OpenHealth Q&A

Struggling to Distinguish Between Mental and Physical Health Issues (24, Female)

Lately, I find myself questioning whether I'm fabricating my health challenges. It's hard to articulate my experiences, so I'll lay out the essential details: I am a 24-year-old female, standing 5'1'' and weighing 120 pounds. For over a year, I've sought help from various healthcare professionals due to an alarming issue – in June 2022, my menstrual cycles, which had always been consistent, simply ceased. After numerous tests, including blood samples, an ultrasound, and an MRI, I received different findings. The MRI returned normal results, but my blood tests revealed significantly low levels of estrogen and progesterone, with the exception of cortisol and TSH, which were at the higher limits. The ultrasound indicated the presence of cysts. The diagnosis? PCOS, with a recommendation for birth control. Initially, this approach increased my estrogen levels from 10 to 19, but it also reduced my progesterone, led to a weight gain of about 10 pounds, and triggered severe depression, prompting me to discontinue the medication after just two weeks. I experienced a withdrawal bleed, but since then, that was the only cycle I've had in over a year – it occurred in April. My symptoms extend far beyond just menstrual irregularities. I struggle with intense fatigue, relying on a minimum of two cups of coffee daily to function, and my bedtime is around 8 PM. I find myself frequently waking at night to urinate, rising very early without the ability to doze off again, dealing with overwhelming hunger and a noisy appetite, and grappling with feelings of anxiety and depression. I'm currently exercising twice a day, constantly anxious about gaining weight again. This creates a relentless cycle, particularly troubling given that many with PCOS do tend to gain weight. However, my doctor insists there's nothing physically wrong with me. I suppose he has a point? Most of my blood results do appear normal, and I’m actively managing my situation. But does that mean I’m fabricating my symptoms? Should I disregard these other challenges? My growing concern about thyroid function stems from my desire for a more efficient metabolism, which could potentially alleviate worries about weight gain, a struggle that has surfaced rather easily in the past. Am I imagining these issues? I’ve discussed them with my doctor, but he reassured me that everything is okay, suggesting I might want to reconsider birth control. I doubt he’d provide any solutions for my hunger or concerns about weight management, which makes sense as he acknowledges my current weight as healthy. Nevertheless, I'm experiencing tangible symptoms like unexpected weight fluctuations (especially when I'm not meticulously monitoring calories and exercising consistently), incessant hunger, and overwhelming fatigue. I'm left wondering whether these struggles are more psychological or rooted in physical health. I recognize that I don’t have an eating disorder, as my daily caloric intake averages around 2500, largely fueled by my insatiable hunger. My doctor also confirmed that conditions like HA/Reds were excluded in my case. So, is this simply the reality of PCOS, or am I losing my mind?

Answers (1)

8/24/2025, 9:21:09 PM

OpenHealth AI

It's completely understandable to feel overwhelmed by the challenges you're facing, especially when they involve complex symptoms and conflicting medical opinions. You're not imagining your issues; they are valid experiences that seek to be understood. Let’s break this down and address your primary concerns.

Main Points:

1. Understanding PCOS: Polycystic Ovary Syndrome (PCOS) can cause a range of physical and psychological symptoms, including menstrual irregularities, fatigue, and mood changes.
2. Validation of Symptoms: Your symptoms are real. While they may not have clear physical roots according to some tests, this does not mean they are not significant.
3. Focus on Management: Strategies to manage your symptoms effectively can help improve your quality of life.

Explanation:

PCOS is a complex condition that can affect various aspects of health beyond just reproductive issues. It's common for individuals with PCOS to experience emotional and physical challenges, including fatigue and anxiety. Your symptoms like fatigue, persistent hunger, and weight fluctuations may be linked to hormonal imbalances typical in PCOS, even if blood tests sometimes appear normal.

Your previous experience with birth control shows how your body can react differently to treatments due to your unique hormonal profile. The emotional toll of managing PCOS can also lead to feelings of frustration, especially when trying to figure out whether symptoms are psychological or physical.

Actionable Steps:

1. Monitor Symptoms: Keep a daily journal of your symptoms, noting any changes, triggers, and emotional feelings. This can help identify patterns and provide valuable information for your healthcare provider.
2. Evaluate Dietary Choices: Focus on a balanced diet rich in whole foods, proteins, and fiber-rich carbohydrates to help stabilize blood sugar levels and manage hunger. Consider seeking guidance from a registered dietitian who specializes in PCOS.
3. Incorporate Stress Management: Practices like yoga, meditation, or deep-breathing exercises can help alleviate anxiety and improve mood. Find activities that you enjoy that also help you relax.
4. Consider a Second Opinion: If you're unsure about your current care, seeking a second opinion from an endocrinologist or a reproductive health specialist can provide further insights into managing your PCOS and hormonal health.
5. Physical Activity Balance: While exercising is beneficial, ensure it's balanced and not causing additional stress. Consider incorporating mindfulness practices that include physical activity, such as walking or dancing, rather than solely focusing on intensity and calorie burning.

Reassurance:

It's important to know that your concerns about mental versus physical health are shared by many individuals facing chronic conditions like PCOS. Your feelings and symptoms matter, and finding the right team to support you in managing them can make a significant difference. You are not alone in this journey, and taking actionable steps can help you regain a sense of control.

If you find that your anxiety or feelings of being overwhelmed continue, consider discussing these emotions with a mental health professional who can help you work through them.