Most women attain menopause between the ages of late 40s and early 60s, the average age being about 51. This is an important milestone in a women's gynecological history. One major change is altered female hormone levels, and this leads to a lot of physiological changes. From hot flashes to mood swings, there is also increased predisposition to osteoporosis and uterine cancer.

If you have not had your menstrual cycles for close to 12 months, chances are you are into menopause. So, that means absolutely no vaginal bleeding anymore whatsoever. However, if you experience bleeding, even spotting, be on the alert. It is not normal and needs to be examined, and if required, diagnosed and treated.

Postmenopausal bleeding or PMB, as it is popularly called, can be due to a variety of reasons. While it could be something as trivial as inflammation of the uterine or vaginal lining, it could also be an indication of more severe issues like cancer.

Atrophic vaginitis: Decreasing hormonal levels lead to increased dryness and therefore inflammation of the vaginal and uterine tissue. This is one of the common causes of bleeding after menopause.

Endometrial atrophy: Also caused by lower hormone levels, the lining of the body of the uterus gradually thins down and can get inflamed.
Polyps: Noncancerous growths in the uterus, cervix, vulva, or vagina can also lead to bleeding.

Infections: General infection of any area along the uterine tract could lead to occasional bleeding.

Cancers: Though only 1 in 10 PMB cases turn out to be cancers, the prognosis improves with early diagnosis and intervention.

Diagnosis: As repeated above, reach out to your doctor if you notice postmenopausal bleeding.  

Diagnostic methods could include the following:
1. Physical exam
2. Transvaginal ultrasound
3. Endometrial biopsy
4. Hysteroscopy
5. Dilatation and Curettage

Treatment: Needless to say, this would depend on the diagnosis. For very minor cases with diagnosis like altered hormone levels, no treatment may be required other than modification of the hormone replacement therapy. For endometrial atrophy and atrophic vaginitis, use of estrogen creams and pessaries would be sufficient. Polyps would require removal followed by cauterization (application of slight heat) to stop the bleeding.

Cancer: This would depend on the type and location and require a combination of chemotherapy and surgery.  Removal of the uterus also may be required in some cases. So, if you have had bleeding of any sort after a year of menopause, do not ignore it. 


Is Postmenopausal Bleeding Normal?

Missing out on your periods or irregular periods once in a while is common. However, the problem arises when irregular periods become every month s story. The irregularity can be an amalgamation of a host of factors. Ignoring the same for long will only complicate things further. For women of reproductive age, the problem can give rise to deleterious consequences, including difficulties in conceiving. In this article, we will discuss some of the common triggers that result in irregular periods and when to seek medical help.

What causes Irregular Periods?
The hormonal balance plays a significant role in the proper functioning of the vital organs of the body. More than often, irregular periods are found to be a manifestation of hormonal imbalance. Some of the conditions that trigger the hormonal imbalance include

PCO is a common medical condition that affects women of reproductive age. PCOS is characterized by the formation of cysts in the ovary (one or both) that affects the ovulation process. In PCOS, there is an increased production of Androgen, especially Testosterone that can cause irregular periods, hair fall, facial hair, weight gain etc.

Time and again doctors and health professionals emphasize the importance of leading a stress-free life. Research suggests stress and anxiety often interfere with the functioning of the Hypothalamus. As a result, the pituitary glands that control and regulate the activities of the ovaries, adrenal glands, and thyroid glands may be affected. These can also trigger a hormonal imbalance giving rise to menstrual problems such as Irregular periods. In case of extreme stress, there may be a short-term cessation of periods (Secondary Amenorrhea).

The hormonal imbalance and irregular periods can also be an outcome of other medical conditions such as endometriosis, a cancer affecting the reproductive organs, fibroids, obesity, diabetes, hyperprolactinemia (characterized by elevated level of prolactin) or even thyroid disorders.

Women who indulge in strict dieting can also suffer from irregular periods. Strict dieting (especially the ones that are without a proper nutritional guidance) can rob the body of the essential nutrients disrupting the hormonal balance.

Irregular periods are normal in women who are nearing their menopause.

When to seek medical assistance?
Irregular periods can be indicative of a severe health problem. Consult a gynecologist

If your regular cycles get delayed by more than 7 days.

There is spotting or bleeding in between the periods.

Your periods last for more than ten days or less than two days.

There is excruciating pain during periods.

The gap between two successive menstrual cycles is more than 35 days or less than 21 days.

Your periods are heavy and unmanageable, affecting your daily routine.

Irregular Periods - When To See A Gynaecologist?

How to ensure a normal period when you're suffering from PCOS?

