Brief Answer: DETAILS ARE GIVEN BELOW. Detailed Answer: Hello, Thanks for writing to us on Healthcare Magic. According to your history and ultrasound scan, irregular bleeding is mostly related to Dysfunctional Uterine Bleeding (DUB), where definite pelvic pathology is not found but marked endometrial hyperplasia is a prominent feature which leads to excessive bleeding. It occurs among 10% new patients attending the OPD. In this condition, anovular bleeding is usually excessive. In the absence of growth limiting progesterone due to ANOVULATION, the endometrial growth is under the influence of estrogen throughout the cycle. Here, some additional investigations like Biopsy following Hysteroscopy, Endmetrial smpling/ D & C may be required to exclude other pathology (if any) under the guidance of your doctor. TREATMENT: Medical management is the key element in this age group to correct hormonal imbalance and arrest bleeding or regularize monthly cycle. Medroxy Progesterone Acetate (like MODUS etc) group of drug is the first choice. It is given for continuous 21 days with 7 days interval for 3 months course. You need follow up examination periodically. Maintain genital hygiene properly and take IRON supplements regularly to combat deficiency or anemia. Hope, it helps for your information. Kindly, close the discussion if you don't have any other query. Wish your good health and take care yourself. Regards, Dr Soumen For future query, you can directly approach me through WWW.WWWW.WW

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Brief Answer: DETAILS ARE GIVEN BELOW. Detailed Answer: Hello XXXXXXX Thanks for follow up queries. 1) You would take healthy protein rich diet with more green vegetables and IRON supplements. It will help to combat with Anemia (specially Iron Deficiency). Drink more water for better systemic circulation and to stay hydrated. 2) Irregular excessive bleeding or heavy period with thickened endometrium (in few percentage) is the main clinical symptom of DUB. However, bleeding disorder, gum bleeding or epistaxis, thyroid disturbance, PID (Pelvic Inflammatory Disease), Poly Cystic Ovary etc should be ruled out by necessary investigations. 3) With regular doses (5 to 20 mg daily), side effects of MODUS is quite tolerable and it depends on adjustment of external hormone inside body system. However, long term use of MODUS (Medroxyprogesterone) may cause some side effects like headache, abdominal pain, weight gain, backache, change in the appetite, fatigue, increase sex drive, prolonged absence of period etc. 4) DUB (Dysfunction Uterine Bleeding) occurs due to impairment of the HPO axis (Hypothalamus- Pituitary- Ovarian) without specific pelvic pathology. Stress, anxiety, emotional disturbances, sexual problem etc are the triggering agent for the same. Therefore, you should control them by regular yoga or meditation. Complete cure rate of DUB is very minimal. At this stage, medical treatment is the key protocol for DUB management. D & C can be done in few cases. Definite treatment is Total Hysterectomy after 40 years age with completed family. 5) DUB should be treated with Hormonal tab or Progesterone supplement (like MODUS) to arrest bleeding and regularize cycle. It is given for 3 months course initially. Then, follow up examination is required to determine whether you need further course of the treatment or not. It may recur or control by own following completed treatment. 6) Irregular bleeding with impairment of ovulation and pattern of endometrium may cause problem in natural conception (Infertility). However, supportive treatment like progesterone supplement, ovulation induction drug etc can facilitate your chance of successful conception. So, you wouldn't be worried about much. 7) Persistent endometrium hyperplasia is a risk factor for developing endometrial carcinoma after 40 years age. Periodic follow up examination is required to your GYNECOLOGIST for proper management. In addition to above, you should underg these tests to rule out other underlying causes. These include Complete Blood Count, PT/ aPTT, FSH, LFT, TSH, Prolactin level, DHEAS etc. Hope, I have answered your all queries. Kindly, close the discussion. All the best and good luck. Regards, Dr Soumen

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