<s>[INST] I ve had sudden headaches, dizziness and fatigue for the past six weeks. I am on Aviane birth control and have been for the past year, but my last period was one day late and only light, but it had pretty bad cramps. This is the first time that has ever happened since being on it. I took a pregnancy test when I was late, but it came back negative. Could I be pregnant or could it be a sudden problem with my birth control? [/INST] Hi there,Thanks for your query.The brief details provided by you, point towards the following possibilities:-*   Mental stress/anxiety, leading to frequent migraines. A long-term course of anti-depressants + anti-anxiety drugs combination will provide you great relief from headaches, dizziness  and fatigue.*   Thyroid problem (hypothyroidism) which, in addition to your symptoms, is also accompanied by weight gain, constant fatigue, mood disorders, hair fall etc. Thyroid hormone profile will rule out/confirm this condition. if the diagnosis is confirmed, thyroid hormone replacement therapy will cure you of all problems.*   Fibroid (a growth) in the uterus, which will be detected on ultrasound.Consult your doctor and apprise him of my opinion. I am certain that he agree with me, order required tests, and- based on the reports-  will prescribe suitable treatment as advised.If you find my response helpful and informative, do not forget an “excellent” rating to my answer, to encourage all doctors- engaged in social service- to render sound advice to the FREE queries. Fond regards and have a nice dayDr. Rakesh Karanwal </s>