Brief Answer:
Confirmation of Pregnancy mandatory

Detailed Answer:
Dear XXXXX,

At the outset, let me inform you that Fizinorm Forte is an Ayurvedic birth control pill; however its efficacy in preventing pregnancy by taking just one pill before intercourse is questionable. In fact, the best way to prevent pregnancy from unprotected sex is to take Plan B post coital emergency contraceptive pill (which contain Levonorgestrel) within 72 hours of the unprotected sex.

After the unprotected intercourse on 23 July, after which she was expecting her menses on 29 July; and she got them. This fact suggests that she is not pregnant due to the intercourse on July 23. However, she missed her period which was expected by August end.

Did you have any sexual relations in the month of August? You mention you had taken necessary precautions during the intercourse. I believe you are referring to intercourse(s) in August. Will you please elaborate as to what precautions you had taken? Was it again Fizinorm forte or some other precaution?

Now her menses are delayed for more than a week. If you perform pregnancy test on her overnight morning first urine sample, it will give you reliable information about her pregnancy status.

Alternatively you may opt for Beta hCG test on her blood. Values more than 25 mIU/ml are diagnostic of pregnancy while in non-pregnant state, the values are below 5 mIU/ml.

Even you can have a direct visual evidence of pregnancy by ultrasonography.

If she is pregnant, the unwanted pregnancy can be very safely and effectively terminated by medicines up to 9 weeks of pregnancy. I shall give you information about the medical methods of termination of pregnancy once the pregnancy is diagnosed. So please upload the reports of the test(s) for detection of pregnancy.

Alternatively, the pregnancy can be terminated by surgical methods like MVA aspiration also.

I am awaiting your response with the requested information and the reports of the tests.

I am always available for you for any more information or advice, XXXXX.

Dr. Nishikant Shrotri

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Brief Answer:
Very rare chance of pregnncy

Detailed Answer:
Dear XXXXX,

You did not have any intercourse after 23 July, you had your menses on 29 July; this means that for practical purposes, you are not pregnant.

However, in some rare cases, some amount of bleeding in early pregnancy at or around the date of expected menses may show up. This used to be called as placental sign in good old days. Keeping this in mind, it would be a good option to get the pregnancy test(s) performed.

If the test(s) reveals that you are not pregnant, you need not be worried. This delay in menses could be due to some hormonal imbalance or sheer stress. So if the pregnancy test(s) report(s) negative, you may take some progestational preparation like Deviry for 5 days; within 4-7 days, you should get withdrawal bleeding. In fact you may take these pills before pregnancy test also. It can serve as therapeutic test of pregnancy.

If you are not pregnant and the similar pattern of delay in menses recurs again next time, you may have to undergo certain investigations; however we will discuss it if the irregularity persists. Please revert back to me in that case.

Please keep me updated about your pregnancy status which will facilitate me to offer you further continued advise.

Please feel free to ask for any more information and/or advice at any time. You may post a good review with 5 star rating for me.

Dr. Nishikant Shrotri

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Brief Answer:
Withdrawal bleeding

Detailed Answer:
Dear XXXXX,

Deviry is Progestational medicine. You may take tablets of 10 mg 3 times a day for 5 days. Being progestational medicine, after stoppage, it causes withdrawal bleeding about 4-7 days after discontinuation of the pills provided there is no pregnancy.

Overdosage of Deviry therapy may cause nausea and vomiting, breast tenderness, dizziness, abdominal pain and drowsiness/fatigue.

Pregtest negative report indicates that the woman is not pregnant. You may upload the report for my review.

You may ask for any more information and/or advice.

Dr. Nishikant Shrotri

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Brief Answer:
Safe

Detailed Answer:
Dear XXXXX,

It is your choice whether to wait for the periods to appear naturally of to go for Progesterone withdrawal bleeding. However, if the menses have not appeared since July end, they are delayed for more than 2 months. If this is without pregnancy, I would advise to have withdrawal bleeding after Deviry or any Progestational medicine. Taking one course of 5 days of these medicines is quite safe and should not cause any problem in future.

Any further queries are welcome, XXXXX.

Dr. Nishikant Shrotri

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