[25F] Experiencing headache, back pain, and prolonged vaginal bleeding

Patient Description

A 25-year-old female presents with a consistent headache primarily above the eyebrows, worse on the left side, rated 6/10 for severity, and accompanied by brief moments of dizziness and increased pain. She also reports lower left back pain near the spine, abdominal cramping with a severity of 4/10, and nausea. The patient has been experiencing a vaginal bleed for 14 days, which is atypical as she has been amenorrheic since starting Depo-Provera in 2021. Additionally, she notes an increase in vaginal discharge with an unpleasant odor but no discomfort during intercourse. She has not taken her prescribed Fluoxetine 20mg daily for the past month. No known allergies, pre-existing conditions, or recent changes in sexual partners are reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible explanations for your symptoms include:

  • Hormonal Imbalance: Depo-Provera, a contraceptive injection, can cause changes in menstrual bleeding patterns, headaches, and mood changes. The hormonal changes can also cause nausea and abdominal cramping.

    • Treatment typically involves managing symptoms and may involve changing to a different form of contraception if symptoms are severe or persistent.

  • Pelvic Inflammatory Disease (PID): This is an infection of the female reproductive organs, often related to sexually transmitted infections. It can cause lower abdominal pain, irregular menstrual bleeding, and changes in vaginal discharge. However, you've mentioned no new sexual partners or exposure to sexually transmitted infections.

    • Treatment usually involves antibiotics to clear the infection.

  • Endometriosis: This is a condition where tissue similar to the lining of the uterus grows outside of the uterus, causing pain and irregular bleeding. It can also cause back pain and nausea.

    • Treatment often involves hormonal therapies or surgery in severe cases.

  • Migraine: Your description of a severe, localized headache could be consistent with a migraine, especially given the associated dizziness.

    • Treatment typically involves medication to relieve symptoms and prevent future attacks.

What you can do

  1. Schedule an appointment with your healthcare provider to discuss your symptoms. They may want to perform a physical examination or order tests such as blood tests, ultrasound, or CT scan to help determine the cause of your symptoms.
  2. Keep a symptom diary. Note down when each of your symptoms occur, their severity, and any potential triggers. This can help your healthcare provider identify patterns and make a diagnosis.
  3. Stay hydrated and maintain a balanced diet. This can help manage your symptoms and promote overall health.
  4. Over-the-counter pain relievers may help manage your headache and abdominal pain. However, you should consult with a healthcare provider before starting any new medication.

What you should look out for

Seek immediate medical attention if:

  • Your pain becomes severe or unbearable
  • You develop a fever or other signs of infection such as chills or a rapid heartbeat
  • Your vaginal bleeding becomes heavy or is accompanied by large clots
  • You experience sudden or severe dizziness, or fainting

Please note that while I strive to provide accurate and helpful health information, I am an AI and not a doctor. Always consult with a healthcare provider for a formal diagnosis and treatment.

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9 mo ago

People Also Ask

Can Depo-Provera cause prolonged vaginal bleeding and other symptoms like headaches and nausea?

Yes, Depo-Provera can cause changes in menstrual bleeding patterns, including prolonged bleeding, as well as headaches and nausea due to hormonal changes. If these symptoms are severe or persistent, it may be necessary to discuss alternative contraceptive options with a healthcare provider.

What are the common symptoms and treatment options for Pelvic Inflammatory Disease (PID)?

Common symptoms of PID include lower abdominal pain, irregular menstrual bleeding, and changes in vaginal discharge. Treatment typically involves antibiotics to clear the infection. It's important to seek medical attention for a proper diagnosis and treatment plan.

How can I differentiate between a migraine and a regular headache?

Migraines are often more severe than regular headaches and can be accompanied by symptoms such as nausea, dizziness, and sensitivity to light and sound. They are usually localized to one side of the head. A healthcare provider can help diagnose and differentiate between the two.

What are the potential side effects of not taking prescribed Fluoxetine for a month?

Not taking prescribed Fluoxetine, an antidepressant, can lead to withdrawal symptoms such as mood changes, irritability, dizziness, and headaches. It's important to consult with a healthcare provider before stopping or restarting the medication to manage these effects safely.

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