[22O] With low appetite, pelvic pain, and missed periods

Patient Description

A 22-year-old individual, assigned female at birth, has been experiencing a gradual onset of low appetite over the past month and a half, accompanied by a few pounds of weight loss. The patient also reports dull, crampy pelvic pain localized towards the sides, rated at a 4 out of 10 in severity, and has missed the last two menstrual cycles. The patient has a history of polycystic ovarian syndrome (PCOS) but notes no worsening of PCOS-related symptoms. The patient recently discontinued birth control approximately two months ago, which may have influenced hormonal balance. Additionally, the patient reports a consistently low mood but no significant changes in sleep patterns, diet, or recent stressors beyond the usual college-related stress. The patient is currently taking a daily multivitamin, myo-inositol, and Naproxen Sodium as needed for pain relief. No known allergies.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possibilities that might explain your symptoms:

  • Polycystic Ovarian Syndrome (PCOS) Related Changes: Since you have a history of PCOS, it's possible that your symptoms of low appetite, missed periods, and pelvic pain are related to this condition. PCOS can cause hormonal imbalances that affect your menstrual cycle and appetite. The recent discontinuation of birth control might have also influenced these symptoms, as hormonal changes can occur when stopping such medications.

  • Nutritional or Stress-Related Factors: Given your college environment, stress and dietary changes could also contribute to a low appetite and mood changes. Stress can impact your appetite and overall well-being, and it's important to consider how lifestyle factors might be playing a role.

While these are common explanations, it's important to rule out other potential causes. If your symptoms persist or worsen, it would be a good idea to consult with a healthcare professional to ensure there are no other underlying issues. They can provide a more comprehensive evaluation and appropriate testing if needed.

What you can do

  1. Monitor Symptoms: Keep track of your symptoms, including any changes in appetite, pelvic pain, and menstrual cycle. Note any patterns or triggers that might be affecting your symptoms.

  2. Lifestyle Adjustments:

    • Diet: Ensure you're eating balanced meals, even if your appetite is low. Small, frequent meals might be easier to manage.
    • Stress Management: Incorporate stress-reducing activities into your routine, such as exercise, meditation, or hobbies you enjoy.
    • Sleep: Maintain a regular sleep schedule to support your overall well-being.
  3. Symptom Relief:

    • For pelvic pain, continue using Naproxen Sodium as needed, following the recommended dosage.
    • Consider using a heating pad on your lower abdomen to help alleviate crampy pain.
  4. Evaluate the Need for Medical Attention:

    • If your symptoms persist, worsen, or significantly impact your daily life, consider scheduling an appointment with a healthcare professional.
    • Prepare a list of your symptoms, medical history, and any questions you have for the doctor.
  5. Follow-Up:

    • Reassess your symptoms in a few weeks to determine if there's any improvement or if further action is needed.
  6. Use MDandMe: Utilize the MDandMe app to journal your symptoms, track your progress, and gain insights. This can be a helpful tool to share longitudinal medical notes with your healthcare provider.

What you should look out for

  • Seek medical attention if you experience severe or worsening symptoms, such as intense pelvic pain, significant weight loss, or other concerning changes.
  • Monitor for new symptoms that could indicate other underlying issues, such as changes in skin condition, hair growth, or energy levels.
  • Stay informed about your condition and any potential changes in your health, and don't hesitate to reach out to a healthcare professional if you have concerns.

Remember, while I can provide guidance, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan. If you have any more questions or need further assistance, feel free to ask!

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29 d ago

People Also Ask


Can discontinuing birth control affect my menstrual cycle and appetite?

Yes, discontinuing birth control can lead to hormonal changes that may affect your menstrual cycle and appetite. It can take some time for your body to adjust to the change in hormone levels.


How does PCOS influence symptoms like missed periods and pelvic pain?

PCOS can cause hormonal imbalances that lead to irregular menstrual cycles, missed periods, and pelvic pain. These symptoms are due to the presence of multiple cysts on the ovaries and the body's response to hormonal fluctuations.


What lifestyle changes can help manage low appetite and mood changes?

To manage low appetite and mood changes, try eating balanced meals, even if they're small and frequent. Incorporate stress-reducing activities like exercise or meditation into your routine, and maintain a regular sleep schedule.


When should I seek medical attention for my symptoms?

Seek medical attention if you experience severe or worsening symptoms, such as intense pelvic pain, significant weight loss, or other concerning changes. It's important to consult a healthcare professional if your symptoms persist or significantly impact your daily life.


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