Brief Answer:
Continue the pill at the same dose for another month

Detailed Answer:
Hello and Welcome

I appreciate your concern

When starting the oral pills , menstrual irregularity inter menstrual spotting, brownish discharge and bleeding is common. This usually subsides down in a month or two as the hormonal alterations are adjusted for. You should continue the pill at the same dose for at least another month before considering an increase in the dose. Yes, By increasing and subsequently lowering the dose the spotting would most likely return.

Wishing you best of health

Thanks

Please consult your doctor before deciding on any course of action described above.

For future follow up / correspondence you may ask me directly at the link given below

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68107

Dr. M.S. Khalil

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Brief Answer:
Need more information

Detailed Answer:
Hello again,

Its not normal to have spotting, bleeding and discharge on a regular basis. Kindly answer the following to have a better idea.

For how long has this pattern of bleed/discharge persisted ? Kindly specify the timeline.
What is your exact age as in the description above its listed 44 with male ? Kindly confirm your age ?
Are you using the OCPs for contraception purpose only or did you have any previous history of abnormal vaginal bleeding ?
Have you had a recent ultrasound pelvis done ? If so kindly upload a scanned copy , if possible.
What medication are you currently using , if any ?

Thanks

Dr. M.S. Khalil

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Brief Answer:
The symptoms can be related to the fibroids, repeat evaluation needed

Detailed Answer:
Hello again,

The fibroid could have grown in size and would require a repeat evaluation. Most Fibroids ( Leiomyomas ) can be managed conservatively by following them up with regular pelvic examinations. However , if there is continuous bleeding and discharge then a pelvic exam and a thorough pelvic ultrasound should be done to rule out any pathology in the uterus, tubes or ovaries. Assessment for endometrial sampling should be done especially with your age i.e 44 years. Depending upon the size of the fibroid tissue , leuprolide can also be advised for pre surgical shrinkage followed by a myomectomy. The vaginal discharge should be worked up via wet mount microscopic examination of the discharge. If there is evidence of infection on the per vaginal, per speculum exam then samples should be taken and antibiotics or anti fungal medication should be started empirically based on clinical evidence.

Let me know if you have any query

Thanks

Dr. M.S. Khalil

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