[42F] Experiencing frequent urination, hormonal issues, and numbness in extremities

Patient Description

A 42-year-old female presents with a constellation of symptoms that have been progressively worsening over the past several years. She reports a persistent urgency to urinate, characterized by a constant need to pee but with minimal urine output, despite high water intake. She has been diagnosed with a urinary tract infection and suspected kidney stones, although she experiences no pain typically associated with stones. Hormonally, she is undergoing 'change of life' and is on an estrogen patch, which has alleviated severe migraines that occurred post-menstruation. She experiences intense hot flashes described as internal waves of heat, which have been present for the last two years. Additionally, she reports numbness in her feet that occurs within minutes of sitting, not associated with any specific activity or position. The patient has very pale skin and dark circles under her eyes, which she attributes to her hormonal imbalance and heavy menstrual bleeding. Her sleep is frequently interrupted, and she does not feel rested. Her medical history includes polycystic ovary syndrome (PCOS), endometriosis, and ulcerative colitis. Current medications include Linzess for constipation, Premarin, a progesterone supplement, and Flomax for urinary symptoms. She has a unique allergy to liquid gel capsules of Advil. The patient expresses concern about her kidney function and the possibility of underlying issues contributing to her symptoms.

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Arora's Assessment

What might be happening

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

  • Urinary Tract Infection (UTI): Given your frequent urination and previous diagnosis of a UTI, it's possible that you might have a recurrent UTI. UTIs can cause a strong urge to urinate but only a small amount of urine to be passed.

    • Treatment typically involves antibiotics prescribed by a doctor.
  • Kidney Stones: Your doctors have mentioned this as a possibility. Kidney stones can cause frequent urination and blood in the urine. However, they typically also cause pain, which you have not reported.

    • Treatment can range from pain management and drinking lots of water to medical procedures to break up or remove the stones.
  • Hormonal Imbalances: Your heavy or absent periods, hot flashes, and use of an estrogen patch suggest that you might be experiencing perimenopause, the transition phase before menopause. This can cause a variety of symptoms, including changes in menstruation and hot flashes.

    • Treatment can involve hormone therapy, like the estrogen patch you're using, and other symptom management strategies.
  • Peripheral Neuropathy: This condition, which involves damage to the nerves in your hands and feet, could explain your numbness and tingling. It can be caused by a variety of conditions, including hormonal imbalances like those seen in PCOS.

    • Treatment typically involves managing the underlying condition and may include medications to relieve symptoms.

What you can do

It would be best to consult a doctor about your symptoms so that they can provide a formal assessment and order relevant tests if necessary. In the meantime, you can try the following to relieve your symptoms:

  1. Drink plenty of water and avoid caffeine, which can irritate the bladder and exacerbate your urinary symptoms.
  2. Continue to use your estrogen patch as directed by your doctor.
  3. Try to maintain a healthy lifestyle with regular exercise and a balanced diet, which can help manage symptoms of perimenopause and PCOS.
  4. Try to get enough sleep. If you're having trouble sleeping, speak to your doctor about possible solutions.

What you should look out for

Reasons to see a doctor more urgently:

  • If your urinary symptoms worsen or you develop pain in your lower back or sides
  • If your periods become even heavier or more irregular
  • If your hot flashes become more frequent or severe
  • If the numbness in your feet worsens or spreads

Remember, while I strive to provide accurate information, I'm an AI and not a substitute for professional medical advice. Please consult with a healthcare provider for a formal diagnosis and treatment.

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11 mo ago

People Also Ask


What are the common symptoms of a urinary tract infection (UTI)?

Common symptoms of a UTI include a strong, persistent urge to urinate, a burning sensation when urinating, passing frequent, small amounts of urine, cloudy or strong-smelling urine, and pelvic pain in women.


How can hormonal changes during perimenopause affect a woman's health?

Hormonal changes during perimenopause can lead to symptoms such as irregular periods, hot flashes, night sweats, sleep disturbances, mood changes, and changes in sexual function. These changes are due to fluctuating levels of estrogen and other hormones.


What are the potential causes of numbness in the feet?

Numbness in the feet can be caused by peripheral neuropathy, which may result from conditions like diabetes, hormonal imbalances, vitamin deficiencies, or nerve damage. It can also be due to poor circulation or prolonged pressure on nerves.


How can kidney stones be managed if they do not cause pain?

If kidney stones do not cause pain, management may include staying hydrated to help pass the stones naturally, dietary changes to prevent stone formation, and monitoring the stones with regular medical check-ups. In some cases, medical procedures may be necessary if the stones do not pass on their own.


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