[19F] With morning nausea, vomiting, and frequent urination

Patient Description

A 19-year-old female has been experiencing severe nausea and occasional vomiting every morning for the past week, starting early in the morning and ending around 10 am. The nausea is triggered by certain smells and occurs first thing upon waking. The patient has also been experiencing frequent urination, needing to go every 30 minutes or every hour if forced to hold it, and tender breasts. The patient had two periods last month but no unusual vaginal bleeding or spotting. There is no abdominal pain, cramping, or changes in bowel movements. The patient reports fatigue and food cravings. The patient has not taken a pregnancy test yet but plans to do so soon. Past medical history includes PCOS, BPD, mood swings, anxiety, depression, and ADHD, all diagnosed at age 16. The patient is allergic to mushrooms, has seasonal allergies, and is allergic to contrast and vancomycin. Current medications include Abilify, buspirone, Concerta, cetirizine, and Maalox, and the patient is taking prenatal vitamins as advised by their OB-GYN. No herbal or alternative remedies are being used.

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Arora's Assessment

What might be happening

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

  • Pregnancy: Given your symptoms of nausea and vomiting in the morning (often referred to as "morning sickness"), frequent urination, tender breasts, fatigue, and food cravings, pregnancy is a strong possibility. Morning sickness typically starts around the 6th week of pregnancy but can start earlier. A missed period or changes in your menstrual cycle can also be a sign of pregnancy.

    • Testing: A home pregnancy test can help determine if you are pregnant. These tests are widely available and can be done in the privacy of your home. If the test is positive, you should schedule an appointment with your healthcare provider for confirmation and to begin prenatal care.
    • Treatment: If you are pregnant, your healthcare provider can offer guidance on managing morning sickness and other symptoms. Eating small, frequent meals and avoiding triggers like certain smells can help alleviate nausea.
  • Polycystic Ovary Syndrome (PCOS): Since you have a history of PCOS, hormonal imbalances associated with this condition can sometimes cause symptoms like nausea, breast tenderness, and changes in your menstrual cycle.

    • Testing: Blood tests to check hormone levels and an ultrasound to look at your ovaries can help in assessing the impact of PCOS on your current symptoms.
    • Treatment: Managing PCOS often involves lifestyle changes, medications to regulate your menstrual cycle, and treatments to manage symptoms like nausea.

What you can do

  1. Take a Pregnancy Test: Given your symptoms, taking a home pregnancy test is a good first step. This will help you determine if pregnancy is the cause of your symptoms.
  2. Consult Your Healthcare Provider: Whether the test is positive or negative, it's important to consult your healthcare provider for a formal assessment. They can provide guidance on next steps and any necessary treatments.
  3. Manage Nausea: Try eating small, frequent meals and avoid foods or smells that trigger your nausea. Ginger tea or ginger candies can sometimes help alleviate nausea.
  4. Stay Hydrated: Make sure to drink plenty of fluids, especially if you are experiencing vomiting. Dehydration can worsen your symptoms.
  5. Use MDandMe: You can use MDandMe to journal your symptoms, track your progress, get insights, and share longitudinal medical notes with your provider. This can be especially helpful in managing chronic conditions like PCOS.

What you should look out for

  • Severe Symptoms: If you experience severe abdominal pain, heavy bleeding, or if your vomiting becomes uncontrollable, seek medical attention immediately.
  • Dehydration: Signs of dehydration include dark urine, dizziness, and feeling very thirsty. If you notice these signs, it's important to seek medical care.
  • Changes in Symptoms: If your symptoms worsen or new symptoms develop, consult your healthcare provider for further evaluation.

Remember, while I can provide information and suggestions, it's important to seek care from real health professionals to receive a formal diagnosis and appropriate treatment.

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5 mo ago

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People Also Ask


What are common early signs of pregnancy?

Common early signs of pregnancy include missed periods, nausea (often referred to as morning sickness), frequent urination, tender breasts, fatigue, and food cravings. A home pregnancy test can help confirm pregnancy.


How can PCOS affect menstrual cycles and related symptoms?

PCOS can cause irregular menstrual cycles due to hormonal imbalances. It may also lead to symptoms like nausea, breast tenderness, and changes in menstrual flow. Blood tests and ultrasounds can help assess the impact of PCOS.


What are some effective ways to manage morning sickness?

To manage morning sickness, try eating small, frequent meals, avoid triggers like certain smells, and consider ginger tea or candies. Staying hydrated and resting can also help alleviate symptoms.


When should I seek medical attention for nausea and vomiting?

Seek medical attention if you experience severe abdominal pain, heavy bleeding, uncontrollable vomiting, or signs of dehydration such as dark urine and dizziness. These could indicate more serious conditions requiring prompt care.


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