient Description

A 19-year-old female reports having heavy and irregular menstrual cycles that vary from 27 to 38 days over the past 8 months. The flow intensity alternates between light and heavy, with periods lasting 3 to 8 days accompanied by heavy clotting. She experiences severe cramps with a sharp aching pain in the lower abdomen, lower back, and buttocks, rated as a 7 out of 10 for pain severity, which worsen with physical activity and are somewhat alleviated by ibuprofen. Additionally, she reports random bouts of fatigue during the day, dizziness, shortness of breath, and dull aching headaches that intensify around her menstrual cycle. The patient has a mental health history of ADD, anxiety disorder, OCD, and depression, diagnosed at various stages of her life, and is currently on a daily regimen of Prozac 30mg. She has discontinued the use of Adderall and has no known drug allergies.

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Arora's Assessment

What might be happening

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

  • Menstrual Disorders: Heavy menstrual bleeding, also known as menorrhagia, is a common condition that can cause significant discomfort and disruption to your daily life. It can be caused by a variety of factors, such as hormonal imbalances, uterine fibroids, or polyps. Dysmenorrhea, or painful periods, is another common menstrual disorder that can cause severe cramps in the lower abdomen, lower back, and buttocks.

    • Treatment options for these conditions can range from hormonal therapies (like birth control pills) to non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, which you've found helpful for your cramps. In some cases, surgical intervention may be necessary.
  • Polycystic Ovary Syndrome (PCOS): This is a hormonal disorder common among women of reproductive age. Women with PCOS may have infrequent or prolonged menstrual periods or excess male hormone (androgen) levels. The ovaries may develop numerous small collections of fluid (follicles) and fail to regularly release eggs.

    • Treatment of PCOS often involves lifestyle modifications such as weight loss and exercise, as well as medications to manage symptoms and prevent complications.
  • Endometriosis: This is a condition where tissue similar to the lining of the uterus is found outside the uterus. It can cause painful periods, heavy menstrual bleeding, and pain in the lower abdomen.

    • Treatment options for endometriosis can include hormonal therapies, pain management strategies, and in some cases, surgery.

Please note that these are potential explanations for your symptoms, but the exact cause can only be determined by a healthcare professional.

What you can do

  1. Schedule an appointment with your healthcare provider: They can provide a formal assessment and order relevant tests if necessary.

  2. Keep a symptom diary: This can help you and your healthcare provider identify patterns and triggers for your symptoms.

  3. Maintain a healthy lifestyle: Regular exercise, a balanced diet, and sufficient sleep can help manage some of your symptoms.

What you should look out for

Reasons to seek immediate medical attention:

  • If you experience severe abdominal pain
  • If you have heavy bleeding that soaks through one or more tampons or pads every hour for several hours
  • If you feel faint or dizzy
  • If your symptoms significantly interfere with your daily life

Remember, while I strive to provide accurate information, I'm not a doctor. Please consult with a healthcare professional for an accurate diagnosis and treatment.

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10 mo ago

People Also Ask


What causes heavy and irregular menstrual cycles?

Heavy and irregular menstrual cycles can be caused by hormonal imbalances, uterine fibroids, polyps, or conditions like Polycystic Ovary Syndrome (PCOS) and endometriosis. It's important to consult a healthcare provider for an accurate diagnosis.


How can severe menstrual cramps be managed effectively?

Severe menstrual cramps can be managed with non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, hormonal therapies such as birth control pills, and lifestyle changes like regular exercise. In some cases, more advanced treatments may be necessary.


What are the common symptoms of Polycystic Ovary Syndrome (PCOS)?

Common symptoms of PCOS include irregular or prolonged menstrual periods, excess androgen levels leading to symptoms like acne or excess hair growth, and polycystic ovaries. It can also be associated with weight gain and difficulty losing weight.


How does endometriosis affect menstrual cycles and what are the treatment options?

Endometriosis can cause painful periods, heavy menstrual bleeding, and pain in the lower abdomen. Treatment options include hormonal therapies, pain management strategies, and sometimes surgery to remove endometrial tissue.


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