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Q. I am having menorrhagia and feeling tired with chest pain and indigestion problem. Why?

Answered by
Dr. Kamalpreet Kaur Nagpal
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Dec 16, 2019 and last reviewed on: Dec 18, 2019

Hello doctor,

I was suffering from menorrhagia after the birth of my second daughter. I went for medication and presently it is almost under control.

I have to take Tranexa two tablets three times daily for the first two days of the menstrual cycle. Suddenly I notice that my hemoglobin has fallen to 7.12 g/dL. I am physically feeling weak and having chest pain (while walking and climbing stairs), swelling of legs, itching and indigestion problem. I consulted a local doctor and they prescribed Autrin twice daily and ZES-30 once daily.

Dr. Kamalpreet Kaur Nagpal

Obstetrics And Gynaecology
#

Hello,

Welcome to icliniq.com.

Since you are 40 years old now and this problem has not suddenly cropped up. You are having menorrhagia (heavy bleeding) from the last 5 years or so, for which you are having 1 gm of Trenaxa to temporarily stop bleeding. That is the reason for anemia, which is low hemoglobin and feeling very weak. But please do not ignore your chest pain and swelling on legs. You need to be thoroughly investigated for this including all routine investigations like CBC (complete blood count), coagulation profile, PTI (prothrombin time test), renal and liver function tests. Above all ECG (electrocardiogram), and ultrasound abdomen to see the cause.

Visit a physician and the most worrying thing which I want to rule out is any evidence of thrombo-embolism and DVT (deep vein thrombosis) for which you may be advised Doppler study of vessels of lower limbs. Be in touch and inform the reports if you like.


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Thank you doctor,

I have had ECG done a few months back and the report was normal. USG was done when I underwent hysteroscopy, D and C, endometrial polypectomy. I have attached my discharge summary. Thereafter I was prescribed with Luprid Depot 3.25 injection after AMH test (report attached). The current hematology report is also attached. Please advise the further course of investigation and treatment.

Dr. Kamalpreet Kaur Nagpal

Obstetrics And Gynaecology
#

Hello,

Welcome back to icliniq.com.

I have seen your reports diligently. (attachment removed to protect patient identity).

If D and C (dilation and curettage) were done after polypectomy, then your bleeding should have been controlled after that and if still need for hemostats now then I think a fresh ultrasound should be repeated and see the cause. If only endometrial hyperplasia, then biopsy needs to be done. Also, fresh ECG and may be echocardiography (ultrasound of the heart) after physician opinion for chest pain should be done.

Regarding AMH (anti mullerian hormone) value, we are not worried about the fertility status at this stage now, rather if premature ovarian failure is considered then also there is no reason for heavy bleeding. Yes, anemia of course needs to be treated as swelling of legs can be because of anemia and hypoproteinemia alone. So, please start the treatment after thorough work up.


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