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Feeling Overlooked: Seeking Guidance on Symptoms

8/26/2025, 10:53:21 AMMale25-34

Hello, I’m reaching out for some insights regarding my health issues. Two years ago, I was diagnosed with polycystic ovary syndrome (PCOS). At that time, I opted to attempt weight loss strategies rather than immediately starting medication to manage my condition. Currently, I have achieved a healthy weight and my androgen levels are within the normal range; however, my symptoms have actually worsened. It feels as though my doctor is dismissing my concerns, as every time I report symptoms, they suggest a blood test, and if those results are normal, there’s no further discussion or investigation. **Demographics:** 20 years old, Female **Symptoms include:** - Prolonged bleeding or spotting that has lasted over two months, making it difficult for me to determine if this is a menstrual cycle. My doctor attributes this to my PCOS, but I’m confused as my hormone levels are now normal. Historically, my menstrual cycles have been irregular, lasting 3-4 weeks followed by absences ranging from 6 to 9 months. I have never experienced bleeding that continues this long before. - I often notice minimal blood on pads, yet the toilet water appears bright red when I urinate. Additionally, I find myself frequently feeling the need to urinate even when my bladder isn’t full (this isn’t due to a urinary tract infection). - Chronic fatigue persists, and I remain low in energy even after sleeping for 6 to 9 hours, with mornings being particularly challenging. - I have a diminished appetite. I am curious about whether these symptoms could indicate a specific issue and if it might be advisable for me to consult another physician for a second opinion. Thank you for your help!

LupusThyroid DisordersRheumatology

Answers (1)

Cony

8/26/2025, 10:53:39 AM

OpenHealth AI

Your health concerns around prolonged bleeding, urinary issues, chronic fatigue, and diminished appetite after managing PCOS are understandably distressing, especially when you feel overlooked. It's essential to explore these symptoms further as they may indicate underlying issues that need to be addressed.

Key Points

  1. Prolonged bleeding and spotting can occur for several reasons beyond PCOS, despite normal hormone levels.
  2. Bright red blood in urine and frequent urination may need further evaluation.
  3. Chronic fatigue and diminished appetite can be linked to various health issues.

Explanation

  1. Prolonged Bleeding: While PCOS can lead to irregular bleeding, the duration you're experiencing (over two months) is concerning. This could be a sign of other conditions such as endometrial hyperplasia (thickening of the uterine lining), fibroids, or a bleeding disorder, especially since you’ve not experienced this type of bleeding before.

  2. Urinary Symptoms: Bright red blood in the toilet after urination could indicate a urinary tract issue or another underlying problem in the urinary system. The sensation of needing to urinate frequently, even when your bladder isn't full, could be related to irritation or infection despite negative tests.

  3. Chronic Fatigue and Diminished Appetite: These symptoms can arise from various factors, including hormonal imbalances, nutritional deficiencies, stress, or even conditions like thyroid disorders or lupus, which you've mentioned.

Next Steps

  1. Monitor Symptoms: Keep a detailed diary tracking your bleeding patterns, urinary symptoms, and fatigue levels. Note any changes or triggers you observe.

  2. Consider a Second Opinion: Given your ongoing symptoms and the feeling of being dismissed, seeking another physician's perspective is a reasonable step. Look for a healthcare provider specializing in women’s health or reproductive endocrinology who understands PCOS and its related complications.

  3. Evaluation for Other Conditions: When you consult a new physician, bring your symptom diary and discuss all your concerns comprehensively. They may recommend additional tests beyond routine blood work, such as:

    • Ultrasound of the pelvis to check for abnormalities.
    • Tests for bladder issues or infections.
    • Assessing thyroid function and autoimmune markers if fatigue continues.
  4. Self-Care and Management: Focus on maintaining a balanced diet that supports your energy levels and overall health. Engage in regular, gentle exercise, as this can help improve your energy and mood.

Reassurance and Support

It's important to advocate for your health, and feeling overlooked can be frustrating. Remember that your symptoms are valid, and seeking further evaluation is a proactive step toward understanding and managing your health better. Let me know if you have more questions or need further guidance!

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