Exhausted by Persistent Fainting Episodes
I’m a 24-year-old female with a complex medical background, but the core issue I’m facing involves persistent low blood pressure and episodes of fainting that have plagued me for the past eighteen months. The lowest blood pressure I’ve documented was a troubling 43/33 while lying down, and just in the past two weeks, I’ve been averaging around 75/50 while sitting. I’ll summarize my experience as clearly as I can: visiting numerous specialists over the last year has left me feeling truly exhausted. My medical history includes asthma, bipolar disorder type 2, anxiety and depression, as well as insomnia. Currently, I’m on a range of medications: venlafaxine (150 mg daily), lamotrigine (100 mg three times a day), seroquel (100 mg daily), zaleplon (5 mg on occasion for sleep), olanzapine (5 mg as needed for anxiety), and I use an albuterol inhaler as required. Last year, I relocated for a new job and was doing well until about four months into my position when I began experiencing episodes of lightheadedness and dizziness. This culminated in a fainting incident at work, which led to an ICU admission where I recorded my lowest blood pressure of 43/33. I have had several ER visits since then, and I noticed that my episodes seemed to happen more frequently around the time of my menstrual cycle, prompting me to consult a gynecologist. To outline my gynecological appointments: I began taking a progestin-only birth control (the mini-pill), which unfortunately only increased the frequency of my fainting spells, so I discontinued it. A transvaginal ultrasound didn’t reveal any abnormalities. I also had a brief consultation with a neurologist who confirmed there was no indication of seizures, thereby dismissing the need for additional follow-up. An endocrinologist assessed my hormones, but my TSH and cortisol levels were within normal ranges. Subsequently, I focused on cardiology. A 30-day Holter monitor showed only brief instances of tachycardia that did not coincide with my fainting episodes. Other cardiac tests, including an echo, chest x-ray, and CT scan, returned normal results. Most recently, I underwent a tilt table test, which did not indicate any orthostatic issues. My blood work reported mostly normal results, with the exception of low hemoglobin during menstruation and general iron deficiency. I received three iron infusions, which provided some temporary relief. My low blood pressure primarily emerges around the time of my menstruation and especially during premenstrual syndrome, although I do not experience heavy bleeding. What was once limited to one week per month has now extended to two weeks. My primary care physician has suggested an IUD, but I’m apprehensive given my negative experience with oral contraceptives. This situation is significantly affecting my life; I often have to take time off work due to extremely low blood pressure, and I feel faint even when short distances away from my office. I’m feeling quite lost and would appreciate any suggestions or insights. Thank you.
Answers (1)
6/15/2025, 9:40:42 PM
OpenHealth AI
I'm truly sorry to hear about the persistent fainting episodes and the challenges you're currently facing. Managing low blood pressure and the complexity surrounding it can be incredibly tough, especially with your detailed medical history. It's so understandable to feel exhausted after navigating multiple specialists without clear answers.
Main Points:
- Your Symptoms and Impact: You are experiencing frequent fainting episodes related to low blood pressure, particularly around your menstrual cycle.
- Underlying Factors: Your medical background, including low hemoglobin and iron deficiency, might be contributing to your symptoms.
- Next Steps to Consider: Focus on immediate lifestyle adjustments, nutrition to manage iron levels, symptom tracking, and discussing alternative treatment options.
Explanation:
Low blood pressure (hypotension) can cause fainting, particularly when it's exacerbated by hormonal fluctuations during your menstrual cycle. It’s also notable that you mentioned lightheadedness and dizziness. The fact that you have a history of iron deficiency could suggest that improving your iron levels might help stabilize your blood pressure.
Additionally, stress from previous healthcare visits and your mental health conditions can add layers to your symptoms, emphasizing the importance of a holistic approach to your wellbeing.
Next Steps:
-
Dietary Adjustments:
- Iron-Rich Foods: Focus on incorporating foods high in iron (like red meat, legumes, spinach, and fortified cereals) to improve your hemoglobin levels. Pairing these with vitamin C-rich foods (like oranges or bell peppers) can enhance iron absorption.
- Stay Hydrated: Increase fluid intake, especially when you anticipate fainting spells (like during your menstrual cycle) to help maintain blood volume.
-
Symptom Tracking:
- Keep a diary of your symptoms, noting when your fainting episodes occur, along with your blood pressure readings and menstrual cycle. This may help reveal patterns and assist any further medical evaluations.
-
Gradual Position Changes:
- When changing positions (from lying down to standing), do so slowly to minimize dizziness. Consider using compression garments (like stockings) which can help improve circulation.
