[21F] With irregular periods, prolonged bleeding, and associated symptoms

Patient Description

A 21-year-old female has been experiencing irregular periods for the past six months. Her menstrual cycle, previously 45 days, now involves missing periods for two months followed by prolonged bleeding lasting 15-20 days, and currently more than 20 days. She reports no abdominal cramps or pain during this time. Additionally, she has noticed an increase in weight and difficulty losing it. She is experiencing hair loss on the sides of her head for the past two months, to the extent that she can see her scalp lines when tying her ponytail. She has also been dealing with acne for the last six months, which has spread from her face to her back and chest. Applying products tends to worsen her acne. She also reports constipation and darkening of the skin around her neck and underarms. There is no increased thirst or urination, no pre-existing conditions or chronic illnesses, and she is not currently taking any medications.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Polycystic Ovary Syndrome (PCOS): PCOS is a common hormonal disorder among women of reproductive age. It can cause irregular menstrual cycles, prolonged periods, weight gain, hair loss, acne, and darkening of the skin. The symptoms you described, such as irregular periods, prolonged bleeding, weight gain, hair loss, acne, and skin darkening, are consistent with PCOS.

    • Typical Treatments: Treatment for PCOS often involves lifestyle changes such as diet and exercise, medications to regulate menstrual cycles, and treatments for symptoms like acne and hair loss. Hormonal birth control is commonly prescribed to help regulate periods.
  • Hypothyroidism: An underactive thyroid can lead to symptoms like irregular periods, weight gain, hair loss, and constipation. While you haven't mentioned fatigue or cold intolerance, these are also common symptoms of hypothyroidism.

    • Typical Treatments: Hypothyroidism is typically treated with thyroid hormone replacement therapy. Blood tests are used to diagnose this condition.
  • Hormonal Imbalance: Various hormonal imbalances can cause irregular periods, prolonged bleeding, weight gain, hair loss, and acne. This can be due to stress, changes in diet, or other underlying health conditions.

    • Typical Treatments: Treatment depends on the underlying cause but may include lifestyle changes, medications, or hormone therapy.

What you can do

While it's important to consult a healthcare provider for a formal diagnosis and treatment plan, here are some steps you can take in the meantime:

  1. Maintain a Healthy Diet: Focus on a balanced diet rich in fruits, vegetables, lean proteins, and whole grains. Reducing junk food and sugary snacks can help manage weight and improve overall health.
  2. Exercise Regularly: Incorporate regular physical activity into your routine. Even moderate exercise can help regulate your menstrual cycle and manage weight.
  3. Track Your Symptoms: Use MDandMe to journal your symptoms, track your menstrual cycle, and note any changes in your health. This information can be valuable for your healthcare provider.
  4. Manage Stress: Practice stress-reducing techniques such as yoga, meditation, or deep breathing exercises. Stress can impact your hormonal balance and menstrual cycle.
  5. Avoid Harsh Hair and Skin Products: Use gentle, non-comedogenic products for your skin and hair. Avoid products that worsen your acne or hair loss.

What you should look out for

It's important to seek medical attention if you experience any of the following:

  • Severe or Sudden Symptoms: If you develop severe abdominal pain, heavy bleeding that soaks through a pad or tampon every hour, or any other sudden, severe symptoms, seek medical attention immediately.
  • Persistent Symptoms: If your symptoms persist or worsen despite lifestyle changes, consult a healthcare provider for further evaluation.
  • Additional Symptoms: If you notice new symptoms such as fatigue, cold intolerance, or significant changes in your health, inform your healthcare provider.

Remember, while this information can help guide you, it's essential to consult a healthcare professional for a formal diagnosis and appropriate treatment.

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4 mo ago


People Also Ask


What are the common symptoms of Polycystic Ovary Syndrome (PCOS)?

Common symptoms of PCOS include irregular menstrual cycles, prolonged periods, weight gain, hair loss, acne, and darkening of the skin. It is a hormonal disorder that affects women of reproductive age.


How is hypothyroidism diagnosed and treated?

Hypothyroidism is diagnosed through blood tests that measure levels of thyroid hormones. It is typically treated with thyroid hormone replacement therapy to restore normal hormone levels.


What lifestyle changes can help manage symptoms of hormonal imbalance?

Lifestyle changes that can help manage hormonal imbalance include maintaining a healthy diet, exercising regularly, managing stress, and avoiding harsh skin and hair products. These changes can help regulate menstrual cycles and improve overall health.


When should I seek medical attention for menstrual irregularities?

You should seek medical attention if you experience severe or sudden symptoms such as heavy bleeding, severe abdominal pain, or if your symptoms persist or worsen despite lifestyle changes. Additionally, if you notice new symptoms like fatigue or cold intolerance, consult a healthcare provider.

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