Brief Answer:
Get investigated for PCOS

Detailed Answer:
Dear XXXXXXX

I feel I have to explain you certain medical facts before I give you any advice.

Provera and Primolut - both are progesterone preparations. Withdrawal bleeding of progesterone is always less. So none will give more bleeding.

Your periods have been delayed - not only delayed but seems that they are becoming irregular. Along with you are putting on weight. This weight gain is not due to delay of the menses. In fact irregular menstruation, obesity (particularly around the waist), coarse hair (may start on shin and then spread to inner thighs, abdomen, chest and face also) are all indicative of a condition called as Polycystic Ovarian Syndrome (PCOS). I would urge you to look for all these symptoms.

PCOS is a condition wherein the eggs are not released by the ovaries and they are trapped in the ovaries. Therefore the woman in most of the times is infertile. This is condition is associated with hormonal imbalance. Along with the infertility, insulin insensitivity and cardiovascular problems also are associated with this. With timely proper treatment, pregnancy can be achieved because of the newer medicines available now.

The best and easier ways to diagnose this condition are:
1. Serum hormonal levels. Serum FSH and LH are most important. Some prefer to get Oestrogen, Progesterone and Prolactin levels also done. FSH and LH tests are done on 2nd or 3rd day of menses.
2. Ultrasonography to visualise the images of ovaries. This shows the condition of ovary.

I would advice you to get your ultrasonography done and also get Serum FSH and LH done with the consultation of your Gynaecologist. Then please upload the reports for my review. This will enable me to clinch the diagnosis. After having a look at these reports, I may suggest you some more investigations.

What is your BMI? This index many times helps us to suspect the PCOS.

Hormonal imbalances if treated earlier give better results. May be the treatment offered to you could be little different that to be given after marriage. However, please cooperate with the Gynaecologist to get yourself properly and correctly diagnosed first.

I feel, I have given you sufficient guidance with information to enable you to take an informed decision.

Please do not neglect; take due care and give me a feedback with the reports. I shall not be only happy, but am keen to guide you further.

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Brief Answer:
Do not neglect your health

Detailed Answer:
Dear XXXXXXX

If you continue to take Primolut, you will not get menses. However after you discontinue it, you should get period within 4-8 days.

Instead, you may take birth control pills for five days and then discontinue them, you should get period within a weeks time.

Also, injections of combination of Oestrogen and Progesterone are available to bring the menses.

You may choose according to your convenience and your Gynaecologist's advice.

You should not discontinue physical activity regardless of menstruation. Apart from any indoor exercises, if at all you are doing, a walk for minimum 40 minutes is very important. You have to walk for 40 minutes at the rate of 90 steps per minute.
XXXXXXX please do not neglect your health for the sake of work. Take proper care of your health; negligence should not affect your health in future.

For any further advice, you may ask me any time. Please upload your reports.

Wish you a healthy life.

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Brief Answer:
Understand the normalcy of menstruation please

Detailed Answer:
Dear XXXXXXX

You have to decide when to stop Primolut tablets. After discontinuing them, you will get menses within 4-8 days. Primolut being a Progesterone preparation, the withdrawal bleeding you get during menses is always less. If you are having scanty bleeding, you should not opt for only Progesterone preparations like Primolut as it goes on diminishing the amount of bleeding during menses. You may prefer Oestrogen + Progesterone preparation with the advice of your Gynaecologist.
XXXXXXX please remove the misconception of menstrual discharge from your mind. In fact the average amount of blood in the menstrual discharge over 4 days is about 38 ml only, rest is the lining of the uterus. Oestrogen grows this lining causing more bleeding. This is not throwing out any dirt from the body. So more bleeding should not make you happy nor less bleeding should make you uneasy. Normal amount of bleeding makes you change two pads on the first or first two days and then one pad a day. The total bleeding is for 4-5 days. There is no food article which would increase menstrual flow, and that is not required also.

Menstruation is not a diseased condition, it is a normal physiological phase of woman's body. So there is no harm in going for a walk of doing yoga during menstruation - in fact it is advisable to continue the normal routine life style (except sex) during menstruation.

Please try to get away from routine external hormones if they are not needed medically and live a normal life.

I am sure you must have got your queries solved. For any further explanation, I am always available for you.

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