[33F] With chronic headaches and hormonal symptoms
Patient Description
A 33-year-old female reports chronic headaches on the front left side of her head, occurring at least four days a week and lasting for weeks. The pain is rated as 7 out of 10 and is exacerbated by stress, with some relief from clonazepam. Other treatments like sumatriptan, acupuncture, tizanidine, and migraine medications have been tried with limited success. The patient also experiences mood swings, depression, low libido, and irregular heavy periods since starting progesterone birth control (Slynd). Weight gain has been noted since the periods became irregular. Bloating and gas occur after consuming gluten, persisting for five years, but without changes in stool. A pituitary cyst was diagnosed two years ago. The patient has no known drug allergies and is not currently taking any medications.
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Arora's Assessment
What might be happening
Your symptoms could be related to several underlying issues:
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Hormonal Imbalance:
- The combination of low progesterone and high DHEA levels, along with irregular periods and mood swings, suggests a hormonal imbalance. This could be related to your pituitary cyst, which can affect hormone production.
- Typical treatments might include hormone therapy or medications to balance hormone levels. Your doctor might also recommend further testing to assess your hormone levels more comprehensively.
-
Migraine or Tension Headaches:
- Chronic headaches, especially those that worsen with stress, could be migraines or tension headaches. These can be influenced by hormonal changes.
- Treatment often involves medications like triptans, lifestyle changes, and stress management techniques.
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Gluten Sensitivity or Intolerance:
- Bloating and gas after consuming gluten may indicate gluten sensitivity or intolerance.
- A gluten-free diet can help alleviate these symptoms. Your doctor might suggest testing for celiac disease to rule it out.
What you can do
Headaches:
- Continue using prescribed medications like sumatriptan as directed by your doctor.
- Practice stress-reduction techniques such as meditation or yoga.
- Keep a headache diary using MDandMe to track triggers and patterns.
Hormonal Imbalance:
- Follow up with your healthcare provider for hormone level assessments.
- Discuss the possibility of adjusting your birth control or exploring other hormonal treatments.
Bloating and Gas:
- Try eliminating gluten from your diet to see if symptoms improve.
- Consider consulting a nutritionist for guidance on a balanced gluten-free diet.
Mood Swings and Depression:
- Seek support from a mental health professional for therapy or counseling.
- Engage in regular physical activity, which can help improve mood.
What you should look out for
- Worsening headaches or new neurological symptoms like vision changes or dizziness.
- Significant changes in menstrual patterns or severe pelvic pain.
- Persistent or severe mood changes impacting daily life.
Remember, it's important to consult with a healthcare professional for a formal diagnosis and personalized treatment plan.
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2 mo ago