Hello,
If the transvaginal ultrasonogram does not show any problems in the uterus, ovaries and surounding tissue, then the pain and heavy bleeding could be due to either a pelvic infection or a condition called endometriosis.
Pelvic infection can cause increased or decreased blood supply to the ovaries and cause a hormonal imbalance that can in turn can cause a heavy blood flow. The infection can also occur inside the uterus and cause heavy bleeding during the periods. Since you have pain and your irregular menstruation has occured recently, pelvic infection is probably the cause of your problems.
Another condition that can cause similar symptoms is endometriosis. Here too, there is heavy bleeding during the menstrual period, as well as pain during the period. Usually you will not get pain when you are not on your period.
Neither of these conditions will show up in an ultrasonogram in the early stages. While infection will be decreased by antibiotics and anti-inflammatory medicines, endometriosis is more difficult to diagnose. You need to be tested for a substance called CA-125 in your blood. You may also lso need a laparoscopy (pin-hole surgery_ for a proper diagnosis.
I hope this helps.
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15 years experience in managing patients with various medical problems