[24F] With amenorrhea, cramps, and hirsutism

Patient Description

A 24-year-old female reports missing her period for 76 days, which is unusual as her cycles are typically regular, occurring every 28-35 days and lasting 5-7 days. She experiences uterine cramps rated 3/10 in severity, with no specific triggers or relief. Additional symptoms include excess facial hair and oily skin, necessitating more frequent washing. The patient has gained 7 pounds and reports increased stress levels. A recent pregnancy test was negative. Family history includes ovarian cancer and other uterine issues. No pre-existing conditions are noted. The patient was taking Lexapro, 10mg daily, until about a month ago.

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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 common hormonal disorder that can cause irregular periods, excess facial hair, oily skin, and weight gain. Stress can also exacerbate symptoms. Diagnosis typically involves a physical exam, blood tests to check hormone levels, and possibly an ultrasound.

    • Treatment may include lifestyle changes, such as diet and exercise, and medications to regulate your menstrual cycle and manage symptoms.
  • Hormonal Imbalance: Stopping Lexapro or stress can sometimes lead to hormonal changes, affecting your menstrual cycle and skin.

    • Treatment might involve managing stress and monitoring symptoms over time.
  • Thyroid Issues: Conditions like hypothyroidism can cause weight gain, menstrual irregularities, and skin changes.

    • Diagnosis involves blood tests to check thyroid function, and treatment usually includes medication.

What you can do

  1. Consult a Healthcare Provider: It's important to see a doctor for a formal diagnosis and to discuss your symptoms and family history.
  2. Track Your Symptoms: Use MDandMe to journal your symptoms, track any changes, and share this information with your healthcare provider.
  3. Manage Stress: Consider stress-reduction techniques such as yoga, meditation, or counseling.
  4. Healthy Lifestyle: Maintain a balanced diet and regular exercise to help manage weight and improve overall well-being.

What you should look out for

  • Seek Medical Attention If:
    • Your symptoms worsen or new symptoms develop.
    • You experience severe pain or any unusual bleeding.
    • You have concerns about your family history of ovarian or uterine issues.

Remember, this information is not a substitute for professional medical advice. Please consult a healthcare provider for a thorough evaluation.

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3 mo ago

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People Also Ask


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

Common symptoms of PCOS include irregular periods, excess facial or body hair, acne or oily skin, weight gain, and sometimes difficulty getting pregnant. It can also cause thinning hair on the scalp and darkening of the skin in certain areas.


Can stopping Lexapro affect my menstrual cycle?

Yes, stopping Lexapro, an antidepressant, can lead to changes in your body's hormone levels, which might affect your menstrual cycle. It's important to monitor any changes and discuss them with your healthcare provider.


How can stress impact my menstrual health?

Stress can impact your menstrual health by causing hormonal imbalances, which may lead to irregular periods, increased cramps, and other symptoms like acne or weight changes. Managing stress through relaxation techniques can help mitigate these effects.


What are the signs of thyroid issues that I should be aware of?

Signs of thyroid issues can include unexplained weight gain or loss, fatigue, changes in menstrual cycle, dry skin, hair loss, and sensitivity to cold or heat. If you suspect thyroid problems, a blood test can help diagnose the condition.


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