[34F] Experiencing menstrual irregularities and premenstrual brownish discharge

Patient Description

A 34-year-old female reports having lighter and sometimes irregular periods, with cycles varying from 21 to 33 days, and lighter flow than usual. This has been occurring for approximately 5-6 months. The patient also experiences cramping at the onset of menstruation, lasting 2-3 days, with a pain severity of 4-5 out of 10, which is worse in the morning. Additionally, there is a small amount of brownish, sticky, and thin vaginal discharge that appears 4-5 days before the period starts, a change that has been consistent for about 5 months. The patient notes a slight odor associated with the discharge. There has been an unexpected weight gain of about 5 pounds in the last month. The patient's mood fluctuates, particularly around the time her period starts, and she experiences acne concurrently. The patient's medical history includes asthma and allergies diagnosed at age 12, high blood pressure diagnosed at age 32, and constipation since age 26 following childbirth. Current medications include a multivitamin, stool softener, amlodipine, Claritin, and zinc. There are no known drug allergies.

Arora's Assessment

What might be happening

Based on the information you've provided, possible explanations for your symptoms include:

Polycystic Ovary Syndrome (PCOS): This condition is characterized by hormonal imbalances that can lead to irregular periods, changes in physical appearance (like weight gain and acne), and difficulties with fertility. The hormonal imbalances can also lead to changes in the uterine lining, which could explain the brownish discharge you've been experiencing before your period.
- Diagnosis typically involves blood tests to check hormone levels and an ultrasound to look for cysts on the ovaries.
- Treatment can involve lifestyle changes, medication to manage symptoms, and fertility treatments if desired.
Thyroid Disorders: Both hypothyroidism and hyperthyroidism can cause changes in menstrual cycle and fertility. Hypothyroidism can also cause weight gain and constipation, while hyperthyroidism can cause weight loss and diarrhea.
- Diagnosis typically involves blood tests to check thyroid hormone levels.
- Treatment involves medication to correct the hormone imbalance.
Perimenopause: This is the transition period before menopause, which can last several years. Symptoms can include irregular periods and changes in menstrual flow. However, this is less likely given your age.

What you can do

It's important to consult with a healthcare provider about your symptoms. They can provide a formal assessment and order relevant tests if necessary. In the meantime, you can try the following:

Maintain a healthy lifestyle: Regular exercise and a balanced diet can help manage symptoms of many conditions, including PCOS and thyroid disorders.
Track your symptoms: Keep a record of your menstrual cycle, any changes in discharge, and other symptoms. This can help your healthcare provider make a diagnosis.

What you should look out for

Reasons to seek medical attention more urgently:

If you notice any severe abdominal pain
If your menstrual bleeding becomes very heavy or lasts longer than a week
If you develop a fever or other signs of infection, such as foul-smelling vaginal discharge

Remember, this advice is intended to be general in nature, and specific causes may not apply to your personal circumstances. Always consult with a healthcare provider for appropriate examination, testing, and care.

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11 mo ago

Top picked over-the-counter products for Painful Periods (Dysmenorrhea)