Will taking Pause 500 help in controlling heavy periods flow?

Question

Hi doctor,

I am a 26-year-old, sexually inactive woman. My present weight is 169 lbs. I have PCOD (polycystic ovarian disease). Two months back, I tried a weight loss medication, and my last period started on the 12th, two months before. First, I had to spot for ten 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 Regestrone (Norethisterone), 5 milligrams, one tablet daily for 21 days. My bleeding stopped after having Regestrone within six days. But unfortunately, I had missed Regestrone for three days and started bleeding again. After consulting my gynecologist again, she prescribed me Regestrone 5 milligrams, two tablets daily for 21 days, to stop this bleeding. Even suggested pausing 500 milligrams as SOS. It has been five days since I have been taking Regestrone 5 milligrams, two tablets daily, but my period has not stopped. Do you think my period will stop after taking Regestrone twice, or do I need to stop?

Answer 1

Hi,

I am glad you chose icliniq for your medical-related queries.

I understand your concern and will try to help you with it.

The bleeding that started after missing Regestrone (Norethisterone) for three days is your withdrawal bleed where the endometrial shed has started because you missed daily pills. This endometrium cannot be repaired again by Regestrone once the bleeding has started. So stop Regestrone tablets and start Pause MF tablet (Tranexamic acid and Mefenamic acid) 500/250 twice daily 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 quarts, as dehydration can further cause bleeding and weakness. Once stopped, then you should be started on a PCOD regimen for the 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.

Thank you.

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Answer 2

Hello, Ideally it takes 3 -4 days for bleeding to get controlled. But please ensure that the difference between each dose is never more than 12 hrs. If the bleeding has increased then you can take it three times a day for next 2 days i.e every 8hrly one tab pause 500. then for the third day switch back again to twice a day. for next 1 day depending on the response. Ideally this should stop the bleed. You can continue the dexorange iron supplementation for next 15 days. It shall help improve hemoglobin. Once the bleeding stops, then you shall be required to get an ultrasound pelvis done to check for endometrial thickness and if less than 5mm then you can be started of pcod regimen with low dose of pills and myo-inositol supplementation for controlling pcod. You may follow up with your USG report for prescription for pcod. Presently increase the pause 500to thrice a day dosage. keep yourself well hydrated and just avoid stressors which can decrease the effect of these tablets. Regards

Answer 3

Hello, I received your follow up just now. Did you stop with your bleeding by now? If yes , then you can be started on pcod regimen with low dose oc pills and myoinositol supplementation. I feel a repeat ultrasound pelvis shall be required to check for the endometrial thickness of the uterus now. Kindly reply.

Answer 4

Hello, AS THE bleeding has reduced in last 2 days with thrice a dosage now, and it is suggested that you continue with thrice a day dosage for 2 more days and then switch to twice a day till bleeding stops. I would suggest of you can switch to PAUSE-MF (500/250mg) which is tranexamic acid +mefenamic acid in combition, it shall work better than plain tranexamic acid tab( pause 500 alone). mefenamic acid is an nsaid and would help the antifibrinolytic (pause /tranexamic acid) to work better and you shall get early results. Please mention as to how many sanitary pads have you changed each day since last 3 days-that shall help me account for amount of bleeding. Thanks

Answer 5

Hello, Bleeding shall reduce. switch to pause-mf immediately. mefenamic acid will take care of the pain as well.Again, reiterating the fact that keep yourself well hydrated. keep in touch..

Answer 6

Hello, I have gone through the reports. It confirms Pcod with mild hepatomegaly and low ferritin levels with anaemia. You should be starting on the pcod regimen from now... 1. TAB GINETTE 35 X 1-0-0 x 21 days. 2. Tab OVABLESS-MYO x 0-1-0 x 30 days. 3. TAB VITAMIN D3 60K IU X 1 tab once a week x 4 weeks. 4. Syp. EVATON -N x 2 tsf x 0-1-0 x 30 days (olcare pharma) 5. Tab DEXORANGE x 1-0-1 x 30 days (iron tabs) z to restore serum ferritin levels and improve hemoglobin. After 21 days of ginette 35, wait for the menses to arrive and then start the next pack from day 3 of your menses. A total of 3 packs /3 cycles have to be taken. ovabless myo and syp evaton-n to continue regularly for 3 months. Avoid oily,spicy, fried and fast foods. Drink 8 to 10 glasses of water daily. Brisk walking x 45 min daily. Practice the regimen and it would help you regularize your menses and control pcod. Regards

