[24F] With menstrual irregularities and gastrointestinal symptoms

Patient Description

A 24-year-old female reports that her period is a week late. She stopped using birth control 8 months ago and has not had regular periods since. When she did have periods, they were very heavy. She has not experienced any significant weight changes, severe abdominal pain, dizziness, or severe headaches. However, she has been feeling nauseous, exhausted, and has had alternating runny bowel movements and constipation. She has not taken a pregnancy test yet. There is no personal or family history of thyroid problems or other hormonal disorders. She does not have any pre-existing conditions or chronic illnesses. The only medication she is currently taking is Venlafaxine at a dosage of 150mg daily, and she is not taking any other medications, supplements, or herbal remedies.

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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:

  • Pregnancy: Since you have been trying to conceive and your period is a week late, pregnancy is a possibility. Nausea, exhaustion, and changes in bowel movements can also be early signs of pregnancy.

    • Testing: A home pregnancy test can help determine if you are pregnant. These tests are widely available and can provide results quickly.
  • Post-Birth Control Adjustment: After stopping birth control, it can take several months for your menstrual cycle to regulate. The body needs time to adjust to the hormonal changes, which can result in irregular periods.

    • Monitoring: Keep track of your menstrual cycle and any symptoms you experience. This information can be helpful for your healthcare provider.
  • Hormonal Imbalance: Conditions such as Polycystic Ovary Syndrome (PCOS) or thyroid disorders can cause irregular periods, heavy bleeding, and gastrointestinal symptoms.

    • Testing: Blood tests to check hormone levels and thyroid function may be recommended by your doctor.
  • Stress and Lifestyle Factors: Stress, significant lifestyle changes, or changes in diet and exercise can impact your menstrual cycle.

    • Management: Try to manage stress through relaxation techniques, regular exercise, and a balanced diet.

What you can do

  1. Take a Pregnancy Test: Since you are trying to conceive and your period is late, taking a home pregnancy test can help determine if you are pregnant.
  2. Track Your Symptoms: Keep a detailed record of your menstrual cycle, symptoms, and any changes you notice. This information can be valuable for your healthcare provider.
  3. Maintain a Healthy Lifestyle: Ensure you are eating a balanced diet, staying hydrated, getting regular exercise, and managing stress.
  4. Consult a Healthcare Provider: Schedule an appointment with your doctor to discuss your symptoms and get a formal assessment. They may recommend further testing or provide guidance on managing your symptoms.

What you should look out for

  • Severe Abdominal Pain: If you experience severe abdominal pain, it could indicate a more serious condition that requires immediate medical attention.
  • Heavy or Prolonged Bleeding: If you notice unusually heavy or prolonged bleeding, consult your healthcare provider.
  • Persistent Nausea and Vomiting: If nausea and vomiting persist or worsen, seek medical advice.
  • Other Concerning Symptoms: If you develop new or worsening symptoms, such as fever, severe headaches, or significant changes in bowel movements, contact your healthcare provider.

Remember, while this information can be helpful, it is important to seek care from a real health professional to receive a formal diagnosis and appropriate treatment.

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6 mo ago


People Also Ask


Can stopping birth control cause irregular periods and other symptoms?

Yes, stopping birth control can lead to irregular periods as your body adjusts to the change in hormone levels. It may take several months for your menstrual cycle to regulate.


What are the early signs of pregnancy?

Early signs of pregnancy can include a missed period, nausea, fatigue, and changes in bowel movements. Taking a home pregnancy test can help confirm if you are pregnant.


How can stress and lifestyle changes affect my menstrual cycle?

Stress and lifestyle changes can impact your menstrual cycle by causing irregular periods or changes in flow. Managing stress through relaxation techniques, regular exercise, and a balanced diet can help.


What should I do if I suspect a hormonal imbalance?

If you suspect a hormonal imbalance, consult your healthcare provider. They may recommend blood tests to check hormone levels and thyroid function to determine the cause of your symptoms.


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