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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor
Category: OB GYN
Satisfied Customers: 51023
Experience:  MBBS, MS. Deal with women related all surgical problems including genito-urinary and breast surgery.
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I have gone back on the pill because I was suffering from

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I have gone back on the pill because I was suffering from very heavy periods, desperate cramping, migranes, condtipation, nausia, tiredness every month for 3-4 days before my period to the end of my period which could last a full 7 days. The pill has reduced all but the constipation issue which is great. My question is should I be having further investigations to be sure that there are no issues going on in my womb or any related areas? I am 43 have low thyroid but no other medical conditions
JA: Are you in any pain? How regular are your periods?
Customer: My periods were fairly regular and the pain was always very bad. I have suffered from this since I started my period at 13. the only time I have relief is when I was on the pill
JA: Anything else in your medical history you think the Doctor should know?
Customer: No

The standard of care is to get it investigated. Though, symptoms resolution by the pill indicates that it is likely to be a hormonal issue. The following investigations are needed for the assessment;

1) Fibroids and polyps of the uterus

2) Endometrial hyperplasia; due to high estrogen.

3) Bleeding disorders.

4) Hyperinsulinemia

5) Both hypothyroidism and hyperthyroidism

6) High prolactin

7) Coagulation disorders.

8) Infections.

You may need the following investigations to ascertain the cause:

Pelvic ultrasonography

Sonohysterography (saline-infusion sonography)

Pap smear


Endometrial biopsy

Complete blood count (CBC)

Total iron-binding capacity

Human chorionic gonadotropin (hCG)

Thyroid function tests

Prolactin level

Liver function tests

Kidney function tests

Hormone assays; Luteinizing hormone, follicle-stimulating hormone, and androgen.

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