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From: anonymous (anonymous@obgyn.net)
Tue, 22 Oct 2002 14:25:54 -0500 (CDT)


Dear doctor,

I am a 26 year old unmarried girl, I hope you can help me. (My periods first began when I was 13yrs old & the flow was moderate & lasted 4-5days, no significant dysmenorrhea). My health problems began when I was 18 years old, that year I got my periods only twice at a gap of 6months each. However, I assumed it was due to the immense amount of mental stress & depression I had that year due to various personal changes in my life. I also developed pedal edema & water retention in my whole body that year – the weight gain would be as much as 4kgs, my undergarments would become tight. Since then, I’ve had the edema till date, it increases whenever I am stressed/upset & also in the pre-menstrual time. There has been no edema-free period since past 8 yrs. I got my urine tested several times when my edema is more & each time the report was normal, no proteins in the urine.

I also became bulimic at 19yrs. From age 19 to date, my periods are very irregular, the cycles range from 30 days to 50days, & atleast once a year, I don’t get my periods for a gap of 3-4months. The flow is moderate, no clots, lasts 3-4 days & sometimes I have dysmenorrhea. I realised I have PMS when I was 19yrs, since then, the duration of my PMS has increased from 2-3 days to 2weeks. My PMS symptoms are severe. I am suffering from depression for the past 8 yrs, though now, the depression is not as severe as it was when it first started at age 18.

I have not taken any medication for any of my symptoms, neither have I consulted a doctor. My parents won’t let me to see a doctor until after I am married b’coz they feel a diagnosis of depression & any gynecological dysfunction would hinder their efforts to finding a good groom. There is no way, they are going to take me to a doctor, even though I have pleaded with them in the past.

I don’t know if it is relevent, but I have eczema (I think it is atopic type eczema) since I was 6 or 7 yrs old. I only apply local corticosteroid cream when it increases.

My height is 165cms & weight is 55kg, my weight fluctuates by 4-5 kgs b’coz I’m bulimic, but I control my weight by exercising which I have been regularly doing since I was 16 yrs old.

Over the past 5 weeks, I noticed there is increased hair growth above my upperlips. It was not present previosly. I have extensively researched all my symptoms, I think I may have PCOD. I don’t know whether to attribute all my symptoms to stress+depression+bulemia or to PCOD alone or to both. Can you give me a diagnosis based on my symptoms,? B’coz I have no blood tests or physicians report, if a definitive diagnosis can’t be made can you atleast tell me all the conditions that I could possibly have & what effect it will have on my health, & will I counter any problems conceiving once I do get married. Is there an age before which I should have a baby i.e. do I have to have one as soon as I get married – b’cos I personally do not want to have kids for atleast 4-5 yrs after getting married. And my marriage has not yet been fixed & it could take another year or two before that happens. My biggest fear is – can my periods stop totally in the next few years?

To summarise my complaints – edema, irregular periods, bulimia, PMS, depression & eczema. I know it’s a rather long letter, thank you for your time, & I sincerely hope you can help me.

Yours, girl in need.

India.




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