[43F] With missed periods, fatigue, and abdominal growth

Patient Description

A 43-year-old female presents with several symptoms over the past couple of months, including persistent fatigue throughout the day, even after taking naps, which worsens with work. She experiences sudden and gradual hot flashes, sometimes feeling like she's on fire even in an air-conditioned room, accompanied by sweating. The patient has noticed abdominal growth and a slight weight gain of a few pounds. She missed her period in April and May, with only spotting, and none for this month. Additionally, she has been craving foods she normally doesn't like and wanting specific foods. Her breasts have become fuller, and she has been urinating more frequently. The patient has a history of diabetes and is currently taking insulin (60 units twice daily) and Jardiance (25mg daily). She has no other chronic illnesses or pre-existing conditions and is not taking any other medications or supplements. She is allergic to Topamax.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Pregnancy: Given your missed periods, breast enlargement, belly growth, cravings, and fatigue, pregnancy is a strong possibility. Pregnancy can also cause frequent urination and hot flashes.

    • Typical tests: A home pregnancy test or a blood test ordered by your doctor can confirm pregnancy.
    • Treatment: Prenatal care is essential, including regular check-ups, a balanced diet, and prenatal vitamins.
  • Perimenopause: This is the transition period before menopause, which can cause irregular periods, hot flashes, breast changes, and fatigue.

    • Typical tests: Hormone level tests can help diagnose perimenopause.
    • Treatment: Lifestyle changes, hormone replacement therapy, and other medications can help manage symptoms.
  • Diabetes-related issues: As a diabetic, changes in your condition or medication side effects could contribute to fatigue, frequent urination, and other symptoms.

    • Typical tests: Blood glucose monitoring and HbA1c tests can help manage your diabetes.
    • Treatment: Adjustments to your diabetes management plan may be necessary.
  • Thyroid Disorders: Hypothyroidism or hyperthyroidism can cause fatigue, weight changes, and menstrual irregularities.

    • Typical tests: Thyroid function tests (TSH, T3, T4) can diagnose thyroid disorders.
    • Treatment: Medications to regulate thyroid hormone levels.

What you can do

  1. Take a Home Pregnancy Test: Given your symptoms, a home pregnancy test can provide immediate insight. If positive, schedule an appointment with your doctor for further evaluation and prenatal care.
  2. Monitor Your Blood Sugar Levels: Ensure your blood sugar levels are within the target range to rule out diabetes-related fatigue and frequent urination.
  3. Maintain a Balanced Diet and Stay Hydrated: Eating a nutritious diet and drinking plenty of water can help manage fatigue and overall health.
  4. Track Your Symptoms: Keep a log of your symptoms, including their frequency and severity, to share with your healthcare provider.
  5. Consult Your Doctor: Schedule an appointment with your healthcare provider to discuss your symptoms and undergo necessary tests for a definitive diagnosis.

What you should look out for

  • Severe Abdominal Pain or Heavy Vaginal Bleeding: These could indicate a serious condition and require immediate medical attention.
  • Persistent or Worsening Symptoms: If your symptoms continue to worsen or do not improve, seek medical advice promptly.
  • New Symptoms: If you develop new symptoms such as dizziness, fainting, or severe headaches, contact your healthcare provider.

Remember, while this information can help guide you, it is important to seek care from real health professionals to receive a formal diagnosis and appropriate treatment.

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6 mo ago


People Also Ask


Can diabetes cause symptoms like fatigue and frequent urination?

Yes, diabetes can cause fatigue and frequent urination, especially if blood sugar levels are not well-controlled. It's important to monitor blood glucose levels and consult with a healthcare provider for proper management.


What are the common signs of perimenopause?

Common signs of perimenopause include irregular periods, hot flashes, night sweats, mood changes, and changes in breast size. Hormone level tests can help diagnose perimenopause.


How can I confirm if I am pregnant?

To confirm pregnancy, you can take a home pregnancy test, which detects the presence of the hormone hCG in urine. For more accurate results, a blood test ordered by a doctor can confirm pregnancy.


What are the symptoms of thyroid disorders that I should be aware of?

Symptoms of thyroid disorders can include fatigue, weight changes, menstrual irregularities, and changes in energy levels. Thyroid function tests (TSH, T3, T4) can help diagnose these conditions.


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