[24F] With missed period, headaches, nausea, and cramps

Patient Description

A 24-year-old female reports that her period is a month late, which is unusual for her as she has not experienced menstrual irregularities before. She has been experiencing headaches, nausea, and cramps for the past week. The nausea is triggered by the smell and taste of alcohol, and she has not found any relief. The headaches are throbbing in nature and rated as a 7 out of 10 in intensity. Additionally, she has noticed some fatigue, acne, and constipation recently. She has not experienced any unusual hair growth, significant stress, lifestyle changes, or changes in her diet or exercise routine. She has not started or stopped any medications recently, nor has she been exposed to new environments or substances. She has a history of IBS and anxiety, diagnosed at the age of 10, and is allergic to penicillin. Currently, she is not 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:

  • Hormonal Imbalance: Hormonal imbalances can cause a variety of symptoms, including missed periods, headaches, nausea, acne, and constipation. Conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders can lead to these symptoms.

    • Typical Treatments: Treatment may involve hormonal therapies, lifestyle changes, and medications to manage specific symptoms. Blood tests to check hormone levels are often part of the diagnostic process.
  • Stress and Anxiety: Even if you haven't noticed significant stress, underlying anxiety can sometimes manifest physically, affecting your menstrual cycle and causing headaches, nausea, and other symptoms.

    • Typical Treatments: Managing stress and anxiety through therapy, relaxation techniques, and sometimes medication can help alleviate these symptoms.
  • Gastrointestinal Issues: Given your history of IBS, gastrointestinal issues could be contributing to your nausea and constipation. IBS can sometimes be exacerbated by stress or dietary changes, even if they are subtle.

    • Typical Treatments: Dietary adjustments, stress management, and medications to manage IBS symptoms can be helpful. Keeping a food diary to identify triggers can also be beneficial.
  • Nutritional Deficiencies: Deficiencies in certain vitamins and minerals can lead to symptoms like fatigue, headaches, and menstrual irregularities.

    • Typical Treatments: Blood tests to check for deficiencies and dietary supplements or changes to address any deficiencies found.

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. Track Your Symptoms: Use MDandMe to journal your symptoms, track your menstrual cycle, and note any potential triggers or patterns. This information can be very helpful for your healthcare provider.
  2. Maintain a Balanced Diet: Ensure you are eating a nutritious diet rich in fruits, vegetables, whole grains, and lean proteins. This can help manage IBS symptoms and support overall health.
  3. Stay Hydrated: Drink plenty of water to help with constipation and overall well-being.
  4. Manage Stress: Practice relaxation techniques such as deep breathing, meditation, or yoga to help manage anxiety and stress.
  5. Avoid Triggers: Since alcohol seems to trigger your nausea, try to avoid it and any other known triggers.
  6. Over-the-Counter Remedies: For headaches and cramps, over-the-counter pain relievers like ibuprofen or acetaminophen may provide relief. Always follow the dosage instructions on the label.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe or Worsening Symptoms: If your headaches, nausea, or other symptoms become more severe or do not improve with self-care measures.
  • New or Unusual Symptoms: If you develop new symptoms such as severe abdominal pain, dizziness, or unusual bleeding.
  • Signs of Infection: If you develop a fever, chills, or other signs of infection.
  • Persistent Missed Periods: If your period continues to be irregular or absent for several months.

Remember, while this advice can help you manage your symptoms, it is not a substitute for professional medical care. Please consult a healthcare provider for a thorough evaluation and personalized treatment plan.

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3 mo ago


People Also Ask


What could cause a missed period besides pregnancy?

A missed period can be caused by various factors including hormonal imbalances, stress, significant weight changes, excessive exercise, thyroid disorders, and certain medications. It's important to consult a healthcare provider to determine the underlying cause.


How can hormonal imbalances affect my health?

Hormonal imbalances can lead to a range of symptoms such as irregular menstrual cycles, acne, weight gain, fatigue, mood swings, and headaches. Conditions like PCOS or thyroid disorders are common causes. Treatment often involves lifestyle changes, medications, and sometimes hormone therapy.


What are some common symptoms of IBS and how can they be managed?

Common symptoms of IBS include abdominal pain, bloating, gas, diarrhea, and constipation. Management strategies include dietary changes, stress management, and medications to relieve specific symptoms. Keeping a food diary can help identify triggers.


How can stress and anxiety impact physical health?

Stress and anxiety can manifest physically, leading to symptoms such as headaches, nausea, fatigue, and even menstrual irregularities. Managing stress through relaxation techniques, therapy, and sometimes medication can help alleviate these symptoms.


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