Seeking Clarity on Amenorrhea
I am a 23-year-old woman, standing 177 cm tall and weighing 110 kg. My hormone levels and thyroid function are normal, though recent blood tests indicated elevated alkaline phosphatase levels, along with a recurring history of anemia, for which I have an iron infusion planned. Initially diagnosed with diverticulitis, I was treated with antibiotics, but my inflammation markers are currently at the higher end of the normal range. I suspect that this condition has been problematic for about a year; a CT scan conducted a year ago revealed its presence, but my previous doctor did not provide any treatment or follow-up. I've recently switched to a new general practitioner. I have dealt with asthma since my early teenage years, managed with budesonide via a rapihaler, which I use morning, night, and as needed. Ultrasound results show: - Antiverted uterus measuring 71 x 32 x 42 mm - Myometrial irregularities - Endometrial thickness of 6 mm, with a trilaminar appearance consistent with the late proliferative phase - Right and left ovary volumes are both at 9 cc - A peripheral distribution of follicles exceeding 12 per ovary - No dominant cyst detected. My last menstrual period occurred in October 2024. Prior to this, my cycles were regular for approximately a year, but before that, I experienced a two-year gap in menstruation. Although my doctor has ruled out polycystic ovary syndrome (PCOS) and any thyroid or hormonal disorders through blood tests, the cause of my amenorrhea remains uncertain. I have a significant history of childhood sexual assault which might be relevant to my situation. My GP has referred me to a gynecologist for further investigation. I am sexually active exclusively with my fiancé, who has undergone a vasectomy, and a blood test has confirmed that I am not pregnant. Could my symptoms indicate conditions such as endometriosis or adenomyosis? I feel that my symptoms do not align well with these conditions; while I experience some pain during menstruation, I possess a high tolerance for pain, making it difficult to assess my discomfort accurately. I have previously sought medical attention with oxygen levels at 86, presenting with minimal distress beyond discomfort and a cough, which often leads to medical staff doubting the calibration of their equipment. Consequently, I find it challenging to receive proper medical treatment and to be taken seriously. Given that my symptoms do not seem to correlate with common causes of amenorrhea, could there be an underlying health issue unrelated to gynecology at play? This has been a concern of mine since I began menstruating at 12 years old, and I have been struggling with it since I turned 14. I would greatly appreciate any thoughts or advice regarding pertinent questions I should pose to the gynecologist during my upcoming visit, which could help illuminate my situation further. Thank you for your assistance!
Answers (1)
3/25/2025, 10:40:47 AM
OpenHealth AI
It sounds like you are navigating a complex and concerning situation with your health, particularly regarding your amenorrhea and history of related symptoms. Your case includes various medical factors, and it’s excellent you’ve sought a referral to a gynecologist for further assessment.
Main Points:
- Your amenorrhea could be influenced by several factors, including your past medical history and the potential impact of stress or traumatic experiences.
- Important conditions such as endometriosis or adenomyosis should be considered despite not aligning perfectly with your symptoms.
- Preparing focused questions for your gynecologist will help you gain clarity about your situation.
Explanation:
Amenorrhea, or the absence of menstruation, can arise from a variety of reasons including hormonal imbalances, structural abnormalities, chronic health issues, stress, or even lifestyle factors. Given your complex medical history, especially the involvement of diverticulitis and anemia, it's wise to approach your condition holistically. Although conditions like endometriosis can cause menstrual irregularities, many women with such conditions often experience specific symptoms frequently associated with them, such as significant pelvic pain, which might not resonate with your experience.
Next Steps:
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List Key Questions for Your Gynecologist: Prepare questions that address your concerns comprehensively. Consider asking:
- What additional tests can help determine the cause of my amenorrhea?
- Are there any non-gynecological factors or conditions that might be contributing to my symptoms?
- Should we consider any imaging studies, such as MRI, for better insights into possible endometriosis or adenomyosis?
- What lifestyle changes or treatments might help improve my overall reproductive health?
- How might my history of trauma impact my current symptoms, and should this be taken into account during my treatment plan?
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Monitor Your Symptoms: Keep a detailed symptom diary prior to your gynecology appointment. Include patterns in menstruation, any pain experienced, emotional states, and any changes in your general health or lifestyle. This information can aid the doctor in understanding your situation better.
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Consider Mental Health Support: Since you mentioned a significant history of trauma, it may be beneficial to seek support from a mental health professional. This can help address any underlying psychological factors that could influence your physical health.
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Focus on Overall Health: Continue managing your existing conditions, such as asthma and anemia, and ensure you're following any prescribed treatment plans. Nutritional support and hydration are vital in maintaining your overall health.
Your active engagement in your health and open communication with your healthcare providers will greatly assist in finding the right answers and solutions. Please feel assured that you are taking the right steps, and it’s important to keep advocating for your health.
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