Table of Contents
Common Questions
Chat with CodyMD
Cody's Chat with Patient
Cody's AI Summary
Top 3 AI Diagnosis List
Review by Dr Albert DiPiero
Resource Center
Testimonials
Share this Case Study
Case Study
Meet your host
Albert DiPiero, MD MPH FACP
I am a co-founder and the Chief Medical Officer at CodyMD and your host for this edition of Cody Grand Rounds. I have been a practicing physician and faculty member at medical schools for over 26 years.
About The AI Doctor Case Study
CodyMD is a partnership between Human Doctors and AI Doctors. Cody is an AI Doctor who helps thousands of people every day. At each Cody Grand Rounds, I select a real case and review it with Cody, the AI Doctor.
Each case is based on a real patient but has been modified to maintain privacy and to emphasize certain teaching points.
Common Questions
What can cause irregular periods and PMS symptoms?
How can AI doctors help in diagnosing PMS symptoms?
Why am I experiencing fatigue before my period?
What can cause mood swings within the menstrual cycle?
How does premenstrual anxiety differ from general anxiety?
What are the common symptoms of PMDD?
Can weight gain affect menstrual symptoms?
How can AI doctors help in diagnosing PMS symptoms?
Chat with CodyMD
Click the button below to initiate a conversation with CodyMD, your AI Doctor.
Cody's Chat with Patient
Below is a conversation transcript between the patient and our AI Doctor CodyMd.
Cody, the AI Doctor
Hello, it’s nice to meet you. I understand you're experiencing irregular periods and PMS symptoms. Is that correct?
Patient
Yes, that’s right.
Cody, the AI Doctor
My goal is to provide you with a thorough assessment and help figure out what might be going on. Let’s start by discussing when you first noticed the irregular periods. How long has this been happening?
Patient
It started about eight months ago.
Cody, the AI Doctor
Thank you. Irregular periods can be quite disruptive. Do you have any idea if there have been any specific triggers or changes in your life around that time?
Patient
Not really. My lifestyle has been pretty consistent.
Cody, the AI Doctor
Understood. I know this can be frustrating. What kind of changes have you noticed in your periods over the past eight months?
Patient
They've become quite variable. Sometimes they’re early, sometimes late, and other times they last longer than usual.
Cody, the AI Doctor
Got it. Besides the irregular periods, you mentioned other symptoms like fatigue, anxiety, and mood swings. How often do these occur?
Patient
I usually start feeling fatigued, anxious, and have mood swings about five days before my period.
Cody, the AI Doctor
Are there any other symptoms you experience before or during your periods?
Patient
Yes, I also get some abdominal pain, bloating, low energy, and headaches.
Cody, the AI Doctor
That sounds difficult. Have you noticed any changes in your weight recently?
Patient
I’ve gained about ten pounds in the last year.
Cody, the AI Doctor
Okay, notable weight changes can sometimes be related. Have you had any changes in your diet or physical activity during this time?
Patient
Not really, my diet and activity levels have been about the same.
Cody, the AI Doctor
I see. You mentioned feeling bloated and experiencing abdominal pain. Is this pain localized to any specific area of your abdomen?
Patient
It's usually all over but tends to be worse in the lower abdomen.
Cody, the AI Doctor
Thanks for sharing that detail. Have you had any unusual vaginal discharge?
Patient
No, none at all.
Cody, the AI Doctor
Understood. Sometimes these symptoms can feel overwhelming. How has it impacted your daily life and interactions with healthcare providers?
Patient
Honestly, it’s been tough. I don’t feel like my concerns are taken seriously or that I'm really being heard by my healthcare providers.
Cody, the AI Doctor
I’m sorry to hear that. Your symptoms and well-being are important, and I want to help you get to the bottom of this. I appreciate you sharing all these details with me. Just a few more questions: Do you use any form of contraception?
Patient
Yes, my partner and I use condoms.
Cody, the AI Doctor
Thanks for clarifying. Do you have any history of depression or other mental health conditions?
Patient
No diagnosed history, but I do feel really low sometimes, especially in the days leading up to my period.
Cody, the AI Doctor
That helps to paint a clearer picture. Thank you.
Cody's AI Summary
- You are a 27-year-old woman experiencing irregular periods for the past eight months.