Answer 7

Hello, If evaton -n syp is not available then you can instead opt for SYP AMYCORDIAL X 2tsf X 0-1-0 X 30 days. Stretch marks can be treated usually by during pregnancy application of bio-oil. However obesity and then sudden loss of weight. The collagen loss of skin can cause this stretch marks, so collagen based moisturizers have shown some promise but still encouraging results have been obtained by laser therapy. Regards

Answer 8

Hello, Loose motions are not a side effect of ova bless - moo. The likely cause is probably infectious either water or outside food intake. If there is no fever then you can opt for conservative management of diarrhoea with supplementation of water loss with ORS satchet ( 1 satchet in 1 litre of water). You can opt for a short course of TAB OFLOX-OZ x 1-0-1 x 5 days to control diarrhoea, which is an antibiotic. There is no need to stop ova bless-myo. Regards

Answer 9

Hello, In that case you can opt for TAB CEFI-O ( cefexime 200mg + Ornidazole 500MG ) X 1-0-1 X 5 DAYS. This shall help. Continue ORS fluid supplementation and you should be fine. Take good care regarding food and water hygiene during your tour to avoid recurrences during the trip. Continue on PCOD regimen as advised. Regards

Answer 10

Hello,, Its good to learn that you have lost 5 kgs, thats nice to hear, but diet , exercise and water intake are the key to treatment for PCOD, so maintain that strictly, as after this third cycle of ginette 35, once you get a withdrawal bleed of the cycle after finishing ginette, we would stop all medications completely for next month and allow your menses to arrive naturally for next month. If it does then the break from medicines continue for another cycle and if they too arrive on time, then treatment would not be required further , but you should be maintaining your diet , weight control, avoidance of fried and fast foods, exercise and water intake to maintain regular cycles hence. PCOD is like diabetes, a lifestyle disease, the lesser you control yourself, the more it would flare up anytime. Ovabless-myo and evaton syrup too shall be stopped along with ginette. just complete the total 90 days dose of theirs , i.e 3 months. Regards

Answer 11

Hello, In that case , just continue OVABLESS-MYO and SYP evaton -n for another month , a total of 4 months since the start, after stopping GINETTE. DIET is primary and you have to follow it. You will not gain weight if your water intake remains 10-12 glasses a day and you completely avoid oily, fried, spicy and fast foods. Eat healthy green veggies including micro greens , citrus fruits. prefer roasted fish or chicken, instead of curry based dishes. Try to maintain a 2000kilo calorie or 1800 kilocalorie diet. I am attaching a diet plan for your to follow and it shall be helpful for you. I am sure you would follow religiously if you are motivated to stay healthy and get rid of PCOD. Regards

Answer 12

Hello, The blood pressure is low indeed and is the likely cause of you feeling weakness and dizziness. This is not the side effect of medicines. You need to improve your water intake and if possible take a satchel of ORS solution in 1 later of water and drink it over next 1 hr, this should help improve your blood pressure and improve your symptoms. If the body ache is present, then you may opt for an NSAID like TAB CROCIN 650 single dose stat . I am attaching the diet plan with this. Last time it didn't get uploaded. Regards

Answer 13

Hello, This is likely midcycle bleed or ovulation bleed which is usually darkish brown in colour and less in flow . It would be important to learn how much has been your weight loss since last month ? If the bleeding is more than 2 pads in a day then you can start pause mf 1 tab twice a day for 2 days otherwise if flow is less, then you may opt out. After your bleeding stops please get an ultrasound pelvis and review. present weight loss? please mention.

Answer 14

Hello, In that case you may use pause mf twice a day for 3 days and this is irregular shedding. you may have to start ginette 35 again for another 3 months after the review usg pelvis to learn the status of ovarian volume. The weight loss is less as you too would understand. Stress has to be tackled at your end as it can easily derange your hormonal balance . So , once bleeding stops get an ultrasound and if volume of ovaries is more than 10cc ghen ypu would have to start ginette again along with ovabless myo to continue for another 3 months. evaton syp can be stopped. weight loss should be focussed upon. Regards

Answer 15

Hello, This is likely breakthrough bleeding. You need to get an ultrasound done by tomorrow. you can take pause mf for today to stop the bleed and then get the usg done. You may have to start Ginette again post ultrasound depending on endometrial thickness and ovarian volume. Regards

Answer 16

Hello Sumita, i am afraid i don't see any ultrasound report been uploaded . Please upload the report and pictures for an opinion. Also please mention your present weight . Last i learnt, it was 72 kgs. I hope you are following the diet chart that i had sent you ...?

