Nausea/vomiting, heat/chills, spotting, cause of symptoms?

Patient

Q: For the past month, I’ve been waking up once or twice a week feeling alternating heat and chills, and extremely nauseated, often actually vomiting. I was prescribed doxycycline hyclate (200 mg/day) for ten days during this time to help fight off pneumonia. I have always had irregular periods and was told this might make it difficult to have children in the future. I’ve noticed some very light bleeding recently. After using a menstrual cup to monitor the flow, it doesn’t seem to be getting any more abundant; just barely enough to spot a little throughout the day. This bleeding has been going on for two days. What could be causing these symptoms? I am 23 years old, do not use any hormonal birth control or IUD, but am sexually active with the same partner of 3 years, never unprotected. Any response/advice would be appreciated!

Symptoms:  Nausea, vomiting, heat/chills, "spotting"/light bleeding.
Doctor

A:   Hello. Welcome to Ask The Doctor.
I would like to keep two possibilities in your case:
1. Thyroid disorder
2. Polycystic ovarian syndrome (PCOS).
In both of these conditions you can have Menstrual Irregularities, Flushes, Alternating Chills and heats.
I would advise you to get following investigations done:
1. Thyroid Profile.
2. Fasting Blood Sugar.
3. Ultrasound Pelvic Organs.
I would recommend you to get these investigations on priority basis.
I won't suggest you any medicines for your problems as the treatment would depend on the cause.
I hope it helps.
Stay Healthy.

Comments / Follow Ups

Patient: Thank you for your response. I do have atypical PCOS (I do not carry much abdominal fat), it was diagnosed when I was 16, but I have never had nausea and vomiting be a part of it. I have had blood tests for both thyroid and fasting blood sugar come back within normal ranges, and ultrasounds show large cysts up to the size of a lemon which cause severe abdominal cramping.
Doctor: Hi
The Abdominal pain you are getting is because of the cyst.
You need to see your gynaecologist for further treatment.

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