Usually due to anovular cycles: General improvement of Health with tonics, Hematinics and exercise is usually enough Syp. Nutrifil 2 tst bd x 30 (Iron). Syp. Ashonil tst bd 2-6 months (Ayurvedic)
If there is no relief with General measures:
Tab. REGESTRONE 5mg bd from 16th to 25th day. (Nor ethisterone acetate) Tab. Sylate 500mg 6 hourly till bleeding stops. (Etamyslate, Hemostatic drugs)
20 – 40 years age (Child bearing age):
P.V. Examination and USG to rule out abnormalities of uterus and Pregnancy.
Hb, WBC, Bleeding disorder profiles, Serum T3, T4 and TSH. Tab. Regestrome 5mg for 16th to 25th day or Tab. Ovlar (1 daily 5th day to 21 (Contraceptive pill).
If contraception is desired. Use contraceptive pills. Otherwise use REGESTRONE. If there is post-menstrual bleeding use pills.
If there is no relief, Refer the patient for endometrial curettage (& Biopsy) followed by Hormone therapy.
If bleedinf persist after curettage advise Hysterctomy.
Peri-Menopausal Age:
Do not waste time. First send the patient for Endometrial curettage and Biopsy to rule out Malignancy.
If biopsy is normal, advise hormone therapy (Pills) for 3 to 4 cycles, refer to Hysterectomy.
When a non-pregnant patient comes with excessive bleeding.
Tab. REGESTRONE 1 bs (or tds) x 10 days (Norethisterone acetic) Tab. Gynaec C.V.P 1tds x 5 days (Hemostatic drug) If bleeding is not controlled in 3-4 days, refer to endometrical curettage.
When a womain in reproductive age group presents with excessive bleeding, first rule out abortion. And in an elderly woman, first rule out malignancy.