Case of menorrhagia

A 28 y/o female complaints of heavy periods with lower abdominal pain. She is unmarried and has a active sexual life and she has only 1 partner since 2 years. She started her period when she was 15 years old and periods lasts for 5 days. She is on contraceptive pills. Cervical examination was normal. No other family or surgical history. Hb of 13.5 g/dL. TVS shows normal endometrial thickness with no mass. Normal thyroid report. What could be the cause for this and management?

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Unmarried with menorrhagia with active sexual life R/o std Most common cause would be either hormonal /pelvic inflammatory disease Treat her with antibiotics 1. Ciplox/ augmentiin - 7 days 2. Doxy 100 mg bd 7 days 3. Tab metrogyl 400 mg bd 7 days Investigations HIV hbsag vdrl hcv Coagulation profile Absteince for next 2 weeks Physical activity atleast 30 minutes every day Maintain Bmi < 25 Hydration most important Antispasmodic if pain still persists During her cycles if she bleeds heavily Tab pause xt tid for 3-4 days
- PID can be, Treated with Antibiotics - it Wan't be DUB, as she is on Contraceptive Pills - High resolution TVS to rule out pathology - If no response with antibiotics, there must be organic lesion , hense must be scrutinized
Sir,Can you please elaborate on why it can't be DUB?
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Pelvic inflammatory disorders. By Treatment advice- Cap Augmentin625 mg BD pc,Tab Metronidazole. 400mg BD pc, Meftal spa TDS for 7days.
Ask for CBC ESR Blood SUGAR BT,CT USG OF WHOLE ABDOMEN FSH LH PROLACTIN AND TESTOSTERONE LEVELS FURTHER TREAT SYMPTOMATIC
Menorrhagia since how many cycles It could be a case of PID Give a course of antibiotics for 7 days
Menorrhagia do USG to r/0 fibroids stop ocp possible withdrawal bleeding
Dub
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PID PS/PV findings? Antibiotics, antispasmodics Pap smear.
? DUB .. UTERINE PATHOLOGY.. ? HORMONAL .. EXPERTS OPINION..
Pid Antiboitics Antiinflammatory Pv Antigungal
Apparently PID A course of antibiotics VDRL, HIV
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