[27F] Experiencing depressed mood and amenorrhea

Patient Description

A 27-year-old female reports a significant depressed mood that is present nearly every day and has been ongoing for approximately 8 months. The patient indicates that the mood changes began following her divorce 2 years ago and have been exacerbated since she experienced amenorrhea 4 months ago. The patient describes feelings of sadness, hopelessness, and a general down mood without any identified alleviating factors. The patient's menstrual irregularity began 8 months ago and has progressed to a complete loss of menstrual periods. She is not currently pregnant and reports high levels of stress. No other symptoms or health conditions were disclosed during the encounter.

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Arora's Assessment

What might be happening

Based on your symptoms, here are a few possible conditions:

  • Major Depressive Disorder (MDD): This is characterized by a persistent and pervasive low mood that is accompanied by low self-esteem and a loss of interest or pleasure in activities that you once found enjoyable. The symptoms you've described, such as feeling sad, hopeless, and crying frequently, are common in MDD.

    • Treatment typically involves a combination of medication, psychotherapy, and lifestyle changes.
  • Premenstrual Dysphoric Disorder (PMDD): This is a severe form of premenstrual syndrome that can cause physical and behavioral symptoms, including mood swings, depression, irritability, and difficulty concentrating. The timing of your symptoms may be related to your menstrual cycle.

    • Treatment can include hormonal birth control, antidepressants, dietary changes, and stress management techniques.
  • Hypothalamic Amenorrhea: This is a condition in which menstruation stops for several months due to problems involving the hypothalamus. Chronic stress, weight loss, and excessive exercise are a few causes. The loss of menstrual periods is the main symptom.

    • Treatment usually involves lifestyle changes to reduce stress and achieve a healthy weight.

What you can do

  1. Reach out to a healthcare provider: It's important to discuss your symptoms with a healthcare provider. They can provide a formal diagnosis and treatment plan.

  2. Seek support: Reach out to trusted friends, family members, or a mental health professional. They can provide emotional support and help you navigate your feelings.

  3. Practice self-care: Try to eat a balanced diet, get regular physical activity, and ensure you're getting enough sleep. These can all impact your mood and energy levels.

  4. Consider therapy: Cognitive-behavioral therapy (CBT) and other forms of therapy can be very effective for managing depression.

What you should look out for

If your symptoms worsen or you start to have thoughts of suicide, it's crucial to seek help immediately. You can reach out to a mental health professional or a trusted person in your life. Remember, it's okay to ask for help, and there are resources available to you.

Please note that this advice is intended to be general in nature, and specific causes may not apply to your personal situation. Always consult with a healthcare provider for accurate information.

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11 mo ago

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People Also Ask


What are the common symptoms of Major Depressive Disorder (MDD)?

Common symptoms of Major Depressive Disorder include persistent sadness, loss of interest in activities, changes in appetite or weight, sleep disturbances, fatigue, feelings of worthlessness or guilt, difficulty concentrating, and thoughts of death or suicide.


How can stress affect menstrual cycles and lead to amenorrhea?

Stress can affect the hypothalamus, which regulates hormones that control the menstrual cycle. High levels of stress can lead to hormonal imbalances, resulting in irregular periods or amenorrhea (absence of menstruation).


What treatment options are available for Premenstrual Dysphoric Disorder (PMDD)?

Treatment options for PMDD include hormonal birth control to regulate menstrual cycles, antidepressants to manage mood symptoms, dietary changes to reduce symptoms, and stress management techniques such as exercise and relaxation practices.


How can lifestyle changes help in managing hypothalamic amenorrhea?

Lifestyle changes such as reducing stress, maintaining a healthy weight, and ensuring adequate nutrition can help restore normal menstrual cycles in cases of hypothalamic amenorrhea. It's important to address any underlying stressors and seek guidance from a healthcare provider.


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