[29F] With swollen lymph nodes, fatigue, and facial pressure

Patient Description

A 29-year-old female presents with sudden onset of facial pressure for the past four days, relieved by sleeping. She reports swollen lymph nodes in the neck or armpits, which are not tender or painful. The patient also experiences fatigue and has missed her period for two weeks, with a negative pregnancy test. She has seasonal allergies, nasal congestion, and changes in her sense of smell. No recent travel or exposure to illness, and no family history of autoimmune or hormonal disorders. She is not on prescription medications but has taken DayQuil once daily for the last two days. No known medication allergies.

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Arora's Assessment

What might be happening

Your symptoms could be related to a few different conditions:

  1. Sinusitis: The pressure in your face, nasal congestion, and changes in your sense of smell could be due to sinusitis, which is often linked to allergies. This can cause facial pressure and fatigue.

  2. Lymphadenopathy: Swollen lymph nodes can occur with infections or inflammation, possibly related to your sinus issues or allergies.

  3. Hormonal Imbalance: A missed period with a negative pregnancy test might suggest a hormonal imbalance, which can also contribute to fatigue.

Typical treatments might include decongestants or antihistamines for sinusitis and allergies. If symptoms persist, a healthcare provider might recommend further testing or imaging.

What you can do

For facial pressure and congestion:

  • Use a saline nasal spray to help clear your nasal passages.
  • Consider over-the-counter antihistamines to manage allergy symptoms.
  • Stay hydrated and use a humidifier to keep your airways moist.

For swollen lymph nodes:

  • Monitor the size and tenderness. If they persist or worsen, consult a healthcare provider.

For missed period and fatigue:

  • Track your menstrual cycle and any other symptoms using MDandMe to share with your provider.
  • Ensure you’re getting enough rest and managing stress.

What you should look out for

Seek medical attention if you experience:

  • Persistent or worsening symptoms.
  • Fever or chills that don't improve.
  • Significant changes in your menstrual cycle or new symptoms.

Remember, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan.

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7 mo ago

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People Also Ask


What are the common causes of facial pressure and how can it be relieved?

Facial pressure is often caused by sinusitis, allergies, or infections. Relief can be found through decongestants, antihistamines, saline nasal sprays, and staying hydrated.


Why might lymph nodes become swollen without being tender or painful?

Swollen lymph nodes can occur due to infections, inflammation, or allergies. They may not always be tender or painful, especially if the underlying cause is mild or non-infectious.


What could cause a missed period with a negative pregnancy test?

A missed period with a negative pregnancy test can be due to stress, hormonal imbalances, changes in weight, or thyroid issues. It's important to track your cycle and consult a healthcare provider if irregularities persist.


How can seasonal allergies affect the sense of smell?

Seasonal allergies can cause inflammation and congestion in the nasal passages, which can affect the olfactory system and lead to changes in the sense of smell.


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