Hello dear understand your concern Following are the causes of your problem: Menopausal state, High level of stress, Change in life style, Late ovulation, Excessive weight gain/loss, Drugs: Birth control pills, thyroid medication, Excessive tea and caffeine, Thyroid problem, Hormonal imbalance, endometrial dysplasia, endometriosis, adenomyosis, PCOS For pain: Take tablet Meftal Spas Two times a day for 3-4 days. Tablet medroxyprogestrone can be used for withdrawal bleeding OCP can be used to regular the cycle Do regular walking and exercise. Eat healthy diet with adequate vitamin and minerals supplements Also note that Menstruation required co ordinate action of various hormone that secreted by ovary (estrogen and progesterone) and brain (FSH and LH). If any above hormone is decreased or increased there is imbalance in menstruation. So please do full hormonal profile : Estrogen, progestron, LH, FSH, HCG and thyroid hormone. That help to diagnose hormonal imbalance. ABDOMINAL USG endometrial biopsy PAP smear Ovarian follicle study After confirmation you can take treatment according So please go ahead. Hope this may help you All the best. Stay healthy. Best regards Dr. Sagar