[21F] Experiencing anxiety and possible hormonal imbalance

Patient Description

A 21-year-old female has been experiencing anxiety, including frequent panic attacks and negative thoughts. This issue has worsened recently after a period of improvement. Work-related stress often triggers these symptoms, leading to intrusive thoughts and panic attacks. The patient suspects a possible hormonal imbalance and reports irregular periods, some skin dryness on the hands, unusual tiredness, and changes in appetite or digestive issues. Additionally, she has experienced abnormal hair growth since high school. There are no weight changes, and she has not been diagnosed with any hormonal disorders like thyroid issues or PCOS. The patient is not currently taking any medications, including birth control or supplements, and does not use substances such as alcohol, tobacco, or recreational drugs. There are no known pre-existing conditions or chronic illnesses. The patient's sister has PCOS.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are a couple of potential diagnoses that could explain your anxiety, panic attacks, and suspected hormonal imbalance:

  1. Generalized Anxiety Disorder (GAD):

    • Rationale: Your frequent panic attacks, negative thoughts, and stress related to work are consistent with GAD. This condition often involves excessive worry and anxiety that can interfere with daily activities.
    • Typical Treatments: Treatment usually involves a combination of therapy (such as cognitive-behavioral therapy), medications (like SSRIs or benzodiazepines), and lifestyle changes.
  2. Polycystic Ovary Syndrome (PCOS):

    • Rationale: Your irregular periods, unusual tiredness, changes in appetite, and abnormal hair growth are symptoms commonly associated with PCOS. Given your family history (your sister has PCOS), this is a strong possibility.
    • Typical Treatments: Treatment may include lifestyle changes (diet and exercise), medications to regulate menstrual cycles (like birth control pills), and medications to manage symptoms like hair growth (such as anti-androgens).

What you can do

Anxiety and Panic Attacks

  • Seek Professional Help: Consult a mental health professional for a proper diagnosis and treatment plan. Therapy and medications can be very effective.
  • Practice Relaxation Techniques: Techniques such as deep breathing, meditation, and progressive muscle relaxation can help manage anxiety.
  • Stay Active: Regular physical activity can help reduce anxiety and improve your mood.
  • Avoid Caffeine and Alcohol: These can exacerbate anxiety symptoms.

Suspected Hormonal Imbalance (Possible PCOS)

  • Consult a Healthcare Provider: It's important to see a doctor for a proper diagnosis. They may perform blood tests and an ultrasound to check for PCOS.
  • Maintain a Healthy Diet: A balanced diet can help manage symptoms. Focus on whole foods, lean proteins, and plenty of fruits and vegetables.
  • Exercise Regularly: Regular physical activity can help regulate your menstrual cycle and improve overall health.
  • Track Your Symptoms: Use MDandMe to journal your symptoms, track progress, and share your notes with your healthcare provider.

What you should look out for

  • Worsening Symptoms: If your anxiety or panic attacks become more frequent or severe, seek medical attention promptly.
  • New Symptoms: If you notice new symptoms such as unexplained weight gain, severe fatigue, or significant changes in your menstrual cycle, consult your healthcare provider.
  • Mental Health Crisis: If you experience thoughts of self-harm or suicide, seek immediate help from a mental health professional or go to the nearest emergency room.

Remember, while I can provide information and suggestions, it's crucial to consult with a healthcare professional for a formal diagnosis and treatment plan. If you have more questions or need further assistance, feel free to continue the conversation.

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4 mo ago


People Also Ask


What are the common symptoms of Generalized Anxiety Disorder (GAD)?

Common symptoms of GAD include excessive worry, restlessness, fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbances. These symptoms can interfere with daily activities and are often persistent.


How is Polycystic Ovary Syndrome (PCOS) diagnosed?

PCOS is typically diagnosed through a combination of medical history, physical examination, blood tests to check hormone levels, and an ultrasound to look for cysts on the ovaries. A healthcare provider will also consider symptoms like irregular periods and abnormal hair growth.


Can hormonal imbalances cause anxiety and panic attacks?

Yes, hormonal imbalances can contribute to anxiety and panic attacks. Hormones like cortisol, estrogen, and progesterone can affect mood and stress levels. Conditions like PCOS, which involve hormonal imbalances, can also be linked to increased anxiety.


What lifestyle changes can help manage symptoms of PCOS?

Lifestyle changes that can help manage PCOS symptoms include maintaining a healthy diet rich in whole foods, lean proteins, and vegetables, engaging in regular physical activity, managing stress through relaxation techniques, and maintaining a healthy weight. These changes can help regulate menstrual cycles and improve overall health.

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