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

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.

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Related Tip: How Not to Miss Your Workout During Your PERIOD

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

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

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

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?

A collection of symptoms typically occurring between ovulation and menses (discharge of blood and from the uterus) is defined as premenstrual syndrome (PMS). Premenstrual syndrome symptoms can either be physical or emotional.

Physical symptoms and signs include:
i. Muscle or joint pain
ii. Headache
iii. Fatigue
iv. Weight gain due to fluid retention
v. Bloated abdomen
vi. Breast tenderness
vii. Acne breakouts
viii. Diarrhoea or constipation

While other behavioural and emotional symptoms include:
i. Anxiety or tension
ii. Depressed mood
iii. Crying spells
iv. Anger or irritability and mood swings
v. Food cravings and appetite changes
vi. Insomnia
vii. Social withdrawal
viii. Poor concentration

Causes 
The exact cause of PMS is unknown. But there are several contributing factors, such as:
1. Cyclic hormonal changes: The hormones oestrogen and progesterone fluctuate a lot while preparing for a normal menstrual cycle. This fluctuation causes some of the symptoms of PMS.
2. Chemical changes: The fluctuation of serotonin, a kind of neurotransmitter (brain chemical), affects the mood, which causes some of the emotional symptoms of PMS. For instance, insufficient serotonin triggers premenstrual depression, insomnia, food cravings and fatigue.
3. Depression: If the PMS symptoms are severe, depression could be the underlying cause, though it doesn't usually trigger all of the symptoms.

Treatment
There is no permanent cure for PMS, but a few lifestyle changes and home remedies can work very well for you. Some treatment options include:

1. To ease abdominal bloating, drink lots of fluids
2. Eat a balanced diet comprised of plenty of vegetables and fruits. Reduce your alcohol, caffeine, salt and sugar intake.
3. You can take supplements such as magnesium, calcium, vitamin B-6 and folic acid to reduce mood swings and cramps.
4. Take vitamin D supplements to relieve symptoms
5. Sleep for at least eight hours in the night to counter fatigue
6. Exercise to improve your emotional health and reduce bloating
7. Try to reduce your stress as much as you can; read a book or walk to relieve some stress.

Besides, these lifestyle changes, you can take over-the-counter medications such as aspirin and ibuprofen to reduce stomach cramps, muscles aches and headaches. Diuretics (drugs that increase urination) are excellent treatments for bloating and fluid retention. However, consult your doctor before consuming any medication or supplement.

Causes and Treatment of Premenstrual Syndrome

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