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?

7 causes of heavy menstrual bleeding you must know about

Heavy menstrual bleeding, also known as Menorrhagia, refers to the state of abnormally heavy bleeding during periods. It's common for women at the premenopausal stage of their life to experience heavy bleeding during periods; but if you are not among them, heavy menstrual bleeding is a matter of severe concern.

If you normally lose a lot of blood during your periods or experience severe cramps that prevent you from leading your normal lifestyle, you must first identify the cause of it.

Here are some of the most common conditions that are responsible for causing Menorrhagia.

Disturbed hormonal balance: Menstruation involves the shedding of the lining of the uterus (endometrium), whose build-up is generally controlled by the balance between oestrogen and progesterone, the two significant hormones of your body. It sometimes happens that there is excess endometrium generation due to disturbed hormonal balance, which results in heavy menstrual bleeding.

Polyps: Sometimes heavy menstrual bleeding occurs due to the occurrence of uterine polyps, which are tiny growths appearing on the uterus lining. This condition is mostly prevalent among women of child-bearing age caused due to raised levels of hormones.

Intrauterine device (IUD): People who use birth control methods like intrauterine device or IUD are likely to experience certain side effects which include heavy menstrual bleeding. If the cause behind your menorrhagia is an IUD, you might need to remove it to get relief from the condition.

Pregnancy complications: If you experience your period later than usual and it is associated with excessive bleeding, it may be caused by a miscarriage. Moreover, you might also experience menorrhagia incase of an ectopic pregnancy, a condition when the fertilized egg is implanted within the fallopian tube in place of the uterus.

Uterine fibroids: Women of reproductive age may develop noncancerous (benign) tumours in the uterus known as uterine fibroids. These fibroids can be responsible for giving you periods lasting longer than usual accompanied with excessive bleeding.

Cancer: Though it is a rare case, sometimes the reason behind heavy menstrual bleeding may be uterine cancer, cervical cancer or ovarian cancer.

Medications: consumption of certain prescription drugs such as anticoagulants and anti-inflammatory medicines may lead to prolonged or excessive menstrual bleeding.





7 Causes of Heavy Menstrual Bleeding You Must Know About

PMS is one of the worst food sensitive diseases. Symptoms include moodiness, bloating and headache. All it takes is one symptom to crop up for the whole body to go down. While environmental changes and preventive measures play a crucial role in dealing with this condition, careful choice of food goes a long way in keeping PMS under control. Here is a list of some best and worst food for PMS:

Foods that are Good During PMS:

Brussels sprouts, Artichokes and Broccoli: These veggies with high fibre content are known to ease bloating. Furthermore, the high water content of these veggies effectively deals with gas, discomfort, and puffiness. The idea is to refrain from foods with high sodium content that only contributes to the suffering.
Quinoa, what berry and popcorn: These foods help to deal with a short temper which is a very common occurring of PMS. Some other good effects of a high carb diet such as these include fighting anxiousness, depression and maintain composure. Consuming whole grain on a daily basis also helps to keep the mood cheerful. This happens because of the added secretion of the feel good factor hormone called serotonin.
Banana: Many women tend to face sleep disturbances before the period sets in. A recent study at the John Hopkins University found that less sleep before the period makes a woman susceptible to cramps and discomfort. Banana contains melatonin. The latter helps the body maintain its natural rhythm.
Eggs: The cravings during PMs can be very difficult to handle. It is therefore very important to start the day a very healthy breakfast. The right amount of protein and healthy fat present in an egg helps to keep the body energised throughout the day. Scrambled egg and an ounce of chicken is a perfect answer to PMs craving.
Some foods to avoid during PMS:

Processed fats: Processed fat contains a lot of processed fats, sodium and salt. Processed fats make a woman puffy and increment bloating. Processed foods contain very high protein content that becomes very difficult for the body to process during PMS.
Sugary foods: Craving for sugary food is pretty normal during PMS. However, too much sugar consumption during PMS fluctuate the blood sugar level. They also aggravate tension and mood swings. The latest study has found that refined sugar can disturb the immune system and creates a lot of fatigue in a woman.
Caffeine: Restricting caffeine during the period can help prevent the cramps and bloating. Certain caffeine such as coffee, cigarettes and chocolate can aggravate breast tenderness, anxiety, and depression. What's more, they systematically create a craving for sweet and other caffeine-related stuff. A better alternative to caffeine during PMs is herbal and green tea, water and fruit juice.

PMS - Foods You Must Have or Avoid During It!

Painful menstruation or menstrual cramp is termed as Dysmenorrhoea and refers to the discomfort or pain associated with menstruation. In 80% cases, cramps are an integral part of the preliminary dysmenorrhoea syndrome. Though this symptom is not deemed as a very serious clinical problem, the pain and its associated symptoms are acute enough to keep an affected woman from normal functioning for the first one or two days. These symptoms may take over one or two days prior to menses, reach their pinnacle on the first day and subside slowly with the passage of time. The pain can be typically depicted as being ached, cramping of the stomach and often reaching to the lower back portion.

