instruction: hello doctor I am a 42 year old female I am facing unexpected suddenly bleeding from yesterday my periods are expected on 20th and it is always too regular date to date I want to point out my periods discharge is always thick clotty and very painful for four to five days this is the first time it is seven days earlier with no indication no pain and no clots too but feeling heavy in the lower side and painful urine infection I am also facing itching in that area today I consulted a gynecologist in my area she suggested pause 500 if needed and also suggested codex ca for 15 days she said not to worry it may be regular periods if bleeding continues for more than seven days then go for us please give your advice also I am hypothyearoid for the past 16 17 years and taking eltroxin 100 my
output: hi the medicine your doctor has prescribed is good take tablet pause 500 my tranexamic acid and mefenamic acid thrice a day for five days I hope your doctor also did a vaginal examination and had a look at your cervix to see for any lesion though mostly hormonal it may sometimes be due to cervical disease or cancer if she has not done a vaginal examination I suggest you go to it also recheck your thyearoid levels to see if any dose change is needed go for an ultrasound seven days prior to your next expected period it is called a premenstrual ultrasound pelvis test for fish follicle stimulating hormone and oh lutenizing hormone too on day two of your next periods consult again with reports