Hi XXXXXXX

Thanks for asking in XXXXXXX

Hormonal imbalance or hypothyroidism is the common cause of irregular bleeding.

Metorrhagia (inter menstrual bleeding) may occur in association with ovulation and that is why your bleeding has started two weeks earlier. Sometimes there will be continuous bleeding so that the normal pattern could not be distinguished.

The most likely cause of bleeding in your case could be Dysfunctional Uterine Bleeding (DUB).

Since the active bleeding has stopped and only spotting is present it can be controlled by a combination of Mafenamic acid (an analgesic and anti inflammatory) and Tranexamic acid (anti fibrinolytic).

Mafenamic acid reduces pain and inflammation and also inhibits uterine contraction. Tranexamic acid controls bleeding. Your pelvic (lower abdominal) pain and abdominal cramps (due to uterine contraction) will also be relieved by Mafenamic acid.

It is always mandatory to investigate the cause, if this menstrual irregularity recurs. You should visit your treating physician to rule out other possibilities.

The other possibilities are submucosal polyps, fibroid uterus and genital tract malignancies.

Investigations like Pap smear, cyto hormonal evaluation, ultrasound, hormonal assay will help in diagnosis.

I hope this helps.

Regards,

---

Hi XXXXXXX

Sharp pain with bleeding irregularities should not be ignored. It could be due to any origin (uterine, ovarian or other abdominal organs). Warning symptoms that necessitates immediate treatment are severe abdominal pain, nausea, vomiting, fever and dizziness.

The origin of the pain needs to be investigated immediately. Although drugs like Dicyclomine can reduce the pain, but it will not give complete relief unless the cause is identified and treated. This drug will be of little use if the pain is due to ovarian origin (ruptured ovarian cyst).

Since the pain has worsened, please get yourself examined by your Gynaecologist "immediately” for further course of treatment.

Take care.
Regards.

---