Beth is a 29 year-old female who visits your clinic due to increasingly heavy periods over the past year. Her presentation was triggered by an episode of flooding while at work which has not happened before. She also reports significant fatigue causing her to lose focus at work, and experience shortness of breath when walking upstairs at home. Beth reports these symptoms have only impacted her over the past few months.
What further history would you seek from Beth?
To gain a comprehensive understanding of Beth’s condition, you would want to ask about the following areas:
1. Menstrual History
– Duration, regularity, and frequency of her menstrual cycle.
– How many days her period lasts and how many pads/tampons she uses per day.
– Any clots in the blood and the size of these clots.
– Whether the heavy bleeding occurs at each period or if it’s occasional.
2. Associated Symptoms
– Any pain associated with menstruation (e.g., cramping, pelvic pain).
– Signs of premenstrual syndrome (PMS) such as bloating, mood changes, or breast tenderness.
– Any recent changes in menstrual pattern or intensity.
3. Systemic Symptoms
– General fatigue, weakness, or changes in energy level.
– Shortness of breath or palpitations, especially with physical activity.
– Dizziness or lightheadedness, particularly during or after her periods.
4. Impact on Daily Life
– How her periods are affecting her daily activities, work, and mental health.
– Any limitations caused by her fatigue or breathlessness.
5. Medical and Surgical History
– History of any gynecological issues (e.g., fibroids, endometriosis, polyps).
– Any past surgeries or medical procedures (e.g., D&C, cesarean section).
– Any history of anemia or bleeding disorders in her family.
6. Medications and Contraceptive History
– Current medications, especially those affecting bleeding (e.g., anticoagulants, NSAIDs).
– Use of hormonal contraception, history of IUD insertion, or any hormonal therapy.
7. Lifestyle and Diet
– Dietary intake, especially iron-rich foods.
– Alcohol, smoking, or caffeine use, which may impact her symptoms.
– Stress levels and recent life changes, as these can affect menstrual health.
8. Obstetric History
– Previous pregnancies, miscarriages, or terminations and any complications associated with these.
– Any issues with postpartum bleeding in past pregnancies.
9. Family History
– Family history of heavy periods, clotting disorders, or reproductive health issues.
These areas will help identify potential causes of her symptoms, such as iron-deficiency anemia, fibroids, or a bleeding disorder, and guide further investigation and management.
