[19F] Experiencing severe abdominal pain, heavy menstrual bleeding, and high blood pressure

Patient Description

A 19-year-old female has been experiencing severe, stabbing, and constant abdominal pain centered in the lower abdomen for two days, accompanied by heavy menstrual bleeding with clots, significantly heavier than her usual periods. The patient also reported high blood pressure readings (170/105), episodes of fainting and lightheadedness, including one instance of complete loss of consciousness, and occasional vomiting without a clear trigger. The symptoms have persisted despite a visit to the emergency room, where no immediate relief was provided. The patient is currently taking Nitrofurantoin (100 mg every 12 hours) for a UTI and high doses of ibuprofen (800 mg as needed) to manage the pain. The patient has not found any relief from the abdominal pain with the medication. There is a family history of bleeding disorders or clotting problems. The patient denies any recent use of recreational drugs, alcohol, or tobacco products and has no known pre-existing conditions or chronic illnesses.

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Arora's Assessment

What might be happening

Based on the information you've provided, the following conditions could be causing your symptoms:

  • Menorrhagia: This is a condition characterized by heavy or prolonged menstrual periods. It can cause severe abdominal pain and heavy menstrual bleeding, which can lead to the formation of blood clots. It can also cause lightheadedness and fainting due to blood loss.

    • Treatment typically involves medication to regulate your menstrual cycle and reduce blood loss. In severe cases, surgical intervention may be necessary.
  • Pelvic Inflammatory Disease (PID): This is an infection of the female reproductive organs, often caused by sexually transmitted bacteria. It can cause severe abdominal pain, heavy menstrual bleeding, and high blood pressure.

    • Treatment typically involves antibiotics to clear the infection. In severe cases, hospitalization may be necessary.
  • Uterine Fibroids: These are noncancerous growths in the uterus that can cause heavy menstrual bleeding and severe abdominal pain. They can also cause high blood pressure.

    • Treatment can range from medication to manage symptoms to surgical removal of the fibroids.
  • Endometriosis: This is a condition where the tissue that normally lines the inside of your uterus — the endometrium — grows outside your uterus. It can cause severe abdominal pain, heavy menstrual bleeding, and high blood pressure.

    • Treatment typically involves medication to manage pain and hormonal therapy to slow the growth of the endometrial tissue. In severe cases, surgery may be necessary.

Please note that these are possible explanations for your symptoms, but only a healthcare professional can provide a definitive diagnosis.

What you can do

Given the severity of your symptoms, it's important that you seek medical attention as soon as possible. In the meantime, here are some things you can do to manage your symptoms:

  1. Continue taking your prescribed medication as directed by your healthcare provider.
  2. Try to rest and stay hydrated. This can help manage your symptoms and prevent dehydration from heavy menstrual bleeding and vomiting.
  3. Use a heating pad or take a warm bath to help alleviate abdominal pain.
  4. Keep track of your symptoms and any changes. This can help your healthcare provider make a diagnosis.

What you should look out for

If your symptoms worsen or you experience any of the following, seek medical attention immediately:

  • Severe or worsening abdominal pain
  • Heavy menstrual bleeding that soaks through one or more pads or tampons every hour for several hours
  • Fainting or loss of consciousness
  • Difficulty breathing or chest pain
  • Severe headache or vision changes

Remember, I'm an AI and not a doctor. It's important that you seek care from a healthcare professional to receive a formal diagnosis and appropriate treatment.

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1 yr ago

Top picked over-the-counter products for Painful Periods (Dysmenorrhea)

People Also Ask


What are the common causes of heavy menstrual bleeding with clots?

Heavy menstrual bleeding with clots, also known as menorrhagia, can be caused by hormonal imbalances, uterine fibroids, endometriosis, or bleeding disorders. It is important to consult a healthcare provider for a proper diagnosis and treatment plan.


How can high blood pressure be related to menstrual issues?

High blood pressure during menstruation can be related to stress, pain, or underlying conditions such as uterine fibroids or endometriosis. It is important to monitor blood pressure and discuss any concerns with a healthcare provider.


What are the potential risks of untreated Pelvic Inflammatory Disease (PID)?

Untreated PID can lead to serious complications, including chronic pelvic pain, infertility, and an increased risk of ectopic pregnancy. Early diagnosis and treatment with antibiotics are crucial to prevent these outcomes.


Can ibuprofen worsen any of the symptoms described?

While ibuprofen is commonly used to manage pain, it can sometimes cause gastrointestinal issues like nausea or vomiting. It is important to use it as directed and consult a healthcare provider if symptoms persist or worsen.


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1 Comments


Patricia#17104

1 yr ago

Have your symptoms gotten any better?

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