Answer 17

Hello, As i can see the report, The endometrial thickness is 5.1mm which is low for the day of your cycle and both ovarian volumes are still more than 10 cc , even in the proliferative phase , which does indicate that PCOD persists and have reduced since last 4 months. You would have to continue ginette 35 again with ova bless myo again for another 3 cycles now along with dietary restrictions, plenty of water and moderate exercises. As far as pigmentation of skin is concerned, yes PCOD per se increases melanin content of the skin and also relative testosterone levels thus causing acne , acanthosis nigricans ( darkening of skin). So i would say continue with spf 50 in sunlight along with PCOD REGIMEN. However TURMERIC and chandan paste would act as antiseptic and unlikely to bring glow to skin. But increased water intake and better skin blood circulation can rejuvenate the skin faster and help reducing melatonin by actually acting as an anti-oxidant. Regards

Answer 18

Hello, Laser treatment offers a permanent solution for removing tattoos and birthmarks but not so for treating tan and melasma. In laser treatment, the concerned skin is exposed to a concentrated beam of light. Due to its high energy, the excess melanin is broken down and dispersed by the natural immune system in the skin. As a result, healthier and brighter skin appears. This treatment is also known as laser peel or laser-abrasion. The laser treatment helps in effectively reducing concerns like skin pigmentation, dark spots, sun tanning, dull skin etc, however in your case I would suggest get treated for PCOD first and control your hormones which too would help bring in your natural skin tone and reduce skin blemishes and tanning. If the results are not satisfactory, then later you can keep laser lightening as an option. Regards.

Answer 19

Hello, Its good to know that you have completed 3 cycles of GINETTE now. How have you been feeling with your menses, acne and weight? you have not mentioned anything. this cycle would be a break from ginette. continue and finish ovabless myo. During the trip , practice restrictive diet, stick to bottled water to avoid diarrhoea. Antiemetics: Tab Perinorm 10mg twice a day for 3 days during travel would help. take it an hour before travel. Antidiarrhoeal: tab cefexime 200mg x twice a day for 5 days + tab metrogyl 400mg x twice a day for 5 days. ( keeping in view that you are allergic to cifran , notini and pan d.) try to eat as much as possible only dried food articles esp while bus travel like khakras biscuits cookies to avoid nausea. Also avoid eating 2 hrs prior to travel. Regards

Answer 20

Hello, You may use ginette for another month and it would keep you tension free with regards to menses, but take a break next month for sure. For your mother you may use the same meds if required for nausea and diarrhoea as advised to you. Ass far as food is concerned, you need to consciously make an effort to avoid junk and oily food to keep your weight in check. Also your prime motivation should be water intake. Please get an ultrasound pelvis during this cycle after 15 day to evaluate the status of ovaries and review. Regards

Answer 21

Hello , As you have already completed the course for pcod, its time for break yes. wait for your cycles to arrive naturally I am afraid i do not see any images uploaded at your end for comment. However with weight reduction and decrease in sugar levels things should have improved. I dont agree to your habit of eating sweets twice a week for it simply nullifies your efforts with sugar so cut down in terms of calories eaxh day to control sugar levels. The diet planned i had shared earlier was apt for the same. Maintain a menstrual calendar for next 3 cycles and continue exercising and diet restriction. please attch your latest usg pics and even the report for evaluation. Thanks

Answer 22

Hi, I have seen the reports. The endometrial thickness and the ovarian volume is near normal now. Ideally the volume should be less than 1cc of each ovary, but its much better now. So stop the meds for this cycle and maintain a menstrual calendar for next 3 months. life style modifications to continue along with exercise and water intake. You may follow up if you miss your next menses by more than 15 days. Please be strict with your life style. Regards

Answer 23

Hello, The present bleed is a mid cycle bleed typically heavy indicating that you have not ovulated again and there is endometrial shedding occurri g in for. of heavy clots. You should be starting on progesterones for next 10 days to allow this endometrium to venture into secretory phase . This would stop the bleed and also the clotting. Start 1. Tab DEVIRY 10mg twice a day for next 10 days. Also you may take pause mf tab twice a day for 3 days to control bleed. the next cycle shall occur after ending 10 days course of deviry. Regards

