[19F] With missed periods, nausea, and fatigue
Patient Description
A 19-year-old female reports missing her periods for the past two months and not ovulating. She had unprotected sex but has had negative pregnancy tests since a positive result four months ago that turned negative a few days later. She experiences nausea, fatigue, difficulty sleeping, and changes in appetite for about four months. Her cervix is high and hard. She has lighter periods with recent spotting, and her menstrual cycle changed from a normal 7-day flow to a heavy 5-day flow. She reports white, stretchy, and sometimes pasty discharge without odor, and pelvic pain rated 4/10 that alternates sides. No significant changes in weight, diet, exercise, or stress levels. No known hormonal disorders or family history of such conditions. No recent infections, illnesses, or travel.
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Arora's Assessment
What might be happening
Based on the symptoms you've described, here are some possible explanations:
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Hormonal Imbalance:
- Polycystic Ovary Syndrome (PCOS): This condition can cause irregular periods, missed ovulation, and symptoms like acne and changes in appetite. PCOS is a common cause of missed periods and can also lead to changes in cervical mucus.
- Thyroid Disorders: Both hyperthyroidism and hypothyroidism can affect your menstrual cycle, causing missed periods, fatigue, and changes in appetite.
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Early Pregnancy Loss:
- The positive pregnancy test followed by a negative one could indicate a very early pregnancy loss, also known as a chemical pregnancy. This can sometimes cause lingering symptoms like nausea and fatigue.
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Stress and Lifestyle Factors:
- High levels of stress, significant changes in weight, or lifestyle factors can also disrupt your menstrual cycle and cause symptoms like fatigue and changes in appetite.
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Other Gynecological Conditions:
- Conditions like ovarian cysts or endometriosis can cause pelvic pain and changes in your menstrual cycle.
What you can do
Hormonal Imbalance:
- PCOS: Consult with a healthcare provider for a proper diagnosis. They may recommend blood tests to check hormone levels and an ultrasound to look at your ovaries. Treatment often includes lifestyle changes, medications to regulate your menstrual cycle, and sometimes medications to manage symptoms like acne.
- Thyroid Disorders: A simple blood test can check your thyroid function. If a thyroid disorder is diagnosed, treatment usually involves medication to normalize thyroid hormone levels.
Early Pregnancy Loss:
- If you suspect an early pregnancy loss, it's important to consult with a healthcare provider. They can provide support and ensure there are no complications.
Stress and Lifestyle Factors:
- Try to manage stress through relaxation techniques like yoga, meditation, or deep breathing exercises.
- Maintain a balanced diet and regular exercise routine.
- Ensure you are getting enough sleep and maintaining a regular sleep schedule.
Other Gynecological Conditions:
- If you suspect conditions like ovarian cysts or endometriosis, consult with a healthcare provider. They may recommend imaging tests like an ultrasound to diagnose the issue.
What you should look out for
- Severe Pelvic Pain: If you experience severe or worsening pelvic pain, seek medical attention promptly.
- Heavy Bleeding: If you experience unusually heavy bleeding or bleeding that soaks through a pad or tampon in an hour, seek medical care.
- Fever or Unusual Discharge: If you develop a fever or notice a foul-smelling discharge, it could indicate an infection, and you should seek medical attention.
Remember, while I can provide information and suggestions, it's important to consult with a healthcare provider for a formal diagnosis and appropriate treatment. You can use MDandMe to journal your symptoms, track your progress, get insights, and share your medical notes with your provider.
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5 mo ago
