How can hormonal imbalances be diagnosed and treated effectively?

Question

Hello doctor,

I am 37 years old and suffering from hormonal imbalances, experiencing heavy bleeding for the past 20 days. Although Trenexa helped control it temporarily, the issue persists with occasional moderate to heavy flow and spotting. I underwent hysteroscopy, which showed normal results, but an ultrasound revealed a bulky uterus. Lab tests for sugar and thyroid came back normal.

Current medication: M2tone.

Lab tests done: Ultrasound, TSH, blood sugar.

What should I do next?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

Your hysteroscopy revealed endometrial hyperplasia, while the ultrasound showed a Bulky Uterus with a fatty liver.

Firstly, we need to address the bleeding. Here is the plan:

Take tablet Norethisterone 10 mg twice daily from day four to day 26 cyclically for three cycles to control bleeding. Start this cycle from tomorrow, considering tomorrow as day day.
Start iron supplements immediately and include iron-rich foods like apples and carrots in your diet.
Get a complete blood count and send me your thyroid report.
If a cervical smear has been done previously, please provide the date of the last test.
If bleeding stops but you notice any unusual discharge, consider a high vaginal swab to rule out pelvic infection.
For spotting or heavy bleeding, you can take Tab Postan 500 mg and Tab Tranexamic Acid 500 mg as needed for two to five days from day two of your cycle.

Additionally:

Consider a hysteroscopic biopsy to rule out any atypical cells in the endometrium.
Compile all your laboratory reports and discuss them with your local gynecologist.
Ensure you undergo a complete check-up and treatment for any underlying health issues.
Maintain a healthy lifestyle with a balanced diet, regular exercise, and maintaining a normal BMI (body mass index).

I hope this information helps. Best of luck.

Thank you.