[19F] With frequent urination, mood swings, and missed period

Patient Description

A 19-year-old female presents with frequent urination for the past two weeks, needing to go to the bathroom about 10 times a day. The onset was sudden, and she describes a pulling sensation during urination, without changes in the color or smell of her urine, and no blood present. She also reports fatigue, mood swings for the past week, and a missed period for two weeks. The mood swings seem to be influenced by interactions with her boyfriend, and she finds reassurance through words of affirmation helpful. Additionally, she has experienced some breast tenderness and lower abdominal or pelvic pain, but no unusual vaginal discharge. She has not had any recent changes in sexual activity, no new partners, and no changes in contraception. This is her first experience with a late period. She has felt kind of nauseous but has not vomited. She has not traveled recently, is not taking any medications or supplements, and does not use tobacco, alcohol, or recreational drugs. Her past medical history includes gallbladder removal last August, and she has no known allergies or adverse reactions to medications.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

Frequent Urination and Discomfort

  • Urinary Tract Infection (UTI): A common cause of frequent urination and discomfort, especially if it came on suddenly. UTIs can cause a pulling sensation during urination and may not always present with changes in urine color or smell.
  • Pregnancy: Given your missed period, breast tenderness, and lower abdominal pain, pregnancy is a possibility. Frequent urination is a common early symptom of pregnancy.

Fatigue and Mood Swings

  • Hormonal Changes: Hormonal fluctuations, possibly related to pregnancy, can cause mood swings and fatigue.
  • Stress: Emotional stress, especially related to personal relationships, can also contribute to mood swings and fatigue.

Missed Period

  • Pregnancy: A missed period is one of the most common early signs of pregnancy.
  • Hormonal Imbalance: Other factors like stress, significant weight changes, or hormonal imbalances can also cause a missed period.

What you can do

Frequent Urination and Discomfort

  • See a Doctor: It's important to consult a healthcare provider to rule out a UTI or other infections. They may perform a urine test to diagnose the issue.
  • Stay Hydrated: Drink plenty of water to help flush out any potential infection.
  • Over-the-Counter Pain Relief: If the discomfort is bothersome, you can take over-the-counter pain relievers like ibuprofen, but follow the dosage instructions carefully.

Fatigue and Mood Swings

  • Consult a Healthcare Provider: Given the combination of symptoms, it's important to see a healthcare provider to rule out pregnancy or other hormonal issues.
  • Self-Care: Ensure you are getting enough rest, eating a balanced diet, and engaging in stress-relieving activities like exercise or meditation.
  • Support System: Continue to seek reassurance and support from your boyfriend and other loved ones.

Missed Period

  • Take Another Pregnancy Test: Given the mixed results from your previous tests, consider taking another test in a few days. First-morning urine can provide a more accurate result.
  • Consult a Healthcare Provider: If your period remains absent and pregnancy tests are inconclusive, a healthcare provider can perform a blood test to check for pregnancy or other underlying issues.

What you should look out for

  • Worsening Symptoms: If you experience increased pain, fever, or any new symptoms, seek medical attention promptly.
  • Positive Pregnancy Test: If you get a positive result, schedule an appointment with your healthcare provider to confirm the pregnancy and begin prenatal care.
  • Persistent Symptoms: If your symptoms persist despite home care, consult a healthcare provider for further evaluation.

Remember, while I can provide information and suggestions, it's crucial to seek care from real health professionals to receive a formal diagnosis and appropriate treatment. You can also use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.

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4 mo ago

People Also Ask

What are the common causes of frequent urination in young women?

Frequent urination in young women can be caused by urinary tract infections (UTIs), pregnancy, increased fluid intake, diabetes, or bladder issues. It's important to consult a healthcare provider for an accurate diagnosis.

How can I differentiate between symptoms of a UTI and early pregnancy?

Both UTIs and early pregnancy can cause frequent urination. UTIs often come with pain or a burning sensation during urination, while pregnancy may include symptoms like missed periods, breast tenderness, and nausea. A pregnancy test and urine analysis can help differentiate between the two.

What should I do if I have a missed period and suspect pregnancy?

If you have a missed period and suspect pregnancy, take a home pregnancy test. For more accurate results, use first-morning urine. If the test is positive or if you have mixed results, consult a healthcare provider for confirmation and further guidance.

How can stress and emotional factors affect menstrual cycles and mood?

Stress and emotional factors can lead to hormonal imbalances, which may cause irregular menstrual cycles and mood swings. Managing stress through relaxation techniques, exercise, and support from loved ones can help mitigate these effects.

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1 Comments

Tina#53017

4 mo ago

There are several conditions could be considered in this scenario:

Pregnancy: The most likely cause of her symptoms, including the missed period, frequent urination, breast tenderness, nausea, mood swings, and lower abdominal pain, is early pregnancy. Even if this is her first experience with a late period, pregnancy should be ruled out first, especially given the timing and nature of her symptoms.

Urinary Tract Infection (UTI): Although she doesn't report typical UTI symptoms like painful urination or cloudy urine, the frequent urination and lower abdominal discomfort could still indicate a UTI. However, the absence of changes in urine color or smell and no mention of fever makes this less likely.

Hormonal Imbalance: Her mood swings, fatigue, and missed period could indicate a hormonal imbalance, possibly related to stress, thyroid issues, or other endocrine disorders. However, the frequent urination is less commonly associated with these conditions.

Ovarian Cyst: Lower abdominal or pelvic pain, missed period, and breast tenderness could also point to an ovarian cyst. Some cysts can affect hormone levels and menstrual cycles.

Given the details provided, a pregnancy test should be the first step. If the test is negative, further evaluation for a UTI, hormonal imbalances, or other potential causes would be appropriate. Additionally, a pelvic exam and possibly an ultrasound might be necessary to check for ovarian cysts or other abnormalities.

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