[37F] With prolonged menstrual bleeding, dizziness, and armpit lumps
Question
How long after a miscarriage can it still be detected & how would I find out for sure if I did in fact miscarry 2-5 weeks ago?
Patient Description
A 37-year-old female has been experiencing severe lightheadedness, weakness, and sweating, particularly after taking showers or standing to cook for 20-30 minutes. These episodes are severe, rated as a 9 out of 10, and typically last about 20 minutes. Lying down, cooling off, and drinking something cold like ice water followed by a fruit cup help alleviate these symptoms. Recently, she had a menstrual cycle that lasted for three weeks, which is much longer than her usual 3-4 days. Two days after the bleeding stopped, she experienced a temporary recurrence of bleeding and cramps after being hit in the lower abdomen. She has noticed white discharge from her nipples when squeezed and has swollen, sore lumps in both armpits, which she has experienced before due to clogged milk ducts. Her hair has thinned significantly over several months, but it is now growing back and feeling thicker due to vitamins and homemade hair treatments. Her feet and ankles have been swelling regularly, especially when she is on her feet more or hasn't had them elevated enough. She has high anxiety and stress levels, but no significant changes in her diet, hydration, weight, appetite, or bowel movements. She has not had any recent blood tests or medical evaluations for these symptoms. She has a family history of hypothyroidism but has never had her thyroid levels checked. She is a daily smoker (about 7 cigarettes a day) and consumes alcohol (2-3 drinks per week). She seldom uses recreational drugs. She has not taken a pregnancy test recently but is willing to do so to rule out pregnancy or miscarriage. She has no pre-existing conditions or chronic illnesses, but she has had issues with her lower back and hips since breaking her back at age 16.
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Arora's Assessment
What might be happening
It is likely that your symptoms are related to multiple issues. Here are some possible explanations:
Lightheadedness, Weakness, and Sweating
- Anemia: This condition can cause lightheadedness, weakness, and sweating, especially when standing for long periods or after a hot shower. Anemia can be due to various causes, including heavy menstrual bleeding.
- Hormonal Imbalance: Given your prolonged menstrual bleeding and nipple discharge, a hormonal imbalance could be a contributing factor. Conditions like hyperprolactinemia (high levels of prolactin) or thyroid disorders could be involved.
- Dehydration or Low Blood Sugar: These can also cause similar symptoms, especially if you are not eating or drinking enough.
Prolonged Menstrual Bleeding
- Hormonal Imbalance: Conditions like polycystic ovary syndrome (PCOS) or thyroid disorders can cause irregular and prolonged menstrual bleeding.
- Miscarriage: It is possible that you experienced a miscarriage, which can cause prolonged bleeding. A pregnancy test might still show positive if you miscarried recently, but it is not definitive.
Nipple Discharge and Armpit Lumps
- Hormonal Imbalance: High levels of prolactin can cause nipple discharge and might be related to the lumps in your armpits if they are due to clogged milk ducts.
- Infection or Inflammation: The lumps in your armpits could be due to an infection or inflammation, especially if you were recently in a dirty environment with animals.
Swollen Feet and Ankles
- Fluid Retention: This can be due to various causes, including hormonal imbalances, heart issues, or prolonged standing.
What you can do
Lightheadedness, Weakness, and Sweating
- See a Doctor: Given the severity of your symptoms, it is important to see a healthcare provider for a thorough evaluation. They may recommend blood tests to check for anemia, thyroid function, and other potential issues.
- Stay Hydrated: Make sure you are drinking enough water throughout the day.
- Balanced Diet: Ensure you are eating a balanced diet with enough iron-rich foods to prevent anemia.
Prolonged Menstrual Bleeding
- Take a Pregnancy Test: To rule out or confirm a recent pregnancy or miscarriage.
- See a Gynecologist: A specialist can help determine the cause of your prolonged bleeding and recommend appropriate treatment.
Nipple Discharge and Armpit Lumps
- See a Doctor: It is important to get these symptoms evaluated to rule out any serious conditions. They may recommend imaging tests or a referral to a specialist.
- Warm Compresses: Applying warm compresses to the armpit lumps may help if they are due to clogged milk ducts.
Swollen Feet and Ankles
- Elevate Your Feet: Try to elevate your feet when sitting or lying down to reduce swelling.
- Compression Stockings: Wearing compression stockings can help reduce swelling in your feet and ankles.
What you should look out for
Given the complexity and severity of your symptoms, you should seek medical care as soon as possible. Reasons to seek care even more urgently include:
- Severe Pain: If you experience severe pain in your abdomen, chest, or any other area.
- Fainting or Severe Dizziness: If you faint or experience severe dizziness that does not improve with rest.
- Unusual Bleeding: If you notice any unusual or heavy bleeding.
- Signs of Infection: Such as fever, redness, or warmth around the armpit lumps.
Remember, I am not a doctor, and it is important to seek care from real health professionals to receive a formal diagnosis and treatment. You can also use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.
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4 mo ago