- Your symptoms include fatigue, anxiety, mood swings, abdominal pain, bloating, low energy, and headaches, especially in the five days before your period.
- You have had a weight gain of ten pounds over the last year.
- You are in a monogamous relationship, using condoms for contraception.
- You have not experienced any unusual vaginal discharge and report feeling unsupported by previous healthcare providers.
Top 3 AI Diagnosis List
Based on the information and conversations with Cody, we have prepared a top 3 AI Diagnosis List.
1. Premenstrual Syndrome (PMS)( 70 % probability)
PMS refers to a variety of symptoms including mood swings, fatigue, abdominal pain, bloating, headaches, and irregular periods, which typically occur in the luteal phase of the menstrual cycle.
2. Premenstrual Dysphoric Disorder (PMDD)(20 % probability)
PMDD is a severe form of PMS and includes similar physical symptoms but is characterized more by mood-related symptoms such as severe anxiety, depression, and significant mood swings before menstruation.
3. Depression(10 % probability)
Depression could be contributing to or exacerbating your symptoms, especially given your feelings of low energy, weight gain, and the sense of not being understood by healthcare providers. It may overlap with PMS or PMDD symptoms but can persist beyond the menstrual cycle.
Review by Dr Albert DiPiero
Dr. Albert DiPiero
The patient’s history of irregular periods over the last eight months, which includes symptoms like fatigue, anxiety, mood swings, abdominal pain, bloating, low energy, and headaches, indeed points towards premenstrual syndrome (PMS) or possibly premenstrual dysphoric disorder (PMDD).
1. Premenstrual Syndrome(60% probability)
The cyclical nature and the onset of symptoms approximately five days before menstruation align with PMS. This condition often involves a combination of emotional and physical changes, such as mood swings, fatigue, and abdominal discomfort, which fits well with the patient's reported experiences. The period of symptoms decreasing after menstruation begins further supports this diagnosis.
2. Premenstrual Dysphoric Disorder (PMDD)(30 % probability)
PMDD is a severe form of PMS and is characterized by more intense mood-related symptoms. The significant impact on the patient's daily life and interactions with others align with the pronounced mood swings and feelings of severe anxiety she describes. Although PMDD overlaps with PMS in terms of physical symptoms, the heightened emotional distress suggests this as a potential diagnosis.
3. Depression(10% probability)
While the patient exhibits symptoms like low energy and weight gain, which can be associated with depression, these occur predominantly in sync with her menstrual cycle. This cyclic pattern makes primary depression less likely but does not exclude it from being a contributing factor to her overall mental health.
Next Steps for Evaluation
Blood Tests: Including thyroid function tests and hormonal profiles to rule out thyroid dysfunction and hormonal imbalances.
Symptom Diary: Maintain a detailed menstrual and symptom diary to track the occurrence, severity, and duration of symptoms in relation to the menstrual cycle.
Mental Health Evaluation: Screening for underlying depression or anxiety disorders.
Treatments
Lifestyle Modifications: Encourage dietary changes, regular exercise, and sleep hygiene to support overall health and symptom management.
Medications: Consider NSAIDs for abdominal pain, SSRIs for mood symptoms, and hormonal contraceptives to regulate menstrual cycles and alleviate PMS/PMDD symptoms.
Psychotherapy: Cognitive behavioral therapy (CBT) or other forms of counseling may help address the emotional and psychological aspects of the patient’s condition.
Conclusion: In conclusion, the primary probable diagnosis is PMS, closely followed by PMDD, with a smaller chance of depression affecting the patient's overall well-being. A detailed evaluation is essential to confirm these conditions and tailor treatment effectively.
Resource Center
Testimonials
CodyMD is a very precise and accessible app. My consultation with CodymMD is commendable and I highly recommend it for others to try CodyMD especially for assessment and consultation purposes.
TrustPilot Review
Dr Cody spot on, better than most Human Drs. Also far more pleasant. Try him, he could better help you understand your issues. He will give you good info for your Drs visit as well.
TrustPilot Review
It gave me the best response possible and suggested simple self care treatment options which I'm in favor with. It has a to the point interface and brief answer for better understanding.
TrustPilot Review