-
Consulting on IUD Options:
- Discuss with your physician about alternative birth control methods that might be more fitting given your experiences, such as hormonal IUDs vs. other methods, if you remain concerned about side effects previously experienced with oral contraceptives.
-
Focus on Mental Wellbeing:
- Consider working with a counselor or therapist to manage anxiety and depression, as addressing mental health can also influence physical symptoms and improve overall wellness.
Conclusion:
Feeling lost in your medical journey is completely valid, and it’s important to ensure you’re supported holistically. These suggested steps should help you take control of your health situation gradually. Please let me know if you need more specific guidance on any of these points!
Related Questions
Navigating Health Concerns: A Young Woman's Plight with Chronic Migraines and Stress
To summarize a very complex situation, last spring in 2025 was exceptionally challenging for me. I faced overwhelming stressors, including family deaths, eviction, and my parents splitting up. This turmoil led to chest pains so severe that I had to visit the emergency room because I couldn’t breathe deeply without experiencing intense pain. The doctors attributed the issue to psychological causes, but I continued to suffer from pain and instances of fainting due to the stress, which worsened as yet another family member was diagnosed with cancer. My psychiatrist suggested medication, and I started on Lexapro and Concerta, which improved my condition somewhat, even though I remained fatigued and felt like I was merely surviving. By the end of August, I contracted a severe case of bronchitis that caused me to experience fevers even while doing laundry. It seemed I was verging on pneumonia, prompting the prescription of prednisone and other steroid medications. Thankfully, I began to recover quickly, but soon after, I was plagued by persistent headaches and an overwhelming sense of paranoia that someone was out to get me. After another emergency room visit, the physicians informed me that, although my symptoms—such as fever, intense pain, night sweats, sensitivity to light, ear pressure, and a stiff neck—were alarming, they were likely just severe migraines that should eventually fade. Unfortunately, they didn’t. I returned to urgent care for further treatment, received antibiotics, and was advised to consult a neurologist. While the antibiotics provided some relief, my symptoms intensified. My primary care physician eventually prescribed sumatriptan, a medication intended to alleviate migraine pain, but instead, it exacerbated the headache. For the next two to four weeks, I endured an exceptionally difficult time, facing numerous strange symptoms that felt worthy of immediate attention, yet each visit concluded with a migraine diagnosis and a waiting period for my neurology appointment. My frustrations pushed me to contemplate risky alternatives for relief, but I resisted, feeling utterly hopeless and unable to cope. I sought an ear, nose, and throat specialist to rule out sinus issues, which turned out to be fine. A painful spot under my jaw led me to suspect nerve involvement, and I visited the emergency room again due to experiencing stroke-like symptoms (including mild left arm weakness, extreme headache, and minor speech issues). Sadly, I was again told it was merely a headache, and the IV medications were ineffective. During my annual check-up, my primary care provider was unfamiliar with my ongoing issues but discovered an enlarged lymph node in the lower left side of my neck and a cyst on my thymus after conducting a soft tissue scan. She reassured me that there was no need for concern and suggested waiting for my neurology visit or getting my eyesight checked. Despite my yellower complexion, increasing stiffness, and joint pain, I accepted her recommendation. While I mentally adapted to the chronic pain, which was always present, it affected my ability to concentrate and engage in daily life. I tried consuming plenty of lemon juice and engaging in lymphatic drainage massages, which provided transient relief and halted my yellowing skin. Now, in the present, I've noticed a peculiar, raised red bump on the side of my foot. It’s hard, tender, and smaller than a dime, without any accompanying rash. It has persisted for a couple of weeks without causing pain while walking. Additionally, more lymph nodes in my neck have become swollen, I have experienced difficulty swallowing, and I occasionally choke on air. My lungs feel heavier with a diminished sense of smell, though I don't have the thick mucus typical of a cold. The headaches, however, are reemerging, sharper than before, which is a concerning development. Throughout all of this, my blood pressure has remained within a low yet stable range, and my blood tests and CT scans have shown no significant issues. I haven’t consumed anything excessively that might raise concern, including food or drugs. Am I truly facing a serious health crisis? Should I prioritize getting another appointment, or do I need to rush to urgent care? I'm scheduled to see the neurologist in about a month, and I'm wondering if I should ask my primary care provider for some preliminary tests like blood work or an MRI beforehand. If so, what specific questions should I prepare for my neurology visit? I believe the pain has a genuine physical basis, although my anxiety definitely amplifies the experience.
