[31F] With prolonged menstrual bleeding and abdominal pain

Patient Description

A 31-year-old female presents with lower right abdominal pain, which is sharp during intercourse and urination, and a dull ache radiating down the leg when sitting, standing, or lying down. She reports having been on her period for approximately two months with moderate to heavy bleeding daily. Accompanying symptoms include bloating, nausea, loose stools for several weeks, frequent urination, chills, and exhaustion despite adequate sleep. The pain developed gradually and is rated as a 6 out of 10 in severity. She has experienced pain and burning during urination but no blood in the urine. There is no unusual vaginal discharge or lower back pain. The patient is sexually active and uses protection. She has no family history of reproductive health issues and has not started any new medications or supplements recently. There have been no recent infections, illnesses, or diagnostic tests performed.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are a few potential conditions that could be contributing to your discomfort:

  1. Endometriosis or Ovarian Cysts: The prolonged menstrual bleeding, lower right abdominal pain, and pain during intercourse could be indicative of endometriosis or ovarian cysts. These conditions can cause hormonal imbalances and lead to symptoms like bloating, nausea, and fatigue. An ultrasound or pelvic exam is often used to diagnose these conditions.

  2. Urinary Tract Infection (UTI): The frequent urination, pain during urination, and chills suggest a possible UTI. UTIs can cause abdominal pain and fatigue. A urinalysis can confirm this diagnosis, and antibiotics are typically prescribed for treatment.

  3. Irritable Bowel Syndrome (IBS) or Gastrointestinal Issues: The loose stools, bloating, and nausea could be related to IBS or another gastrointestinal condition. These can be exacerbated by stress or dietary factors. A healthcare provider might recommend dietary changes or medications to manage symptoms.

  4. Pelvic Inflammatory Disease (PID): Although less likely given the lack of unusual discharge, PID can cause abdominal pain, prolonged bleeding, and pain during intercourse. It often requires antibiotics for treatment.

What you can do

Abdominal Pain and Menstrual Irregularities:

  • Schedule an appointment with a healthcare provider to discuss your symptoms and consider an ultrasound or pelvic exam.
  • Keep a journal of your symptoms, including pain levels, bleeding patterns, and any other changes, using MDandMe to track your progress and share with your provider.

Frequent Urination and Pain:

  • Drink plenty of water to help flush out your urinary system.
  • Avoid irritants like caffeine and alcohol, which can exacerbate urinary symptoms.
  • Consider seeing a healthcare provider for a urinalysis to rule out a UTI.

Bloating, Nausea, and Loose Stools:

  • Try to identify any dietary triggers that may worsen your symptoms and avoid them.
  • Eat smaller, more frequent meals to help manage bloating and nausea.
  • Consider over-the-counter medications for symptom relief, but consult with a healthcare provider for persistent issues.

Fatigue:

  • Ensure you are getting adequate rest and managing stress, as these can impact your energy levels.
  • Maintain a balanced diet and stay hydrated to support overall health.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe abdominal pain or pain that suddenly worsens
  • High fever or persistent chills
  • Blood in your urine or stool
  • Fainting or severe dizziness
  • Unexplained weight loss

Remember, while this information can help guide you, it's important to consult with a healthcare professional for a formal diagnosis and appropriate treatment.

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1 mo ago

People Also Ask

What are the common symptoms of endometriosis or ovarian cysts?

Common symptoms of endometriosis or ovarian cysts include prolonged menstrual bleeding, pelvic pain, pain during intercourse, bloating, nausea, and fatigue. Diagnosis often involves an ultrasound or pelvic exam.

How can a urinary tract infection (UTI) be diagnosed and treated?

A UTI can be diagnosed with a urinalysis, which tests for bacteria and white blood cells in the urine. Treatment typically involves antibiotics prescribed by a healthcare provider.

What dietary changes can help manage symptoms of irritable bowel syndrome (IBS)?

To manage IBS symptoms, it is often recommended to avoid trigger foods such as caffeine, alcohol, and high-fat foods. Eating smaller, more frequent meals and increasing fiber intake can also help.

When should someone seek medical attention for abdominal pain and menstrual irregularities?

Medical attention should be sought if there is severe abdominal pain, pain that suddenly worsens, high fever, persistent chills, blood in urine or stool, fainting, or unexplained weight loss.

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