Brief Answer:
Some more information required

Detailed Answer:
Hello XXXX,

I have read your menstrual history and have few doubts in it.

You had period twice in XXXXXXX Will you please mention the exact dates of the periods. Moreover, I would like to know:
1. What is your periodicity of the menstrual cycle.
2. How many days do you bleed?
3. Are your menses regular otherwise?
4. Please furnish me with your detailed menstrual history.

Yes, aversion of the taste, pica do suggest the pregnancy, however, the uterus has not risen to the abdomen as yet, hence tightness of the abdomen cannot be due to pregnancy.

The cardinal symptoms of pregnancy are:
1. Missed period: which you have
2. Nausea, vomiting and aversion in the taste. This also you are experiencing.
3. Frequency of urination
4. Breast Changes: Engorgement, tenderness, darkening of nipples & areola with increase in the size of areola and secretions through the nipples.
You have not mentioned any thing about the last two symptoms; so I presume they are absent.

Now it is almost 6-8 weeks since you have missed your period (I do not know the date of your last period). So if you perform urine pregnancy test (UPT) and/or ultrasonography now, you will get clear indication about the possibility of pregnancy. The last UPT test was negative, probably because it was performed too early. UPT before 8-10 days after missing a period can be false negative and non-conclusive. Hence the date of last period is important to me.

Till you get these tests performed, please furnish me the requested information and after the tests, please upload the reports and images so that I can vouch my opinion to clarify your dilemma.

If you are not pregnant, then you will have to be investigated for irregular menses. Then I will require further more information, may be I might advise you some investigations after I get the details I have requested for. After getting these facts, I will be better equipped to guide you further.

For any more information, I am always available for you, XXXX.

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Brief Answer:
Let us investigate for PCOS initially

Detailed Answer:
Hallow XXXX,

Let us first discuss about your two periods in XXXXXXX First period was on 2nd XXXXXXX and the second period was on 21st XXXXXXX So there is a gap of almost 3 weeks between the two. Since your periods are irregular, this could have been a bit earlier, however not too much earlier than 28 days.

I feel, we have to concentrate on the irregularity of your periods. Now considering your other symptoms which you have mentioned in this message are acne, cramping emotional disturbances. Considering irregular menses and acne, I would like to first have a look at the possibility of Polycystic Ovarian Syndrome (PCOS). I had requested for your height, weight and BMI. This data will help me for the probable diagnosis of PCOS. In addition, do you have coarse hair at unwanted places like face, chest or abdomen? Are the hair on your legs too coarse?

To start with, would you please get your hormonal profile done? Please get your blood examined for FSH, LH, Progesterone and Oestrogen levels. These values will help me in further diagnosis. Also, I want your ultrasonography of abdomen done which will throw light on the size of ovaries and thickness of the lining of uterus.

After these reports are available, I will have some direction for further workup. Please upload the reports and the images.

I am awaiting for your investigation reports and images. Meanwhile if you want any more information or explanation, I am always available for you XXXX.

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