My daughter is 26 years old. Every month she has heavy bleeding and severe backache during menses. She feels like crying. Her irritation reaches maximum level. She cannot control her anger. Her backache increases if she eats something. She wants to remove her uterus. That much pain she has in each month. She is taking three to four Combiflam daily she cannot control it. I request you to suggest a proper remedy.
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This appears to be a case of primary dysmenorrhea with menorrhagia. Ideally, the evidence of pain during menses in a nonmarried lady would indicate possible endometriosis, but if there is a pelvic inflammatory disease accompanied, then too the menses can be painful and also heavier than usual.
It is important that she undergo an USG pelvis examination to learn if there is adenomyosis or possible polycystic ovarian disease and add clinical examination to rule out PID (pelvic inflammatory disease) infection.
The bleeding and dysmenorrhoea can temporarily be controlled with antifibrinolytics like tablet Tranexamic acid + Mefenamic acid 500/250 mg for three days then twice a day for two days from day two of her cycle. Also, she has to keep her hydration status good to reduce dysmenorrhea. Please follow up with the reports and hormonal profile.
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