The amount of emotional upheaval that periods, or no periods (for that matter) can cause, is something that every woman is aware of. It's normal to miss your period for different reasons occasionally, but it is a matter of concern if this absence persists over a period of time. The condition is then termed as a case of secondary amenorrhea. Although most people are quick to consider pregnancy while dealing with the various reasons for missed periods, there are a number of possibilities which are seldom mulled over, but should be considered in order to take effective precautions and seek proper medical care:

1. Weight
Body weight is responsible for affecting hypothalamus and this may, in turn, upset your menstrual cycle. BMI level under 18-19 may result in triggering irregularities since enough estrogen will not be created. This is also why underweight women, who suffer from bulimia or anorexia, tend to miss their periods frequently. 

On the other hand, overweight women may stop ovulating due to increase in the production of estrogen and therefore, have heavy, infrequent periods. Therefore, it is essential that body weight be regulated to avoid any disappointment at 'the time of the month.'

2. Stress
Any type of physical or emotional stress is bound to affect your cycle. This is because, the production of stress hormones in the body increases and an elevated level of adrenaline and cortisol may impair the functioning of the reproductive system. Under stressful situations, the body employs its amino acids to assist the neurotransmitters to produce stress hormones over sex hormones. As a consequence, the chances of missing your periods increase.

3. Exercising Too Much
While regular workout is indispensable for battling a sedentary lifestyle, overdoing it might cause your body to produce lesser estrogen and delay your periods. Women, who are into athletics and gymnastics, are more likely to suffer from amenorrhea. In fact, other aspects of over-exercising, like sleeping less, fasting, and infections also contribute to such irregularities.

4. Breastfeeding
Prolactin is the hormone that aids in milk production and may also repress ovulation for a while. Many breastfeeding moms may not get their periods for a month or more as a result. But this doesn't do away with your chances of getting pregnant. A span of three months is expected to pass before the abnormalities are done away with.

5. Food Allergies
Celiac disease or untreated gluten allergy can directly harm hormone production. They are directly related to your gut health and your adrenal glands which is why they can influence the sex hormone creation.


5 Reasons For Absent Periods

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?

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?

Heavy menstrual bleeding, technically called menorrhagia, is one of the most common types of abnormal bleeding from the uterus. Menstrual bleeding is said to be heavy if there is so much blood that a tampon or pad remains soaked for several hours. 

Here are all the possible causes of heavy menstrual bleeding:
1. Hormonal imbalance
Estrogen and progesterone levels are the primary control mechanism for periods. If the ovaries have a problem in functioning, hormonal imbalances may occur. Heavy menstrual bleeding is most common in females who are at the start of menopause. Puberty menorrhagia can occur in adolescents who are experiencing their first menstrual period. 
2. Fibroids
Fibroids most commonly occur around the age when women can get pregnant. Uterine fibroids are non-cancerous growth on the uterus.
3. Ectopic pregnancy
An ectopic pregnancy is when a fertilized egg stays in the fallopian tube, but does not reach the uterus.
4. Blood thinners
These are medicines, which are usually anticoagulant or antiplatelet drugs.
5. Problems with iud
A non-hormonal intrauterine device is a t-shaped device used for birth control which is inserted into the uterus.
6. Adenomyosis
This is a condition in which the muscular wall of the uterus also gets the lining of the uterus intermingled with it. However, this condition is rare and only happens in middle aged women with several children.
7. Pid
Pid stands for pelvic inflammatory disease and refers to any infection within the organs of the reproductive system.
8. Cancer
Uterine, ovarian and cervical cancer are just some of the cancers, which may cause heavy menstrual bleeding.
9. Other diseases
Liver, kidney and thyroid diseases are all included.

Possible Causes of Heavy Menstrual Bleeding

Vaginal bleeding is something that most women experience between their periods when they are not due for a menstrual cycle. It is considered as an abnormal occurrence when you bleed before you are expecting your menstrual period, or after you are done with your monthly cycle. It is usually characterised by bouts of spotting where a thick brown reddish discharge may be experienced. Also, this kind of bleeding is considered abnormal if it occurs during pregnancy or menopause.

Here are a few causes of abnormal vaginal bleeding:
1.  Hormones: An imbalance in the hormones like the estrogen and progesterone can lead to abnormal vaginal bleeding. These are the hormones that help in regulation of the monthly menstrual cycles. An imbalance can occur due to side effects caused by birth control pills that may not suit the individual, a contraceptive patch, or even contraceptive implants and injections. Further, an intrauterine device may also be the cause for this kind of bleeding. The hormonal balance can also get affected due to internal ailments like a dysfunctional thyroid gland and ovaries.

2. Pregnancy and Delivery: Some amount of spotting is considered normal in the first trimester of one's pregnancy. Yet, severe bleeding and persistent spotting must be reported to the gynaecologist immediately. Women also bleed for a while after the delivery of the baby, in the postpartum period. This may also happen when an abortion takes place as the uterus may not have come back to its original size and due to remaining foetal tissues within. Complications during the pregnancy like an ectopic pregnancy or a miscarriage can also lead to such kind of bleeding. An ectopic pregnancy is one where the egg gets implanted in the fallopian tube instead of entering and implanting itself in the uterus.

3.  Fibroids: Uterine fibroids are usually considered as non-malignant and non-cancerous growths within the uterus. These are common in many women who have gone through childbirth. These fibroids can also cause some amount of bleeding and spotting.

4. Infections: When there is an infection in the reproductive organs like the ovaries and uterus of the patient, there may be some amount of bleeding. An infection in this area can also cause inflammation, which is one of the primary causes of abnormal bleeding. This can also occur due to a sexually transmitted disease or STD, as well as painful intercourse and sexual abuse which can lead to scarring as well.

5. Cancer: One of the least common causes includes cervical, ovarian and other forms of cancer. 
Stress and diabetes can also cause abnormal vaginal bleeding in rare cases. It is best to see a doctor as soon as such bleeding takes place.

Causes of Abnormal Vaginal Bleeding

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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