Hello doctor, I am a 26-year-old, sexually inactive woman. My present weight is 77 kg and I have PCOD. Two months back, I tried a weight loss medication and my last period started on 12th, two months before. First I had spotting for 10 days and started bleeding heavily after that and it did not stop. I consulted a local gynecologist a month later to stop my bleeding and she suggested me Regestrone, 5 mg one tablet daily for 21 days. My bleeding stopped after having Registrone within six days. But unfortunately, I had missed Regestrone for three days and started bleeding again. On consulting my gynecologist again she prescribed me Regestrone 5 mg, two tablets daily for 21 days again to stop this bleeding and even suggested Pause 500 mg as SOS. It has been five days since I am taking Regestrone 5 mg, two tablets daily but my period has not stopped. Do you think my period will stop after taking Regestrone twice or do I need Pause 500?
Hello. The bleeding that started after missing Regestrone (Norethisterone) for three days is your withdrawal bleed where endometrial shed has started because you missed daily pills. Now, this endometrium cannot be repaired again by Regesterone once the bleeding has started. So just stop Regesterone tablets and start Pause MF tablet (Tranexamic acid and Mefenamic acid) 500/250 twice a day for the next five days. These are antifibrinolytics and shall help in reducing and further stopping the bleeding. Please increase your daily water intake to 3 to 4 liters as dehydration can further cause bleeding and weakness. Once stopped, then you should be started on PCOD regimen for next three cycles from day three of your next menses to control your PCOD induced hormonal imbalance and anovulatory cycles which are often the causes of prolonged spotting and menorrhagia thereafter in PCOD untreated patients. Please follow up with your hormonal profile, thyroid profile, serum prolactin, and ultrasound pelvis to assess the severity of PCOD.