OpenHealth Q&A

Persistent Swollen Lymph Nodes for Five Months

Personal Background: I’m a 19-year-old transgender male, standing at 175 cm (approximately 5’9”) and weighing around 125 lbs. I am of Caucasian descent and have been sober from alcohol for eight months and from marijuana for seven months, with no use of other recreational drugs. My current medications include 25 mg of sertraline daily (I began taking sertraline when I was about 13 or 14 years old; my dosage peaked at 150 mg but has remained at 25 mg for nearly two years), a weekly subcutaneous injection of 50 mg testosterone enanthate (started 3.5 months ago), 20 mg of lisdexamfetamine (initiated 1.5 months ago), and I take daily contraceptive tablets containing 0.15 mg levonorgestrel and 0.03 mg ethinyl estradiol (I’ve been on birth control since I was 14, which I started about six months after my menstrual cycles began due to intense pain and excessive bleeding; I switched to the current BC pill at age 17). Additionally, I was diagnosed with high cholesterol two months ago, with my cholesterol profile being: total cholesterol at 200 mg/dL, triglycerides at 101 mg/dL, HDL at 52 mg/dL, LDL at 130 mg/dL, non-HDL at 148 mg/dL, and LPA at 83 nmol/L (my LDL previously peaked at 171 in December 2023). I also have diagnoses of autism and ADHD. I experienced precocious puberty starting at age five due to a benign cyst in my pineal gland. My family history includes cancer, with one parent having had colorectal cancer and the other cervical cancer, both of whom are now cancer-free. Main Concern: I have noticed two swollen lymph nodes in my neck, located just below my ear, behind and slightly above the angle of my jaw. The left node has been enlarged for a minimum of five months, while the right one has been swollen for at least four months. Both nodes feel firm and do not move when I apply pressure. The left node initially grew to the size of a medium pea before stabilizing as I began noticing the right node. For months, both lymph nodes were approximately the size of a smaller than dime but have recently increased in size over the last two to three weeks. The dimensions from the top (underneath my ear) to the bottom of both are roughly equivalent to the length from my fingertip to the first knuckle on my index finger. Their shapes have become more oval, with the left node presenting a smaller bump atop the larger one. Both nodes are now slightly visible from the front and become more prominent when I tilt my head. I first identified these nodes after accidentally bumping them and have since tried to avoid excessive touching to prevent worsening their condition. What could this indicate? I currently do not have a primary care provider but see an endocrinologist at my university for testosterone and cholesterol management. I have an upcoming appointment with my endocrinologist in two weeks. Should I wait until then to discuss my concerns, or would it be advisable to secure an earlier appointment with another physician?

Answers (1)

9/12/2025, 2:31:05 AM

OpenHealth AI

It's understandable to feel concerned about persistent swollen lymph nodes, especially given their duration and recent increase in size. Here's a breakdown of key points regarding your condition and effective next steps:

Main Points

1. Swollen Lymph Nodes: Lymph nodes can swell due to several reasons, including infections, inflammation, or, less commonly, malignancies. Your situation warrants attention, especially considering their persistence and recent growth.
2. Current Medications and Health Background: Your ongoing medical treatments and medications might interact with your symptoms, highlighting the need for comprehensive evaluation.

Explanation

Lymph nodes play a significant role in your immune system, responding to infections or other issues in your body. The fact that the lymph nodes have been swollen for five months and have recently increased in size is important. While it’s common to have lymph nodes swell in response to infections (like a cold), longer-lasting swelling can sometimes indicate more serious conditions.

Given your health background, notably your family history and the complexity of your current medications, it's essential to ensure that any potential underlying issue is addressed.

Next Steps

1. Seek Medical Evaluation Sooner: Given the persistent swelling and recent changes, it would be advisable to contact a healthcare provider to discuss your symptoms. If possible, try to see someone before your endocrine appointment. Look for a primary care physician or an urgent care facility if you can’t find a specialist immediately.

2. Document Symptoms: Before your appointment, keep a detailed record of your symptoms, including:

   • The exact size and changes in the lymph nodes.
   • Any associated symptoms (fever, weight loss, night sweats, discomfort, etc.).
   • Any recent infections or illnesses.

3. Avoid Manipulation: Continue avoiding touching or pressing on the lymph nodes, as this can lead to irritation and potentially exacerbate any underlying condition.

4. Prepare for Your Appointment: At your appointment, be prepared to discuss your complete medical history, including your current medications, family history of cancer, and any other symptoms you may have.

5. Lifestyle Considerations: Maintain a balanced diet, stay hydrated, and manage stress as best as you can. While these may not directly address the lymph node issue, they support your overall health.

This may be a concerning time, but taking these proactive steps can lead you to clarity and appropriate management. Please keep me updated, and let me know if you have any further questions or need more guidance.