[37F] Experiencing low energy, sexual health concerns, and unexplained weight loss

Patient Description

A 37-year-old female has been experiencing a constellation of symptoms that have significantly impacted her quality of life over the past year. The most prominent concerns include severe vaginal dryness that persists regardless of arousal level, a marked decrease in sex drive, and difficulty achieving climax. These sexual health issues have been ongoing for approximately a year. Additionally, the patient reports a significant loss of energy for the past six months, which has affected her ability to complete daily tasks and engage in social activities. She also noted a weight loss of 15 pounds during this period without intentional changes in diet or exercise. The patient's menstrual cycle has been characterized by very heavy periods, but she has not experienced hot flashes, night sweats, mood changes, or a decrease in breast size. There is no known family history of hormonal disorders. The patient is currently taking Lyrica (100mg twice a day) for an unspecified condition. No other medications, including over-the-counter drugs, supplements, or herbal remedies, have been reported. The patient has not mentioned any pre-existing conditions or chronic illnesses.

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Arora's Assessment

What might be happening

Based on the information you've provided, there are several possibilities that could explain your symptoms:

  • Hypothyroidism: This condition occurs when your thyroid doesn't produce enough thyroid hormones. Symptoms can include fatigue, weight gain, depression, and changes in menstrual cycles. However, you've mentioned weight loss rather than gain, which is less typical for hypothyroidism.

    • Treatment typically involves taking a daily hormone replacement tablet.
  • Perimenopause: This is the transition period before menopause. It can cause symptoms like irregular periods, vaginal dryness, and changes in sexual desire. However, you're relatively young for perimenopause, and you haven't reported some of the other common symptoms like hot flashes.

    • Treatment can involve hormone therapy, antidepressants, or other medications to manage symptoms.
  • Depression: This mental health disorder is characterized by persistently depressed mood or loss of interest in activities, causing significant impairment in daily life. It could explain your low energy and changes in weight and sexual desire.

    • Treatment can involve psychotherapy (talk therapy), medications, or a combination of both.
  • Sexual dysfunction: This refers to persistent, recurrent problems with sexual response, desire, orgasm or pain that distress you or strain your relationship with your partner. Causes are often complex and involve physical, mental and interpersonal issues.

    • Treatment can involve addressing any underlying medical or psychological conditions, medication changes, or sex therapy.

What you can do

Please consult with a healthcare provider for a formal diagnosis. They may order blood tests to check your hormone levels, among other things. In the meantime, here are some general tips that might help:

  1. Try to maintain a balanced diet and regular exercise routine. This can help boost your energy levels and overall health.
  2. Consider over-the-counter lubricants for vaginal dryness. They can provide temporary relief for discomfort during sexual activity.
  3. If you're feeling stressed or overwhelmed, consider relaxation techniques like deep breathing, yoga, or meditation. These can help improve your mood and energy levels.
  4. Open communication with your partner about your sexual health concerns can also be beneficial.

What you should look out for

Please seek immediate medical attention if you experience:

  • Severe depression or thoughts of harming yourself
  • Severe and sudden abdominal pain
  • Any other severe symptoms that concern you

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

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10 mo ago

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People Also Ask


What are the common symptoms of perimenopause, and could I be experiencing it at 37?

Perimenopause is the transition period before menopause, typically occurring in women in their 40s and 50s, but it can start earlier. Common symptoms include irregular periods, hot flashes, vaginal dryness, and changes in sexual desire. While you are relatively young for perimenopause, it's not impossible. A healthcare provider can help determine if this is the cause of your symptoms.


How can hypothyroidism affect my menstrual cycle and energy levels?

Hypothyroidism can lead to fatigue, weight changes, and menstrual irregularities due to insufficient thyroid hormone production. While weight gain is more common, some people may experience weight loss. A blood test can confirm if hypothyroidism is affecting your energy levels and menstrual cycle.


What are some potential causes of sexual dysfunction in women, and how can it be treated?

Sexual dysfunction in women can be caused by a variety of factors, including hormonal imbalances, psychological issues, chronic illnesses, or medications. Treatment often involves addressing any underlying medical or psychological conditions, medication adjustments, or therapy, such as sex therapy or counseling.


Could my medication, Lyrica, be contributing to my symptoms of low energy and sexual health issues?

Lyrica (pregabalin) is used to treat nerve pain and can sometimes cause side effects like fatigue and changes in sexual desire. If you suspect Lyrica is contributing to your symptoms, discuss this with your healthcare provider, who may adjust your dosage or suggest alternative treatments.


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