Q. I am having diarrhea, severe headaches, and fatigue after contraceptive pill withdrawal. Why?

Answered by
Dr. Uzma Arqam
and medically reviewed by Dr. Divya Banu M
This is a premium question & answer published on Jan 02, 2020

Hello doctor,

Since I came off the pill 14 months ago, I have had lots of issues: black, brown, smelly spotting, irregular periods, severe pain, severe fatigue, been to the emergency department many times with different issues (stomach bleeding, severe stomach pains, lightheadedness, back and neck ache, etc.). I developed a headache about 6 months ago, MRI showed a pituitary microadenoma, have been to endocrinologist but he has ruled out hormonal reasons and sent me away saying another MRI will be done in 6 months and have referred me to a fertility specialist. I cannot live like this, severe stomach issues, cannot eat properly, diarrhea, severe headaches 2 weeks leading up to periods, have lost 5 kg within 5 months, severe fatigue, no energy for anything, palpitations, any exercise makes me very lightheaded. Someone please help.

Dr. Uzma Arqam

Obstetrics And Gynaecology


Welcome to icliniq.com.

In your description you have mentioned lots of issues that needs to be investigated and sorted out in detail individually. Microadenoma and hormonal imbalance are two separate issues actually those can cause different symptoms, need different investigations, precautions and treatments. It would be better if you could send me your detailed reports.

Adenoma related issues need to be consulted with endocrinologist on regular basis. For rest of the medical issues need to be consult with consultant general physician to sort out for every symptom. Have some counseling sessions with pshychaitrist to help feel emotionally balanced.

For irregular periods have transvaginal scan and blood tests on day 2 of periods (testosterone, progesterone, prolactin, insulin, FSH and LH , thyroid function tests), high vaginal swab, cervical smear. Collect all laboratory tests and discuss here. Have combined oral contraceptive pills for 3 cycles to have hormonal support and regulate periods. After collection of swab from vagina, have injection Ceftrioxone 500 mg intramuscular once. Azithromycin 1 gm per oral once. Tablet Doxycycline 100 mg twice daily and tablet Metronidazole 400 mg 8 hourly for 14 days. Have balanced diet , weight and BMI. Complete treatment of any health issue you have. Have daily walk, exercise and yoga. Have recreational activities and quit recreational drugs. Have cold milk at bed time and after waking up before breakfast.

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