How do I treat my anal fissure, facial hair, and irregular periods?

Question

Hi doctor,

I have what seems to be an anal fissure. I sometimes have small amounts of blood on my toilet paper after going. Also, itching and stinging sort of pain during and for about ten minutes after going. I also had to go to the hospital a few weeks ago for what seemed to be a gal stone. I had horrible pain in between my shoulder blades that moved to the front. I was given an Endone, and the pain was gone in the morning. I have been dizzy and have had trouble concentrating for about six weeks now. For a few years now, I have been getting between three to ten black hairs on my chin, also irregular periods. Five years ago, I gained 35 kg in seven months and had not been able to get rid of the weight. I tighten up with exercise and better eating, but nothing seems to really help. I am 25 years old, female, 169 cm tall, and 128 kg.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern. Your symptoms point towards a number of things.

The weight gain, along with hirsutism (the facial hair), the menstrual irregularities, and infertility, is all very likely due to a condition called polycystic ovarian syndrome. This is a hormonal disorder but can be easily and effectively corrected with proper medication. However, we need to confirm the diagnosis first; for that, you need to get some investigations done. The anal symptoms are probably just hemorrhoids and not fissures, as an anal fissure would be very painful. Eat a fiber-rich diet and work on reducing your weight. For now, you do not need medication for this. The gallstone issue is that you are suffering from cholecystitis which sometimes causes reffered pain to the tip of the right shoulder. The weight gain has possibly contributed to the development of gallstones, and we need to get an ultrasound scan of the abdomen to confirm that. Please read the following investigation plan and subsequent treatment.

It is helpful to do the following investigations:

Upper and lower abdominal ultrasound to rule out both polycystic ovarian syndrome and cholecystitis.
Serum LH (luteinizing hormone) and FSH (follicle-stimulating hormone) levels.
Serum Testosterone levels. Differential diagnosis: Hypothyroidism.

The differential diagnosis is hypothyroidism, and the probable diagnosis is a polycystic ovarian syndrome with cholecystitis and hemorrhoids.

Please get the investigations done first, and based on the findings, we need to proceed with the treatment.

Eat a fiber-rich diet and plenty of water to avoid constipation.

Please revert to the test results to proceed with a treatment plan.

Hope this helps.

Thank you for visiting icliniq.com.