Polycystic ovary syndrome (PCOS) is a hormonal disorder affecting 12-18% of women of reproductive age. PCOS is a condition where at least two of the following conditions occur:

1. Appearance of acne, excessive hair on your body

2. Irregular delayed periods

3. The presence of 10 to 12 small cysts in the ovaries.

You do not ovulate each month, and some women do not ovulate at all if they are suffering from PCOS. This is because although the ovaries of women, suffering from PCOS, usually have many follicles, they do not develop fully and so ovulation often does not occur. If you do not ovulate, you may not have periods.

So what can you do to have normal periods?

Although some women with PCOS have regular periods, high levels of androgen and also the hormone insulin, can disrupt the monthly cycle of ovulation and menstruation. If you have PCOS, your periods may be irregular or may stop altogether. The average menstrual cycle is 28 days with one ovulation, but anywhere between 21 and 35 days is considered normal, and for a woman suffering from PCOS, this cycle can take as much as 3 months to complete.

To ensure a normal period during PCOS, your doctor can prescribe hormonal contraception. The medication can also reduce menstrual cramps, acne, and excess hair growth. The estrogen and progesterone in hormonal contraception act to override the body's normal hormonal control of menstrual cycle and ovulation. Production of hormones such as testosterone is greatly reduced by the oral contraceptive pill. Some oral contraceptive pills not only aim to block the effects of testosterone but also increase insulin resistance.

By allowing the regular shedding of the uterus lining during menstruation, the pill can reduce the risk of developing endometrial cancer while ensuring you get normal periods.

Note: it is important that you closely watch your weight. Lifestyle changes and weight reduction help a lot when you are suffering from PCOS.

If you would like to consult with me privately, please click on 'consult'.
Related Tip: How Not to Miss Your Workout During Your PERIOD

How to Ensure a Normal Period When You're Suffering from PCOS?

Bloating, cramping, headaches, nausea are very common during menstruation painful symptoms women go through when during their monthly cycle. During this time, women tend to crave salt, desserts, caffeine or liquor. One should look out for different alternatives to prevent menstrual cramps and satisfy their cravings.

Menstrual cramps cause a great deal during the menstrual cycle since the withdrawals interrupt the blood stream to the wall of the uterus. Stomach aches, lower back pain and leg cramps are some common and basic side effects. Here are a few ways yoga can cure the problem:

Janu sirsasana (head-to-knee forward bend): Go down on the floor in a sitting position with your legs stretched out forward. Twist the right knee outward to a 90 degree angle and press the right foot into the insides of the left thigh. Get the left shin or foot, breathe in, tighten the hips, and place the stomach over the straight leg. Breathe out, and broaden the spine and stretch out the chest. Straighten your back.
Pasasana (noose pose): Come into a full squat position with you feet together and drop your hips down towards your heels. In case your heels do not reach the floor, put a pillow underneath. Breathe in and twist your knees to one side as you turn your abdomen to one side. Breathe out, touch the back of your upper left arm with the outside of your right leg and reach the left lower arm to touch the foot.
Ustrasana (camel pose): Bow on the floor with the knees and hips. Turn your thighs inside and press your shins and feet firmly into the floor. Lay your hands on the back of your hips. Breathe in, lift your chest, and press your shoulders down towards the ribs. Breathe out, push the hips forward as you stretch the front of the body and bend backwards. Keep your hands on the back of your hips or on the back of the heels. In case you put your hand on the heels, press your toes into the floor to lift the heels higher.
Supta padangusthasana (reclining big toe pose): Lie on your back with your arms by your sides and stretch the legs. Lay your head on the floor, breathe in, bend the right knee, and hold the toe with the right fingers. Put your left hand on top of the upper left thigh to put the left leg down.
Towel hook: Breathe out and stretch the right leg to the extent your body permits. You can likewise use a towel or belt to wrap around the right foot to help. Breathe in; lift your head up towards the right leg and hold the left leg down.


Menstrual Pain - 5 Yoga Asanas To Help You Relieve The Pain!

What Causes Light Periods in Women?

Light periods refer to menstrual periods that have very light flow and are characterized by a lesser number of days than usual. Although the menstrual cycles vary from a woman to another, the duration for a normal period is around every 28 days. Each period lasts for approximately four to seven days. The amount of blood loss in a normal period is around 20 ml to 80 ml. However, loss of blood below 20 ml can be considered as light periods.

The causes of light periods can vary for different woman. Some of them are:

- An imbalance in hormone levels in the body like PCOD (polycystic ovarian disease).

- Light periods are most common in women who are approaching menopause. This is because, at this time, women tend to produce less estrogen, a hormone responsible for regulating menstrual periods.

