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.

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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?

10 natural remedies to cure irregular periods

One common problem amongst a lot for women is irregular periods. While normally women have eleven to thirteen periods in a year, those suffering from irregular periods might have lesser than even six or seven. While this can be due to various problems, there exist some foods which can help cure this problem

1) ginger - often used to relieve menstrual pain, ginger is also used to correct irregular periods. You can include powdered ginger in your food or drink ginger tea.

2) cinnamon - one superfood which has a lot of health benefits is cinnamon. One can have cinnamon powder with tea or lemon juice to cure irregular periods.

3) aloe vera - it is responsible for regulating hormones in our bodies. Drinking aloe vera juice not only helps reduce weight but also regulates the periods.

4) turmeric - it is known to balance the hormones and stimulate flow of blood in the uterus. Drinking it with milk helps relieve spasm and regulate irregular periods.

5) papaya - raw papaya aids in increasing the flow of blood in the uterus and in uterine contractions, thus helping cure irregular periods.

6) sesame seeds - these help in producing and balancing hormones. Eating them also helps in regulating irregular pain.

7) jaggery - it is rich in minerals and iron, hence help cure irregular periods which can arise due to anemia.

8) grapes - grapes too contain iron and help curing irregular periods caused due to anaemia.

9) buttermilk - with calcium, potassium, proteins and vitamin b complex, buttermilk aids hormone secretion, thus helping cure irregular periods.

10) coriander - its juice is another food that helps cure irregular periods.


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10 Natural Remedies To Cure Irregular Periods

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

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

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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