Answer 24

Hello, I would just suggest stop their protein shake completely but you can stick to the diet plan as it's healthy. instead of tea which they offer increase your water intake with electrolytes supplementation twice a day with ors fluids. This would keep your dehydration away and undue abdominal cramps as well. Herbal life has been heavily promoted in West Bengal but it's not a product of choice among medical fraternity. Regards

Answer 25

Hello, You need not panic at all. If there has been no contact with a possible.covid 19 suspect or any travel history , then chances are low again if you are strictly- following the lockdown. Nextly , exertion in itself can cause rise in body temperature with exhaustion. The fever can be because of a possible urinary tract infection even which would need evaluation or.just due to upper respiratory tract throat infection or pharyngitis . Keep your water intake high to keep well hydrated to boost immunity. Strictly follow quarantine and eat healthy. If the cough headache and fever persists, then you may need to be evaluated. Regards

Answer 26

Good to hear from you, Regarding the white discharge per vaginum , the most common reason which is seen in most women is when they use some chemical soaps like detol, cinthol or any other bathing soap to clean the vaginal area. Ideally this should be strictly avoided and nothing but plain water should be used . However if the vaginal discharge is persistent then you should opt for using alkaline vaginal wash like V-WASH OR INTIWASH to clean both externally and internally. This would surely help. If the discharge is accompanied with foul smell, then there is an element of bacterial infection as well and then you shall need a short course of antibiotics for 7 days at least. Nextly regarding anti-aging, antioxidants should be used to clear the free radicals from under the skin. Ideally speaking water is the best anti-oxidant , so its intake should be liberal and 3-4 liters per day is mandatory. Also you can opt for vitamin c ( 10MG 1 TAB X TWICE A DAY X 15 DAYS) and d3 supplementation ( 1 TAB ONCE A WEEK X 8 WEEKS)along with b-complex capsules ( 1 TAB TWICE A DAY for MONTH) along with CAP EVION ( VITAMIN E 400MG ONCE A DAY FOR 15 DAYS). I hope this would help. Regards

Answer 27

hello, it's good to hear from you again. The fact that you have vulval itching in spite of using alkaline vaginal wash daily indicates that there is a possible external fomite which is causing this allergic aur possibly a fungal infection as characterized by itching. it is recommended that you should start using antifungal dusting powder each time after you use your washroom in order to keep the local area dry I which would help preventing any secondary growth of any fungal spore. you can use it 4 times a day for at least next 7 days and I'm sure you would be helped. please use cotton undergarments without lace to avoid any such vulvovaginitis infection. You can take a short course of TAB ITRACONAZOLE 200MG x 0-1-0 X 3 DAYS as anti fungal therapy. Regards

Answer 28

Hello, Thanks for the query, The symptoms appear that of possible Urinary tract infection relapse or there may be a vaginal cyst which is causing pressure while urination or you may have developed a bartholin cyst. You shall need a proper physical gynaecological examination to rule out the above. The weight being a concern in your case here. You need to start doing some physical exercise like brisk walking twice a day fro 45 min and keep your hydration status good to help you reduce your weight. It is suggested that you meet a dietician as well to help you control and reduce your weight. I have prescribed investigations. You may follow up with reports. Regards

Answer 29

Hello, The prescription has been attached and its waiting approval from the website. We cannot connect directly with you on whats app as its against the website policy. you shall get the prescription on this platform once it gets approved. Regards

Answer 30

Hello, I have gone through the reports. its good to see that ovaries have returned back to their normal volumes and polycystic features are no more present.The remaining reports are normal except the urine analysis report. The urine report shows calcium oxalate crystals which indicate that you have a propensity towards developing possible calculus or renal/ ureteric stones , so you have to increase your daily water intake and avoid dehydration as much as possible. The hepatomegaly is mild and not of concern here. The pain during menses can be controlled with TAB MEFTAL SPAS X 1-1-1 X 3 DAYS. This is an antispasmodic which specifically helps during dysmenorrhoea ( painful periods). You have already undergone the tests and no further need of tests is seen here. I shall be sending you prescription for the pain relief. Maintain a menstrual calendar and keep drinking water. The weight reduction shall need exercises. Regards

Answer 31

Hello, You can add : 1. TAB BIOTIN 10mg once a day x 60 day. ( Proanagen tab already has 5mg per tablet which you are already on) 2. TAB VIT D3 60K IU X 1 TAB ONCE A WEEK X 6 WEEKS. Back pain seems to be postural and yes weight here is definitely an.issue which needs to be addressed by you sooner the better. Regards

Will taking Pause 500 help in controlling heavy periods flow?

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