Is bleeding twice a month in PCOS or PMOS normal with ECP?

Question

Hello doctor,

My friend has been married for a year. She has PCOS or PMOS. She has had her period for the fourth time in the last two months. Is it normal? The second one was a shorter two-day period, and the third one lasted for five days.

Her previous period (third) started in the third week of last month, and today her period started again after 15 to 16 days. She had intercourse with her husband before he left.

They are not financially stable enough to afford a child, so he made her take a contraceptive right after. What should she do? Should she wait for the bleeding to stop naturally?

I would be thankful if you could respond as soon as possible. She is desperate for help. If she needs to take medicine, please let me know. I will help her with it. She has taken Myteka, Xaltide, ECP, and HCG activator for weight loss.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

You have not mentioned the complete history, but I will try to help as much as I can. We can sort out her problems serially and try to take precautions for each problem; the symptoms will go away as the cause is relieved.

For menstrual irregularities, try to have COCP (combined oral contraceptive pills for at least two cycle) so you can have regular menses and reduction in blood loss and do investigations as I am advising on day two of menses (serum progesterone, serum LH (luteinizing hormone) and FSH (follicle stimulating hormone), serum insulin, serum prolectin, thyroid function test, serum testosterone, and complete blood picture).

For heavy blood flow, take Ponstan (Mefenamic acid) and tablet Tranexamic acid 500 mg (milligrams) every eight hours for a two to five-day period. Have a transvaginal scan to have a clear idea of pelvic pathology. She is asthmatic or allergic, as she uses antiallergy and inhalers that also need to be sorted out, as some of the antiasthmatic drugs increase weight, and the risk of PCOS (polycystic ovarian syndrome), now known as polyendocrine metabolic ovarian syndrome (PMOS), increases in people with high BMI (body mass index). I suggest it is better to have gargles and take steam when you notice early symptoms appearing, so that harsh symptoms can be avoided even without extra medications.

Try to take proper treatment for all problems she has been diagnosed with. Follow a strict diet with less sugar, oil, salt, and spices. Walk and exercise daily. For three days, take a tablet of Tranexamic acid (Transamin) 500 mg with Ponstan every eight hours for bleeding. Now, after bleeding stops, start oral contraceptive cyclic pills for three cycles to regulate the cycle and reduce bleeding. Take iron supplementation to reduce the risk of anemia.

Do all laboratory tests and scans I have mentioned above on day two of periods in the coming months and discuss here or with a local gynecologist. Discuss with her asthma specialist about PCOS or PMOS and request that steroids be avoided for her.

I hope this helps you.

Thank you.