Q: My daughter aged 20 years attained her puberty at the age of 13 years. Right from that time, she didn't get her periods regularly. I have tried my level best with all the doctors here - everyone uniformly says that this will last upto 25 years of age or until she gets married. Initially she was given primolut-n and later on novelon tablets and she is continuing this for past 6 years. Is it good to use this tablet for such a long period? She gets her period exactly when she uses this tablet. It is irregular when she is not using the tablet. During the period she gets severe clots and unbearable pain. Atleast 10 pads are used per day. Suggest me what is the permanent remedy to this difficulty?

A:You have to get an USG of the ovaries and uterus done immediately. Polycystic ovarian disease and thyroid dysfunctions need to be ruled out. Also, her coagulation status needs to be checked, which includes platelet count. Specific treatment is possible if any of these diseases is diagnosed. There is no harm in giving cyclic progestogens (Regestrone or Primolut-N) for 10 days of each month - it is likely to decrease the flow and regularise the cycles. However, it is surprising that despite Novelon, the periods are heavy and painful. Ultrasound of uterus and ovaries is a MUST. Do not worry, this problem can be dealt with by an experienced gynaecologist.