Oligomenorrhea is considered when menstrual cycle is greater than 35 days. Amenorrhea is considered when menstrual cycles are absent for 3 consecutive months. It is vital to rule out pregnancy before starting medical treatment.
Medications:
- Tab. Modus-10 (Medroxyprogesterone 10 mg) 1 tablet once a day for 5 days. Patient will experience withdrawal bleeding 3 to 5 days after stopping the treatment.
- Tab. Ovral-L (Ethinyl estradiol 0.03 mg and Levonorgestrel 0.15 mg) 1 tablet per day from day 5 of periods. Continue it for 21 days. Patient is likely to start menstruating approximately 4-7 days after stopping it.
Supportive treatment:
- Tab. Mefkind–Spas (Mefenamic acid 250 mg; Dicyclomine 10 mg) 1 tablet thrice a day for pain during withdrawal bleeding.
Investigations:
- Urine pregnancy test – to rule out pregnancy.
- TSH, T3 and T4 – to rule out thyroid dysfunctions.
- Serum Prolactin – to rule out hyperprolactinaemia.
- USG Abdomen and pelvi s- to rule out fibroid, polycystic ovaries, endometrial thickening or other endometrial pathologies.
Specific advice:
- Patient needs to use barrier contraception during the treatment with progesterone to avoid pregnancy.
Referral:
Consider referral to gynaecologist patient fails to respond to the above treatments or presents with additional complications.