[28F] Experiencing a range of symptoms while trying to conceive

Patient Description

A 28-year-old female is experiencing a constellation of symptoms while trying to conceive. She reports constant fatigue for the past two weeks, which is alleviated by sleep. Additionally, she has been feeling bloated and occasionally dizzy, with a sensation similar to spinning that occurs when turning or sitting up, but it is not severe enough to interfere with daily activities. She has been dealing with heartburn for a week or two, described as a burning sensation in her chest that is not triggered by food or drink. The patient also experiences occasional constipation and diarrhea, along with headaches, TMJ pain, and hip pain. She notes that her breasts feel larger and has had vivid dreams recently. Her medical history includes an ectopic pregnancy and a missed miscarriage in the previous year. She has tested negative on a recent pregnancy test. She is currently taking prenatal vitamins and probiotics and has no known allergies or chronic conditions.

Arora's Assessment

What might be happening

Based on the information you've provided, there are several possibilities that could explain your symptoms:

Early Pregnancy: Although your pregnancy test was negative, it's possible that it was taken too early to detect a pregnancy. The symptoms you're experiencing such as fatigue, bloating, dizziness, occasional nausea, and larger breasts can be early signs of pregnancy.
Pre-Menstrual Syndrome (PMS): The symptoms you're experiencing can also be associated with PMS, which can occur in the days leading up to your menstrual period.
Gastroesophageal Reflux Disease (GERD): This is a condition where stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus and cause heartburn.
Anemia: This is a condition characterized by a lack of healthy red blood cells to carry adequate oxygen to your body's tissues. Fatigue is one of the most common symptoms of anemia.
Viral infection: Some of your symptoms like fatigue, dizziness, and occasional nausea can be caused by a viral infection.

Please remember that this is not a comprehensive list of all possible diagnoses and you should consult with a healthcare provider for a formal diagnosis.

What you can do

Retake a home pregnancy test: If you're trying to conceive and have been experiencing these symptoms, it might be worth taking another pregnancy test. The hormone hCG, which is detected by pregnancy tests, doubles approximately every 48 to 72 hours in early pregnancy.
Lifestyle modifications for GERD: If your heartburn continues, try avoiding foods and drinks that trigger heartburn such as fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine. Also, try to eat smaller meals and avoid lying down for at least two hours after a meal.
Stay hydrated and maintain a balanced diet: This can help with your fatigue and dizziness.
Over-the-counter treatments: For your heartburn, over-the-counter antacids may provide quick relief. But they can't heal an esophagus damaged by stomach acid.

What you should look out for

If your symptoms persist or worsen, or if you develop new symptoms, you should seek medical attention. In particular, if you experience severe abdominal pain, heavy vaginal bleeding, severe dizziness or fainting, or severe chest pain, you should seek immediate medical attention.

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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11 mo ago

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