- Light periods can be common in girls who have just started to menstruate.

- Excessive bouts of exercise, a thyroid condition or an eating disorder can be also responsible for light periods in women.

- Women who use hormonal or oral contraceptives may also have a chance of experiencing light periods.

- An important cause of scanty menses is implantation bleeding. That means sometimes, despite being pregnant, little amount of bleeding can happen at the expected time of menses in the first three months of Pregnancy. So it's important to rule out pregnancy at the earliest.

Certain symptoms usually follow light periods. These symptoms vary according to the underlying causes of this condition.

Some of the common symptoms which accompany light periods are:

- Abdominal pain
- Frequent infections, namely yeast and other fungal infections
- Painful sexual intercourse
- Missed periods

In some cases, light periods might turn out to be a sign of a fatal condition that should be immediately administered to. An example of such would be an ectopic pregnancy, which can cause light or heavy bleeding. Although light periods are rarely due to serious diseases, neglect can lead to heightened complications and irreversible damage.

Some of the complications can are:

- Serious discomfort and pain
- Difficulty in conception or infertility
- Osteoporosis and osteopenia



What causes light periods in women?

In an incredibly fast paced and unhealthy lifestyle of the modern world, irregular menses aren t exactly an unusual situation. The length of a monthly cycle may either last longer than usual or end earlier than usual, only to begin in a short while again, accompanied by greater abdominal pain and blood loss. Irregular cycles may vary from 8 to 21 days or more. The variation of 21 days or more is considered highly irregular and abnormal. A woman may face some menstrual irregularities at both ends of menstrual life, (onset- menarche and end of cycle- menopause) which is normal and in most of the cases, it is self-establishing. 

Causes of Irregular Menstrual Cycle: 

The cause of irregularities in menstrual cycle is basically hormone imbalance. The altered levels in the body lead to irregular cycles. There are many factors in routine life which affect hormonal balance. Some of them are: 

Poor diet or wrong dietary habits 
Stress and anxiety, thoughts and emotions
Lifestyle: Lack of physical activity and exercise, too much physical exertion, stress and strain during menses. 
Illness: Long-term illness like fever, tuberculosis, thyroid problem etc. 
Medication: Certain medicine if taken for a long time, like oral contraceptive pills, hormonal therapy etc., alters hormonal balance. 
Imbalance of Tridosha (vatta, pitta and kapha) in body, leads to irregularities of reproductive system. 
As per Ayurveda, Vatta is the main culprit in menstrual irregularities. 

How To Deal With Menstrual Irregularities:

With the sudden acceptance of eastern concepts of yoga and organic and indigenous medicines around the world, Ayurveda has gained importance in treating irregular menses, gynecological and obstetric problems. 

Lifestyle and Food- There is no alternative for lifestyle and food habits correction. Eating healthy and nutritious food, regular exercise, yoga, physical activity, outdoor games lead to good physical health. 
Meditation and Breathing: Exercise is good for taming hormones. It keeps a person physical and mentally healthy. 
Avoid heavy physical work during menses. 
A good oil massage over body keeps Vatta in balance (one of the important tridoshas of body: vatta, pitta and kapha). 
Ayurveda has proven to be much helpful in regulating the menstrual cycles. According to certain studies, Ayurveda came in rather handy while tackling PCOS, a disease distressing 1 in 3 women today. It is certain that Ayurveda medicines work better in certain scenarios and definitely have fewer risks in comparison to allopathic medicines and surgeries. Over a period of time, they have proven much more beneficial in overcoming the irregular menses and the irritation along with the accompanying pain and PMS symptoms. Ayurvedic medicines use herbs and roots and almost everything found in nature to discover a rather organic cure for diseases. Certain plants like Shatavari are used to reduce the much spoken about mood swings or PMS symptoms during periods which can only worsen in case of an irregularity. The bark of the Ashoka tree has proven to be quite helpful in relieving menstrual pain and excessive bleeding. Other plants and their parts like the Lodhra, Guggul, Guduchi and Amlaki, Jatamansi etc. are useful in regulating periods and reducing the stress and irritation accompanied by it. 

Panchkarma- Basti therapy (Enema- administration of medicines through rectal route). In this treatment, decoction of different herbs and medicated oils are used for giving enema. Basti has proven its efficacy since centuries, for treating Vatta. A course of 5, 8, 15, 30 or 60 basti, as per person s requirement can be given for menstrual problems. Irregular periods, although are faced by a large chunk of women, pose different symptoms for different people and hence individualized treatment is advised.

Irregular Periods - Ayurvedic Home Remedies to Treat It

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