[20F] Experiencing irregular menstruation, genital itching, and painful intercourse with non-menstrual bleeding

Patient Description

A 20-year-old female reports a history of irregular menstruation, with cycles sometimes lasting longer than a month and periods that can extend up to 7 days, often accompanied by heavy flow and pain. The patient has observed a dark spot on the external genitalia that has been present for several years, without changes in elevation or texture. She experiences frequent genital itching and painful intercourse, and recently noted bleeding unrelated to menstrual activity. Additionally, there is a presence of a white, thick, paper-like substance accumulating on the sides of the vagina. The patient has a long-standing diagnosis of type 1 diabetes since age 4 and is currently on insulin therapy. No recent weight changes, fever, severe pelvic pain, or foul-smelling vaginal discharge have been reported. No known drug allergies or other medications have been indicated.

Arora's Assessment

What might be happening

Based on the information you've provided, possible conditions include:

Polycystic Ovary Syndrome (PCOS): This condition is characterized by irregular periods, heavy bleeding, and sometimes pelvic pain. Women with PCOS may also have higher levels of androgens (male hormones) which can cause darkening of the skin in certain areas, including the genital area.
- Treatment typically involves lifestyle changes and medication to manage symptoms and prevent complications.
Vaginal Yeast Infection: This is a common condition characterized by itching in the genital area and a white, thick discharge. It can sometimes cause pain during sex and bleeding.
- Treatment typically involves antifungal medication.
Contact Dermatitis: This is a skin condition that can cause dark spots and itching. It's usually the result of an allergic reaction or irritation from substances like soaps, fabrics, or feminine sprays.
- Treatment typically involves avoiding the irritant and using creams or ointments to relieve symptoms.

Please note that these are potential conditions and you should consult with a healthcare professional for an accurate diagnosis.

What you can do

Schedule an appointment with your healthcare provider to discuss your symptoms. They may want to perform a physical examination or order tests to determine the cause of your symptoms.
In the meantime, try to avoid any potential irritants in the genital area, such as soaps, fabrics, or feminine sprays, to see if this helps relieve your symptoms.
Keep a record of your menstrual cycles, including the length and severity of your periods, to help your healthcare provider understand your symptoms.

What you should look out for

If your symptoms worsen or you develop new symptoms, such as severe pelvic pain or heavy bleeding with clots, seek immediate medical attention.
If you notice any changes in your weight or hair growth, these could be signs of a hormonal imbalance and should be discussed with your healthcare provider.
If you develop a fever or foul-smelling vaginal discharge, these could be signs of an infection and should be evaluated by a healthcare professional.

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for accurate information.

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11 mo ago

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