Dear Er. Dinesh Kumar Baxi,
Form the history you have provided, Mrs. Rachana seems to be in her perimenopuasal period. During this phase of life, irregular menses are known. However, continued bleeding for a fortnight should not be neglected.
Please get her blood examined to find out whether this bleeding is making her anaemic. Anyway, start iron tablets in advance. This much bleeding will make her anaemic. Etosys
is Tranexamic acid
which helps control bleeding from any site in the body. However, I feel before taking the medicines, she should undergo certain investigations to avoid masking of any signs and/or symptoms. Ultrasonography
at this stage will be very helpful. It will inform us about any tumour present in the uterus
or outside, any other pathology in the pelvis and most importantly thickness of the uterine lining (endometrium). Endometrial thickness less than 4 mm allows to take a sigh of relief. If endometrial thickness is mote than 4 mm, endometrial microscopic study is warranted.
Hysteroscopy/Hysteromicroscopy gives a good view of the endometrium and guides us for taking biopsy
of the endometrium from suspicious site for microscopic study. After these reports, further management may be planned.
If there are any tumours in the uterus or adnexa, they will call for active management, may be by surgical intervention, since it has landed in excessive bleeding. However, usually the bleeding with tumours is associated with pain in the abdomen. She does not seem to have any pain.
At this stage, I would not give much weightage to the teen age irregularity of menses as immediately after menarche
, the menses are irregular for a couple of years or so.
I feel management of Mrs. Rachana seems to be on correct line. After ultrasonography, your Gynaecologist will decide further on endometrial study.
We can discuss on this more after you get her reports. You may upload the reports and ask me Direct question.
Till that this information should help you.
Dr. Nishikant Shrotri