[29F] Experiencing a Range of Symptoms Including Weight Gain and Migraines

Patient Description

A 29-year-old female has been experiencing a variety of symptoms over several years, including significant weight gain from 117 to 240 pounds over 12 years, and facial hair growth under the chin for the past 7 years. She reports migraines tied to eye strain and light sensitivity, rating the pain intensity as 4/10, with relief from laying down in dark, quiet spaces. Additionally, she has visual disturbances described as a small, blurry, or wavy area in the center of her vision, which occurred once four years ago. She has had back pain for as long as she can remember, describing it as achy with a severity of 3/10, located in the lower back near the tailbone or on the right side of the upper back between the spine and shoulder blade. The patient also reports fluctuating bowel habits, ranging from constipation to diarrhea since 2009, and hypermobility since birth. She has been diagnosed with ADHD and depression, for which she has been taking Bupropion HCL XL 300 and Mirtazapine 15 mg for just over a year and about 9 months, respectively, without significant side effects. The patient occasionally takes a women's multivitamin.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible conditions include:

  • Polycystic Ovary Syndrome (PCOS): This is a hormonal disorder common among women of reproductive age. Women with PCOS may have infrequent or prolonged menstrual periods or excess male hormone (androgen) levels. The ovaries may develop numerous small collections of fluid (follicles) and fail to regularly release eggs. Symptoms include weight gain, facial hair growth, and acne.

    • Treatment of PCOS may involve lifestyle modifications and medication to manage individual symptoms, such as birth control pills to regulate menstruation, medication for increased hair growth, and medications to manage other symptoms.
  • Hypothyroidism: This is a condition in which your thyroid gland doesn't produce enough of certain crucial hormones. Hypothyroidism may not cause noticeable symptoms in the early stages. Over time, untreated hypothyroidism can cause a number of health problems, such as obesity, joint pain, infertility and heart disease. Symptoms include fatigue, weight gain, constipation, increased sensitivity to cold, and depression.

    • Treatment typically involves daily use of the synthetic thyroid hormone levothyroxine, which restores adequate hormone levels and reverses the symptoms of hypothyroidism.
  • Migraines: Migraines are a type of headache characterized by intense pain and often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Migraine attacks can last for hours to days, and the pain can be so severe that it interferes with your daily activities.

    • Treatment is aimed at preventing a full-blown attack, and alleviating the symptoms that come with an attack. Lifestyle alterations might help reduce migraine frequency.
  • Orthostatic Hypotension: This is a form of low blood pressure that happens when you stand up from sitting or lying down. Orthostatic hypotension can make you feel dizzy or lightheaded, and maybe even faint.

    • Treatment of orthostatic hypotension is aimed at managing the underlying cause, if identifiable.

Please note that this is not an exhaustive list and these conditions may coexist. It's also possible that there could be different conditions that could explain your symptoms.

What you can do

It would be best to consult a doctor about your symptoms so that they can provide a formal assessment and order relevant tests if necessary. In the meantime, you can try the following to manage your symptoms:

  1. Maintain a healthy lifestyle: Regular exercise, a balanced diet, and adequate sleep can help manage many of your symptoms including weight gain, constipation, and fatigue.
  2. Stay Hydrated: This can help with managing constipation and low blood pressure.
  3. Manage stress: Stress can exacerbate many of your symptoms, including migraines and hormonal imbalances. Techniques such as yoga, meditation, and deep breathing can help manage stress levels.

What you should look out for

Reasons to see a doctor more urgently:

  • If your symptoms worsen or if you develop new symptoms
  • If you experience severe abdominal pain or heavy menstrual bleeding
  • If you experience severe headache, sudden numbness or weakness, difficulty speaking, or loss of balance or coordination

Please remember that while I strive to provide accurate information, I'm not a doctor and this advice should not replace a consultation with a healthcare professional.

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8 mo ago


People Also Ask


What are the common symptoms of Polycystic Ovary Syndrome (PCOS)?

Common symptoms of PCOS include irregular menstrual cycles, excessive hair growth (hirsutism), acne, weight gain, and sometimes difficulty with fertility. Women with PCOS may also experience mood changes and fatigue.


How is hypothyroidism typically treated?

Hypothyroidism is typically treated with a daily dose of synthetic thyroid hormone levothyroxine, which helps restore normal hormone levels and alleviates symptoms such as fatigue, weight gain, and depression.


What lifestyle changes can help manage migraines?

Lifestyle changes that can help manage migraines include maintaining a regular sleep schedule, staying hydrated, managing stress through techniques like yoga or meditation, avoiding known migraine triggers, and eating regular, balanced meals.


What are the potential causes of orthostatic hypotension?

Orthostatic hypotension can be caused by dehydration, prolonged bed rest, certain medications, or underlying health conditions such as heart problems or nervous system disorders. It is important to identify and manage the underlying cause to treat this condition effectively.


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2 Comments


Patricia#17104

7 mo ago

This sounds quite a bit like PCOS, especially the weight gain and facial hair growth. It can be associated with depression too. One of my friends has it. Have you even gotten a formal diagnosis?

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Anonymous#5646

7 mo ago

It doesn't seem to be that. Not only are my hormones right in the middle of normal ranges, but I also have short periods (longest being about 5 days usually) with minimal cramping. I also had no issues getting pregnant.

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