[34F] Experiencing intermittent anal bleeding and hirsutism

Patient Description

A 34-year-old female reports experiencing intermittent anal bleeding over the past couple of years, with episodes occurring approximately once every six months and lasting about a day. The bleeding resolves on its own without any identifiable triggers or relief measures. Additionally, the patient reports weight gain localized to the abdominal area and has been experiencing excessive facial hair growth on the chin and neck for over five years, comparable to leg hair growth. The patient has an intrauterine device (IUD) in place and has not had a menstrual period in five years. Current medications include Adderall 30 mg and Alprazolam 1 mg. Family history of hormonal or metabolic disorders is unknown. No known allergies reported.

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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 experiences:

  1. Anal Discomfort with Blood: This could be due to hemorrhoids, which are swollen veins in the lower rectum or anus that can cause discomfort and bleeding. They often resolve on their own but can be recurrent. Other possibilities include anal fissures or less commonly, inflammatory bowel disease.

  2. Weight Gain and Excessive Facial Hair: These symptoms could be indicative of a hormonal imbalance, such as Polycystic Ovary Syndrome (PCOS). PCOS is a condition that affects hormone levels, leading to symptoms like weight gain, hirsutism (excessive hair growth), and irregular menstrual cycles. Since you have an IUD and haven't had a period in five years, it might be worth discussing with a healthcare provider to rule out PCOS or other hormonal issues.

What you can do

Anal Discomfort and Bleeding:

  • Consider using over-the-counter treatments like topical creams or suppositories designed for hemorrhoid relief.
  • Increase your fiber intake and stay hydrated to help prevent constipation, which can exacerbate hemorrhoids.
  • Avoid straining during bowel movements and try to maintain a regular bathroom routine.

Weight Gain and Excessive Facial Hair:

  • Schedule an appointment with your healthcare provider to discuss your symptoms and explore potential hormonal causes.
  • Maintain a balanced diet and regular exercise routine to help manage weight.
  • Consider hair removal options such as waxing, laser treatment, or prescription creams for managing excessive facial hair.

General Health:

  • Use MDandMe to journal your symptoms, track progress, and share insights with your healthcare provider. This can help in identifying patterns and making informed decisions about your health.

What you should look out for

  • If you experience severe pain, significant changes in bowel habits, or heavy bleeding, seek medical attention promptly.
  • Monitor for any new symptoms or changes in your current symptoms, and discuss these with your healthcare provider.
  • Be aware of any signs of hormonal imbalance, such as changes in mood, energy levels, or additional hair growth, and report these to your doctor.

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a formal diagnosis and personalized treatment plan.

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People Also Ask


What could be causing intermittent anal bleeding?

Intermittent anal bleeding could be caused by hemorrhoids, which are swollen veins in the rectum or anus. Other causes might include anal fissures or inflammatory bowel disease. It's important to consult a healthcare provider for an accurate diagnosis.


How can hormonal imbalances lead to weight gain and excessive facial hair?

Hormonal imbalances, such as those seen in Polycystic Ovary Syndrome (PCOS), can lead to symptoms like weight gain and excessive facial hair growth. This is due to elevated levels of androgens, which are male hormones that women also produce in smaller amounts.


What are the potential side effects of having an IUD for an extended period?

An IUD can cause changes in menstrual cycles, including the absence of periods, which is common with certain types of IUDs. However, it's important to discuss any concerns with a healthcare provider to ensure there are no underlying issues.


How can I manage excessive facial hair growth effectively?

Excessive facial hair growth can be managed through various methods such as waxing, laser hair removal, or prescription creams. Consulting with a healthcare provider can help determine the best approach based on individual needs and underlying causes.


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