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?

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

Menstrual cycle is an integral part of a woman's life. Isse mahilao ki reproductive shakti ka pata lagta hai. A typical menstrual cycle has a timeframe of about 28 days. Lekin kuch ladies mein yeh timeframe 35 days tak bhi ho sakta hai. Every female has different cycle. Usually, it is 11th to 14th day, counting from 1st day of the period, are the most fertile days.

Periods are important because it signifies the childbearing age of a woman. In a normal menstrual cycle, the innermost lining of the uterus starts to thicken to prepare itself for embedding of a growing foetus. In the absence of a foetus, the lining breaks down and results in periods.

Aap periods ke baad kitne din mein pregnant hote hain ye aapke menstrual cycle ki length pe depend karta hai. Typically, in a woman with a normal menstrual cycle length of 28 days, ovulation happens around the 14th day.

Ovulation ke waqt aapki ovary ek mature egg release karti hai. The released egg sits in the Fallopian tube to meet a sperm for fertilization, jiske turant baad aapki pregnancy start ho jaati hai. While a sperm can survive in the uterus of a woman for up to three to five days, female egg sirf 12 to 24 hours ke liye available rehta hai.

Yadi is timeframe ke beech sperm, egg se mil jaata hai toh aapke pregnant hone ke chances zyada hote hain. While it may not be a great idea to try getting pregnant after ovulation, egg release hone se pehle agar aap koshish karein toh pregnancy possible hai.

Therefore, periods hone ke baad se 12th to 16th day pregnancy ke liye kaafi crucial hote hain. In case you have unprotected sex during these days, then there are bright chances that you may get pregnant in this window.

There are certain signs of ovulation that indicates that your body is the most fertile in those particular days. For example, ovulation ki date ke aaspaas aap abdominal bloating, pet ke ek side mein dard aur increases sense of smell mehsus kar sakte hain.

In addition, there is an excessive production of clear cervical mucous, which closely resembles egg white. Agar aap ye symptoms experience karein to iska matlab hai ki your ovulation date is near and you can try and get pregnant around this time.

One way to determine your individual fertile period is to keep a record of your menstrual cycle (for eight or more months, if possible). Select your shortest cycle (say 27 days) and subtract 18 from it. The resulting number nine is your first potentially fertile day. Subtract 11 from your longest cycle (say 30 days) and you get 19. This marks your last potentially fertile day. So if the cycles you measured over several months were between 27 and 30 days long, you would be most fertile somewhere between days 9 and 19. 

This is still a very wide window of opportunity. You can narrow it further by charting your basal body temperature (your morning temperature before getting out of bed). For most women, it ranges from 96 to 98 degrees Fahrenheit. When your temperature rises slightly (four- to eight-tenths of a degree), it usually means you have ovulated within the past 12 to 24 hours. 


Periods Ke Kitne Din Baad Pregnant Hote Hai

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

4 Types of irregular periods and their causes

Menstruation is a cyclical process when at a certain time of the month, the lining of the uterus is shed and vaginal bleeding occurs. Sometimes there can be abnormalities in this cycle. Irregular periods in women are abnormal variations in the length, volume, duration and quality of menstrual cycle. Irregular periods aren't uncommon among menstruating women.

Abnormalities in periods can be of the following nature:

- Varying time between successive periods
- Loss of more or less blood than usual
- Varying length of your periods

Based on these categorizations, the different types of periods are:

1. Irregular menstrual bleeding - Irregular menstrual bleeding is characterized by bleeding that takes place for more than 20 days in a solitary cycle, which can lengthen over a period of a year.

2. Absent menstrual bleeding - In this type of menstrual bleeding, a woman does not get her period at all within a span of 90 days.

3. Heavy menstrual bleeding - This involves excessive blood loss that may intervene with a woman's physical, psychological and social quality of life.

4. Heavy and prolonged menstrual bleeding - This is less common than heavy menstrual bleeding and is different from in terms of duration. A different type of therapy is required to treat the condition as it is more severe in nature.

5. Light menstrual bleeding - Light menstrual bleeding is characterized by less blood loss than usual.

Irregular periods can be caused due to several reasons. Some of them are:

- Switching from one birth control pill to another or taking certain medication
- Excessive exercising
- Breastfeeding or pregnancy
- Stress
- Hyperthyroidism
- Polycystic ovary disease (PCOS)
- Uterine fibroids
- Getting an IUD (intrauterine device)
- Gradual thickening of uterine lining or the development of polyps on the uterine lining
- Scarring of the lining of the uterus can also be a possible cause

Changes in the body's level of hormones can also disrupt a woman's periods. Estrogen and progesterone are the chief hormones that play a crucial part in the menstrual cycle and influence the flow as well, thereby giving rise to abnormalities if their balance is disturbed.

When it comes to treating irregular periods, modifying your lifestyle, treating the underlying issue behind an irregular cycle, changing your birth control pills (if that is the cause), opting for hormone therapy or even surgery are viable treatment options.



All about Irregular Periods : Their Types and Causes

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!

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