Pre menstrual syndrom

Respected curofy dr. I want to discuss a case a lady age:19years wt:55kg compain :only 1 day menses come duration last4 to 5 years. Prior to menses lumbar pain pain in abdomen present. On previous report20 jan20 her s.prolactin is 51 (high).thyroid and CBC is normal.plz suggest management?

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HYPERPROLACTINAEMIA. Ask for headache, diplopia, reduction of visual field or other vision related problem. Ask and see whether there is any nipple discharge (galactorrhoea). If those findings are present then MRI (more sensitive) or CT Scan is required to rule out pituitary adenoma. USG lower abdomen is needed to rule out PCOD. Give Cabergolin 0.25 mg twice a week. Test for Prolactin level after 1 month dose can be increased to 0.5 mg if needed. Once normal level is achieved then continue the same dose for at least 6 months. Give other symptomatic treatment.

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Hyperprolactinaemia with Premenstrual tension Oligomenorrhoea is secondary to increased level of prolactin MRI of brain to exclude Pituitary tumour USG to exclude PCOS Better to start with in young lady Bromocryptine 2.5mg bd For PMS Tab Furesemide 20mg at 7AM×4days Tab Meftal spas bd×4days Tab Clone 0.25mg hs×4days In every month Exercise & regulations of diet for increased BMI

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BMI...IF HIGH ADVISE LIFESTYLE MODIFICATION.. FREE T3,T4,TSH... GOOD LAB FOR HIGH PROLACTIN.GIVE CABGOLJN O.25 MG BIWEEKLY... GIVE IRON SUPPLEMENTS ALSO

Her hb is 14
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High prolactin is main cause MRI for Pituitary Bromocriptin 2.5 mg bd USG for PCOS Antispasmodic 1sos

Thanks Dr. Chanchal Tiwari , Dr. Nazia Tabassum, Dr. Dinesh Gupta
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SUGGESTIVE. OF HYPERPROLACTINAEMIA NEEDS. FURTHER. EVALUATION

अशोक घृत 5 ग्राम सुबह-शाम खाने के साथ दे। लौह भस्म सहस्र पुटि 4 रत्ती सत गिलोय 4 रत्ती शहद में मिलाकर सुबह-शाम सेवन कराएं। अशोकारिष्ट दशमूलारिष्ट लौहासव तीनों को मिलाकर 25 ग्राम सुबह-शाम खाने के बाद दें। योग परिक्षित है। पिछले 40 वर्ष से प्रयोग कर रहा हूं।

May be case of depression or malnutrition

Suggest USG

Normal finding
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