Brief Answer:
Ultrasonography and Endometrial study indicated

Detailed Answer:
Dear XXXX,

Continuous bleeding for more than 45 days does require a serious cognisance. Moreover, the bleeding is of considerable degree.

At the age of 52, you have to look for so many lesions which may be responsible for such bleeding. Prima facea, it appears to be endometrial hyperplasia; however it needs to be confirmed. Before I advise you on this, would you please inform me the following information?

1. Are you menopausal or still get your menses? If so, please explain the characteristic of menstruation.

2. I would like to know your marital history and Obstetric history in detail.

3. Is this the first ever even of this type of bleeding or you had any such events previously? How did the bleeding start? Any precipitating event?

4. Do you have any pain associated with this bleeding?

5. Are you on any medication?

Once you provide me this information, I may have to ask some more questions. :)

Currently you are taking Trapic MF tablets. Trapic Mf Tablet contains Mefenamic Acid and Tranexamic Acid. The former give spasmodic pain relief while the later is useful for controlling the bleeding. However, since this is not useful in controlling the bleeding, immediately Add some potent Progestational medicine like Deviry in higher doses.

Simultaneously, let us try to find out the cause behind this bleeding. It appears to be from uterine origin; however, cervical lesions also will have to be looked for.

Please get your ultrasonography performed. It will report about the size of the uterus, any tumour in the uterus and the thickness of the uterine lining (endometrium). Please upload the images and the report for my review. Based on this report, the further investigations may be suggested. Hysteroscopy with endometrial biopsy for microscopic study would be a good step.

Along with, please report to your Gynaecologist for thorough internal examination. Please inform me his findings in details.

Since, you are bleeding for such a long time, you must have lost considerable blood. Please get your complete haemogram done. Please upload the report. Start iron tablets with high protein diet to take care of the blood loss. Also get your blood coagulation profile examined.

Sometimes, atherosclerotic changes in the blood vessels do cause such bleeding. Please inform me your blood pressure.

With all the information I have asked for, I can advise you more specific.

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

Dr. Nishikant Shrotri

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