Inquiry Regarding Metronidazole Use for Recurrent Bacterial Vaginosis
I am a 32-year-old female, measuring 5 feet 5 inches tall and weighing 248 pounds. My current medications include Vyvanse at a dosage of 40mg, a medication for asthma, vitamin D, a 325mg iron supplement, and as of now, I am also taking amoxicillin to treat strep throat. I am about to begin using Metronidazole 0.75% Vaginal Gel, with a total of 70 grams available. The instructions indicate that I should administer 5 grams vaginally twice a day for seven days, followed by twice a week for a period of two months. During the initial treatment phase when I will apply the gel twice daily, I anticipate abstaining from sexual activity. However, once I transition to the twice-weekly application, is it permissible to engage in sexual intercourse? I would normally consult my physician about this matter, but she is currently unavailable, and the nurse is also out of the office, which is quite frustrating.
Concern Regarding Persistent Tongue Bump with White Coating
I am a 24-year-old male, standing at 190 cm tall and weighing 109 kg. For the past five weeks, I've experienced a peculiar issue on my tongue. Specifically, there's a noticeable bump on the right side near the tip, which I believe may have been developing over time, although I'm not entirely sure about that timeline. Recently, I've been troubled by an unusual sensation, including dryness, an odd taste, and a slight decrease in my sense of taste. Additionally, I've observed a white coating that is more pronounced on the aforementioned side of my tongue. The bump in question: - Does not cause any pain. - May have increased slightly in size over the weeks, though I'm uncertain. - Appears smooth with a pink surface, free of bleeding or ulceration. Given that this issue has persisted for over a month, I am feeling quite anxious and am concerned that it may indicate a serious problem. I have no significant medical history, but I confess that my dental hygiene has not been up to par, as I haven’t been brushing regularly. At this moment, I’m also under medication for H. pylori, known as Pylera, but this tongue concern predates my treatment. I am a non-smoker and am reaching out for any insights on this condition. Has anyone experienced something similar? Could this be a sign of irritation, infection, or something benign? I really appreciate any guidance you could provide. Thank you!
Experiencing Clear Fluid from Ear with No Discomfort: Should I Wait for My Appointment?
I am a healthy 57-year-old female, weighing 120 pounds and standing 5 feet 5 inches tall. My daily medications include 100 mg of Losartan for effectively managed high blood pressure, 200 mg of Lyrica taken twice daily for post-herpetic neuralgia, 100 mg of Synthroid following treatment for thyroid cancer, and a combination hormone replacement therapy patch. Additionally, I take Zyrtec and Flonase every day to combat allergies. Since October, I have been dealing with persistent tinnitus in my right ear, accompanied by some pressure and a muffled sensation. Recently, I've noticed that when I speak, it feels akin to the sensation I experience when my ears clear during a flight after chewing gum—my voice sounds amplified in my head. I've scheduled an appointment with a physician's assistant in an ear, nose, and throat (ENT) office for the end of March due to my worries about the tinnitus and any potential hearing impairment. Yesterday, I noticed that my ear emitted a clear fluid. Thankfully, there was no associated pain. The fluid was somewhat thicker than water, completely odorless—unlike the unpleasant discharge I recall from my daughter's ear infections—and there was no sign of blood. Could this indicate a perforated eardrum? I suspect this might be the case, but can this occur without an underlying infection? Should I seek attention sooner than my appointment in March? I would prefer to avoid urgent care during flu season; however, if this situation is serious, I am prepared to take precautions and visit.
Assessing My Health Concerns: How Anxious Should I Be?
I’m a 32-year-old woman, weighing 124 pounds and standing at 5 feet 6 inches tall. For over a year, I have been experiencing bright red rectal bleeding. Initially, I attributed this issue to hemorrhoids that developed during my pregnancy two years ago. The bleeding occurs with most of my bowel movements, sometimes happens without one, and on a few occasions, has been enough to stain the toilet bowl significantly. The color of the blood is typically darker than what I observe during a hemorrhoid flare-up. There is a notable family history of bowel cancer on both sides; one family member was diagnosed at age 45, and another at 60. In the past six months, I have encountered several episodes of severe abdominal pain—3 to 4 instances—intense enough to consider a trip to the emergency room. However, the pain usually subsides within about an hour. It’s unusual for me to experience such acute pain, given my high tolerance for discomfort; for example, I once played rugby shortly after dislocating and fracturing my finger. Recently, I mustered the courage to consult with my doctor, who recommended a FIT test, which returned a positive result (30.1). Additionally, I underwent a complete blood test, and aside from having low ferritin levels (7 µg/L), all other results were normal. I have since been referred for a colonoscopy on a two-week waiting list to rule out any possible bowel cancer. Given these circumstances, how concerned should I be? Thank you for your input.