### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi doctor , I m 52 yrs old and having backpain and on the sides of pelvis i still get my periods and quiet heavy but tolerable, only for 3 days due to which i am anaemic 10.3 haemoglobin and . now i have fever 99 degrees c for past 4 days accompanied withspasmodic backpain and pain in sides of pelvis.This pain is on and off from august 13.USG was done 4 times since then and it revealed bulky uterus with size 98x43 x62 and a small anterior wall fibroid 24x20 x16mm endometrial thickness 9.3mm ovaries are normal in size and echotecture. my menses are due today but i did not get still, but i have back pain sides of pelvis , 99degrees fever and slight nausea. i took 3 tablets of meftal spas since yesterday and is getting temporary relief.i also take rabeprazol 20 in the morning and levogastrol for my acidity and tenormin 50 mg for BP and escitolopram for anxiety . please advice

### output:

Hi, i can understand your feelings, at age of 52,probably you're in premenopausal stage. Back pain with heavy bleeding made u anemic.I have a suspicion of pelvic inflammatory disease. Due to fibrils in uterus wall, uterus is bulky it seems and also leading to spasmodic pain.I have seen patients getting benefitted by taking antispasmodic medicines during this stage. Along with medications, my pts used warm pads on abdomen and back 2-3 times in a day.I hope and wish you will also be benefitted.thanks.you're welcome for any further quarries.