[19F] With pelvic pain and mood swings

Patient Description

A 19-year-old female presents with sharp, stabbing pelvic pain that occurs daily and rates as a 9 out of 10 in severity during episodes. The pain is sudden, transient, and not associated with any specific triggers. Accompanying symptoms include increased vaginal discharge described as milky and whitish, a missed menstrual period for about a month, mood swings, increased fatigue, stomach aches, and food cravings. The patient reports a history of irregular periods and was diagnosed with a right ovarian cyst a few months ago, which was noted to be resolving. She has a history of anemia and has recently stopped taking her prescribed medications, including iron pills, Prozac, and prenatal vitamins. The patient has not taken a pregnancy test and reports no recent travel or family history of hormonal or reproductive issues.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are a few possible explanations:

  1. Pregnancy: Given the missed period, increased vaginal discharge, mood swings, and fatigue, pregnancy is a possibility. These symptoms are common in early pregnancy. A home pregnancy test can help determine if this is the case.

  2. Hormonal Imbalance: Irregular periods, mood swings, and fatigue can also be signs of a hormonal imbalance, such as polycystic ovary syndrome (PCOS) or thyroid issues. Your history of irregular periods and ovarian cysts could be related to this.

  3. Ovarian Cyst: The sharp pelvic pain could be related to the ovarian cyst you mentioned. While you were told it was going away, cysts can sometimes cause pain if they rupture or grow.

  4. Anemia: Your history of anemia could contribute to fatigue and mood changes, especially if your iron levels are low due to not taking your supplements.

What you can do

Pregnancy:

  • Consider taking a home pregnancy test to rule out or confirm pregnancy. These are available at most pharmacies and are easy to use.

Hormonal Imbalance:

  • Schedule an appointment with your healthcare provider to discuss your symptoms. They may recommend blood tests to check hormone levels or an ultrasound to assess your ovaries.

Ovarian Cyst:

  • If the pelvic pain becomes severe or is accompanied by fever, vomiting, or dizziness, seek medical attention promptly, as these could be signs of a ruptured cyst.

Anemia:

  • Consider restarting your iron supplements if advised by your healthcare provider, as this can help with fatigue and overall energy levels.

General Tips:

  • Keep a symptom journal using MDandMe to track your symptoms, mood changes, and any potential triggers. This can be helpful for your healthcare provider.
  • Ensure you are eating a balanced diet rich in iron, especially if you are not taking your supplements.
  • Try to maintain a regular sleep schedule to help manage fatigue.

What you should look out for

  • If you experience severe abdominal pain, dizziness, or fainting, seek medical attention immediately.
  • Monitor for any changes in your symptoms, such as increased pain or new symptoms like fever or unusual discharge, and report these to your healthcare provider.
  • If your mood swings become more severe or you feel unable to cope, consider reaching out to a mental health professional for support.

Remember, while I can provide guidance, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan.

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1 mo ago

People Also Ask

Could my symptoms indicate pregnancy, and how can I confirm it?

Yes, your symptoms could indicate pregnancy, especially with a missed period and other signs like fatigue and mood swings. You can confirm pregnancy by taking a home pregnancy test, which is available at most pharmacies.

What are the potential causes of sharp pelvic pain in someone with a history of ovarian cysts?

Sharp pelvic pain in someone with a history of ovarian cysts could be due to a cyst growing, rupturing, or causing torsion. It's important to monitor the pain and seek medical attention if it becomes severe or is accompanied by other symptoms like fever or vomiting.

How can hormonal imbalances affect menstrual cycles and mood?

Hormonal imbalances, such as those seen in conditions like PCOS or thyroid disorders, can lead to irregular menstrual cycles and mood swings. These imbalances can affect the body's regulation of hormones that control the menstrual cycle and mood.

What are the effects of anemia on energy levels and mood, and how can it be managed?

Anemia can lead to fatigue and mood changes due to low levels of iron, which is essential for producing hemoglobin in red blood cells. Managing anemia typically involves taking iron supplements and eating a diet rich in iron, as advised by a healthcare provider.

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