There is probably no woman across the world, who has not undergone the painful menstrual cramps. But don't fret! Homeopathy treatment has a range of remedies to relieve you off this unease.

1. Cimicifuga: Normally menstruation cramps indicate a pain that flows across the pelvic region from one side to the other. This remedy will particularly be helpful in neuralgic and rheumatic cases as well as congestive cases where it works effectively with Veratrum Viride and Belladonna. It is also very efficient in combating headaches preceding menses, acute pains across abdomen, labor like pains and scanty flow.

2. Caulophyllum: This remedy is great for treating spasms and pain that flow downwards. The spasmodic periodic pains that need to be treated with Caulophyllum are mostly concentrated around the groin and radiate to other surrounding parts. Gelsemium can also be taken for treating neuralgic as well as congestive dysmenorrhoea when the pain bears down. The pains are often labor-like and spasmodic with flow of pale urine. In order to get faster relief, it can be taken along with hot bag press.

3. Belladonna: If you are afflicted with the congestive forms of menstrual cramps, then you may take Belladonna. In most cases, a pain and discomfort is felt prior to the flow and a feeling of something heavy around the vulva can be relieved if you sit up straight. This pain occurs and subsides all of a sudden making the flow clotted and restricted. This kind of dysmenorrhoea is extremely painful and makes the genital dry. In case the pain gets severe and cuts through the pelvis, then Veratrum viride can also be administered.

4. Zanthoxylum: This remedy is very effective in fighting dysmenorrhoea and uterine spasms. It is very effective when the pain is burning, agonising and extending down through the thighs making the limbs paralysed and numb. You can take this measure when the pain is affecting your ovaries as this medicine works closely for neuralgic form of menstrual cramps. Women with delicate nervous temperament can also take this remedy as it relieves from headache and eye pain caused from 
Menstruation.

Homeopathy has a huge range of medicines and it becomes difficult for a commoner to select an ideal one. Therefore, when you are deeply affected with menstrual cramps, you can always consult an expert before administering any medicine.

Pain During Menstruation

The Movie 'PadMan' is making waves much across India and is now attracting the attention of the international media as well, to a problem most women and girls have been facing in India. The movie is inspired by the life of Arunachalam Muruganatham, the inventor of a low-cost sanitary pad the manufacturing machine. He fought social stigma and faced social ostracization for trying to understand the fears and discomfort of women. He worked hard to come up with a low-cost sanitary pad that could be afforded by the poor women all across India.

Taboo:

The taboos, misgivings, and fears surrounding the menstruating women are not new, it is deeply rooted in our culture and its teachings. Such reservations exist in all the cultures whether it is Islam, Hinduism, Judaism, Christianity or Buddhism. There are several kinds of rules imposed on women like the prohibition of visiting a temple, physical intimacy, cooking and many more.

Present Condition:

India is a land of contrasts and while there are working women who do not think twice about pulling an 'all-nighter' at work, you also have women who have probably never stepped into a well-constructed or a clean bathroom in all their lives. What any woman of this generation would consider basic menstrual hygiene is probably grossly missing in the latter s case.

Apart from having minimum water to clean themselves, they use sanitary cloths (really old and discarded cloth) which are washed and reused for every period. They have very less water to wash these sanitary cloths and they are forced to dry them out in a dark and dingy corner of their house lest anyone sees it. In fact, there are several reports of women in rural India using straw, ashes, and sand instead of sanitary pads.

Complications:

Majority of such women in the rural areas report reproductive tract infections.

Lack of awareness amongst men about menstruation makes them ill-informed. As a result, they follow the mindless rituals and beliefs which make the problem much larger than it already is.

Lack of awareness about menstrual hygiene management has resulted in several young girls picking up infections thanks to the usage of hay, straw, and sand as a replacement for sanitary pads.

But, Bollywood's latest blockbuster 'PadMan' has broken the silence and stigma by starting out the conversation openly about sanitary pads. Having said that, below given are some of the basic hygiene tips that should be encouraged in every single woman.

Some Basic Hygiene tips

There are several small things women can do to prevent issues and problems. This can be done by following some simple changes in your routine:

Make sure you change pads frequently to avoid infections.

Soaps and Vaginal washes should be avoided as these can wash the  good bacteria  away.

Avoid wearing jeans and tight-fitting clothes as this can cause excessive sweating.

Make sure you dispose of the used pads correctly and wash your hands with warm water and soap to prevent bacterial infections.

While such awareness about menstrual hygiene is in its nascent stages, there is hope and that is thanks to men like Arunachalam Muruganantham. So, take a step forward and play your part in spreading awareness about menstrual hygiene and its effect on a female s overall health.

The PadMan Effect - Why Menstrual Hygiene is Such a Big Deal In India!

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?

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