[21F] Experiencing a range of symptoms including possible early pregnancy signs

Patient Description

A 21-year-old female presents with a variety of symptoms that have developed over the past couple of months. She is currently four days late for her menstrual period, which was last noted to start on January 16. The patient reports feeling tired, experiencing nausea (rated 4/10 for severity) that comes and goes, primarily in the morning or at night, and headaches. She also notes new-onset acne on the lower cheeks and chin, consisting of 5-6 pimples. The patient is experiencing a dull, constant pain in the lower back and hips, rated 5/10 for severity, ongoing for two weeks, with no known injury or accident as a cause. Additionally, she has been dealing with moderate nasal congestion and post-nasal drip for several weeks without associated fever or chills. The patient mentions a slight breast tenderness and has observed weight changes in the past couple of months. She has a history of endometriosis, diagnosed in December 2022, but is not on any medications and has no known drug allergies.

Arora's Assessment

What might be happening

Based on the information provided, here are some possibilities:

Pregnancy: Given your age, sex, recent weight gain, nausea (especially in the morning), late period, and breast tenderness, it's possible that you could be pregnant. Pregnancy can cause all of these symptoms. A home pregnancy test can help confirm this.
Hormonal changes: Changes in hormones can cause symptoms like acne, weight gain, and changes in your menstrual cycle. Conditions like Polycystic Ovary Syndrome (PCOS) can cause these hormonal changes, but this is less likely given your history of endometriosis.
Endometriosis: This is a condition where tissue similar to the lining of the uterus grows outside of the uterus, causing pain and sometimes changes in your menstrual cycle. However, it doesn't typically cause weight gain or nausea.
Common cold or sinus infection: Your congestion and post-nasal drip could be due to a common cold or a sinus infection. These conditions can also cause fatigue, but they don't usually cause the other symptoms you're experiencing.

What you can do

Take a home pregnancy test: Given your symptoms and the fact that your period is late, it would be a good idea to take a home pregnancy test. These tests are usually accurate about a week after your missed period.
See a healthcare provider: If your symptoms persist or worsen, or if you're not pregnant and can't explain your symptoms, it would be a good idea to see a healthcare provider. They can help figure out what's causing your symptoms and how to treat them.
Rest and hydrate: If you have a cold or sinus infection, rest and hydration can help your body recover. Over-the-counter medications can also help with symptoms like congestion.

What you should look out for

Severe pain: If your pain becomes severe or unbearable, seek medical help immediately.
Signs of pregnancy complications: If you're pregnant and you experience severe abdominal pain, heavy bleeding, or severe headaches, seek medical help immediately.
Signs of a severe sinus infection: If your congestion is accompanied by a high fever, severe headache, or facial swelling, seek medical help immediately.

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 appropriate examination, testing, and care recommendations.

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11 mo ago

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