[33F] Experiencing irregular and heavy menstrual bleeding

Patient Description

A 33-year-old female presents with a history of irregular menstrual cycles, including a recent episode where she did not have a period for 2 months. When her period resumed at the end of January, it started light and then became very heavy, lasting over a week. She reported needing to change sanitary pads frequently, sometimes wearing three at a time, and passed large blood clots. Over the past year, she has experienced on-and-off irregularities with her menstrual cycle but does not track it consistently. She denies any dizziness, fainting, unusual hair growth, worsening acne, or intermenstrual bleeding. The patient feels depressed around her period, a long-standing issue, and sometimes experiences breast tenderness. She engages in social drinking but does not use tobacco or recreational drugs. There is no known family history of reproductive health conditions, no known allergies or adverse reactions to medications, and she is not currently taking any medications. The patient is overweight but maintains a workout routine and tries to eat healthily.

Arora's Assessment

What might be happening

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

Polycystic Ovary Syndrome (PCOS): This condition is characterized by irregular periods, heavy bleeding, and sometimes weight gain. It's caused by an imbalance in reproductive hormones, creating problems in the ovaries.
- Diagnosis usually involves blood tests to check your hormone levels and an ultrasound to look for cysts on your ovaries.
- Treatment typically involves lifestyle changes like diet and exercise, and sometimes medication to manage symptoms and prevent complications.
Hypothyroidism: This is a condition where the thyroid gland doesn't produce enough thyroid hormone. Symptoms can include fatigue, weight gain, and irregular periods.
- Diagnosis usually involves a simple blood test to check your thyroid hormone levels.
- Treatment typically involves taking a daily hormone replacement tablet.
Uterine fibroids: These are noncancerous growths in the uterus that can cause heavy or prolonged menstrual periods.
- Diagnosis usually involves a pelvic exam and ultrasound.
- Treatment can range from medication to manage symptoms to surgery to remove the fibroids.

What you can do

You should make an appointment with a healthcare provider to discuss your symptoms. They may want to perform some tests to help diagnose your condition. In the meantime, you can:

Keep a symptom diary: This can help you and your healthcare provider understand your symptoms better. Note down when your periods happen, how heavy they are, and any other symptoms you experience.
Maintain a healthy lifestyle: Regular exercise and a balanced diet can help manage many of the conditions that cause irregular periods.
Over-the-counter pain relievers: Non-prescription medications like ibuprofen can help manage pain associated with heavy periods.

What you should look out for

You should seek immediate medical attention if you:

Soak through one or more sanitary pads or tampons every hour for several consecutive hours
Need to use double sanitary protection to control your menstrual flow
Have menstrual periods lasting more than a week
Have a fever or chills
Notice an unexpected increase in your menstrual flow

Remember, I'm an AI and this advice is based on the information you've given me. It's always important to consult with a healthcare provider for an accurate diagnosis.

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10 mo ago

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[33F] Experiencing irregular and heavy menstrual bleeding

What might be happening

What you can do

What you should look out for

Experiencing symptoms?