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

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

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?

Menstruation is a healthy experience of a woman s life, and it must come habitually every 28 days, for a period of 3-4 days without coagulating, and the blood loss should correspond to about a quarter of a cup. For a woman, menstrual cycle is a virtuous indicator of her overall wellbeing. Some women get irregular periods that appear at longer intervals, an unpredictable discrepancy in the duration of the cycle and the normal twenty-eight day cycle is missing. Some women have very insignificant problems with menstrual cycles, while others experience a monthly torture.

Irregular menses is typical in early puberty and not generally perturbing. Women should be alarmed when periods are spaced out for more than two months, as this may suggest hormonal imbalance and ovulation problems. A woman s customary hormonal cycle is contingent upon a subtle equilibrium between different hormones. Several potential triggers can stimulate hormonal imbalance leading to irregular menses. If a woman fails to ovulate, her ovaries will not receive a signal to produce a hormone called progesterone. Progesterone is essential in regulating the Uterine lining called endometrium, which is discarded during menstruation. Without progesterone, the endometrium persistently grows until it starts to break down and is disposed off as a very heavy uterine bleeding. The endometrium may also shed partially and intermittently, and bleeding becomes irregular or prolonged.

Causes of Irregular Menses:

Puberty.

Birth control pills.

Stress.

Poor diet due to anorexia, bulimia can influence your hormones.

Excessive weight loss or gain.

Intense exercise.

Breast-feeding.

Anxiety regarding pregnancy.

Anemia.

Menopause.

Excessive production of Androgen (a steroid hormone such as testosterone that controls the development and maintenance of masculine characteristics).

Uterine fibroids, cysts, polyps.

Polycystic Ovarian Syndrome (in this condition the ovary does not make all the hormones needed for any egg to mature fully, due to which some follicles remain as cysts, ovulation does not occur and the hormone progesterone is not made. Without progesterone a woman s menstrual cycle is irregular or absent).

Endometriosis (this is a condition where cells similar to those found inside the uterus grow and are attached outside the uterus forming implants. This can lead to infertility and irregular menses).

Pelvic infection.

Ovarian cancer.

Inflammatory Bowel disease.

Thyroid disease.

Heart disease.

Symptoms of Irregular Menses:

Inconsistency in the length of menstrual cycle.

Acne.

Bloating.

Low energy levels.

Sore breasts.

Fever.

Chills.

Changes in sexual desire.

Infertility.

Depression.

Osteoporosis.

Uterine cancer.

Endometrial Hyperplasia (excessive cell growth in the inner lining of the uterus due to excessive estrogen production as a result of delayed ovulation).

Homeopathic Approach to Irregular Menses:

Homeopathy offers an extensive range of options than conventional medicine. Homeopathic treatment for Irregular Menstruation is very competent, non-invasive, safe and inexpensive. Homeopathy treats the patient as a whole and looks deeper into the problem, promotes the immune function and maintains uterine health by eliminating the causative factor. Homeopathic Constitutional treatment based on the holistic approach stimulates the natural hormonal balance without administering any harmful hormone preparations. The goal of this Homeopathic approach is to enliven the body's natural healing and self-repair ability to treat the underlying condition, to prevent it and to create the highest state of health and well-being.

Constitutional Homeopathic treatment with the management of an experienced and professional Homeopath is an excellent choice for Irregular Menstruation. Some Homeopathic remedies that are commonly used to treat Menstrual Irregularities are given below. These are just a few of the commonly used Homeopathic remedies and are mentioned only to create awareness about the effectiveness of Homeopathic medicines in Menstrual Irregularity. It is not advisable to resort to self-medication for any disease.

Homeopathic remedies for Irregular Menses:

Pulsatilla: Pulsatilla is one of the first remedies thought of, in affection, peculiar to women. It's essentially feminine disposition of gentleness timidity, mildness, docility    excellent thing in woman    is most characteristic of the drug; even tearfulness, another feminine attribute, strongly points to Pulsatilla. Then, we have fickleness, indecision and changeableness, which are certainly characteristic of Pulsatilla and of some women. Dark menses which are delayed and accompanied with this severe menstrual colic and the characteristic temperament will be the indications. The menses of Pulsatilla, besides being scanty, are quite apt to appear too late. 
Caulophyllum: This is a valuable remedy in treating irregular periods, difficulty becoming pregnant or slow childbirth due to weak muscle tone of the uterus. The patient feels menstrual discomfort with heavy bleeding and drawing pains in the pelvic region, thighs, and legs. These patients complain of habitual abortion due to uterine debility.
Cimicifuga Racemosa: This remedy is intended for irregular and painful menses, with shooting pains that go down the hips and thighs, or cramps similar to labor-pains that are felt in the pelvic area. Women become restless, fearful, and depressed before a menstrual period. These women are strong, talkative, depressed, they try to injure themselves, and have dreams of impending evil, with fear of riding in a closed carriage.
Lachesis: This remedy is suggested to women who are passionate, with a tremendous need for an outlet, both physically and mentally. The menstrual flow is irregular, heavy and brings relief of tension. These patients are very outspoken with strong feelings of suspicion or jealousy. They have an intolerance of restrictive clothing around the waist or neck.
Lycopodium: This is an outstanding remedy for delayed menses that follows a heavy flow lasting more days. These patients have a ravenous appetite with a strong craving for sweets. They complain of abdominal bloating and flatulence, and always have a worried look with lack of confidence, though they may be bossy with their family.
Murex Purpurea: This remedy works amazingly in Irregular Menstruation with large clots and feeling of protrusion. These patients feel very weak, are very conscious of a womb, and feel as if something is pressing on a sore spot in the pelvis. This sore feeling is worse on sitting, hence the patient always sits with legs tightly crossed. Least contact of parts causes violent sexual excitement in these women.
Secale Cornutum: This is a useful remedy for Irregular menses in thin, shriveled skinned women. Their whole body is pervaded by a sense of great heat and they have burning pains in the uterus. Menses is irregular, dark and at times, there is continous oozing of watery blood until the next period. Their pregnancy concludes in a threatened abortion in the third month
Sepia: This remedy is best suited to women who feel weary and dragged-out, and are indifferent to their own family members. She feels taken for granted and overworked, becomes irritable and sarcastic if demands are made. Menses is delayed with a feeling that the pelvic floor is weak, or as if the uterus is sagging.
Self-care measures for Irregular Menses:

Relax and ease stress.

Avoid exhausting physical exercise.

Eliminate any eating disorders.

Eat a balanced diet with lots of fresh fruits and vegetables.

Reduce your intake of salt and caffeine.

Hence, appreciate a natural way to a healthy uterus, convalesce healthy living and curtail the changes that happen during your menstrual years.

How To Effectively Treat Irregular Periods With Homeopathy?

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

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