[24F] Experiencing abdominal pain and menstrual irregularities with PCOS

Patient Description

A 24-year-old female presents with constipation, extreme fatigue, cramping without menstruation, and severe abdominal and shoulder pain. The patient's last menstrual period started on October 2, 2023, and she has a history of irregular menstrual cycles since discontinuing birth control pills last year. The patient has been diagnosed with Polycystic Ovary Syndrome (PCOS) and is not currently on any medications. No known drug allergies. The patient also reports symptoms of depression. Over-the-counter Tylenol provides some relief during her menstrual cycle. There are no reports of dizziness, fainting spells, or vomiting.

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Arora's Assessment

What might be happening

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

  • Polycystic Ovary Syndrome (PCOS): This is a hormonal disorder common among women of reproductive age. Women with PCOS may have infrequent or prolonged menstrual periods or excess male hormone (androgen) levels. The ovaries may develop numerous small collections of fluid (follicles) and fail to regularly release eggs. The exact cause of PCOS is unknown.

    • Treatment of PCOS typically involves lifestyle modifications and medication to manage symptoms and prevent complications.
  • Pregnancy: Given your age, sex, and symptoms, it's possible that you could be pregnant. The symptoms of early pregnancy can vary greatly from person to person, but can include missed periods, fatigue, and abdominal cramping. Some women may also experience constipation and mood changes like depression.

    • If you suspect you might be pregnant, it would be a good idea to take a home pregnancy test. These are usually very accurate when used correctly.
  • Other Hormonal Imbalances: Your symptoms could also be due to other hormonal imbalances, such as thyroid disorders or adrenal disorders. These can cause a variety of symptoms including changes in menstrual cycle, fatigue, and mood changes.

    • Diagnosis of these conditions typically involves blood tests to measure hormone levels.

What you can do

  1. Take a home pregnancy test: If there's a chance you could be pregnant, taking a home pregnancy test would be a good first step. These are usually very accurate when used correctly.

  2. Consult a healthcare provider: Given your symptoms and medical history, it would be a good idea to consult a healthcare provider. They can provide a formal assessment and order relevant tests if necessary.

  3. Lifestyle modifications: Regular exercise, a healthy diet, and maintaining a healthy weight can help manage symptoms of PCOS and other hormonal imbalances.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • Severe abdominal pain
  • Heavy vaginal bleeding
  • Severe nausea or vomiting
  • Fainting or dizziness
  • Shortness of breath

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.

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11 mo ago

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

People Also Ask


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

Common symptoms of PCOS include irregular menstrual cycles, excess hair growth, acne, weight gain, and difficulty getting pregnant. Some women may also experience thinning hair and darkening of the skin.


Can irregular menstrual cycles affect the chances of pregnancy?

Yes, irregular menstrual cycles can affect the chances of pregnancy as they may indicate irregular ovulation. However, it is still possible to become pregnant with irregular cycles, so it's important to track ovulation and consult with a healthcare provider if trying to conceive.


What lifestyle changes can help manage PCOS symptoms?

Lifestyle changes that can help manage PCOS symptoms include maintaining a healthy weight, engaging in regular physical activity, eating a balanced diet rich in whole grains, fruits, and vegetables, and managing stress levels.


How can hormonal imbalances be diagnosed?

Hormonal imbalances can be diagnosed through blood tests that measure hormone levels, such as thyroid function tests, testosterone levels, and other relevant hormones. A healthcare provider may also consider symptoms and medical history in their assessment.


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