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?

Periods, on their own, can be very uncomfortable but sometimes it can also trigger a rash making it all the more uncomfortable. This is a common problem faced by women who use commercial pads or sanitary napkins during this period. This is because they contain plastics, scents and chemicals that can irritate the sensitive skin in your genital area. Here are a few tips to help you deal with these rashes:

Change Your Pads Regularly: Whether your flow is light or heavy, the same pad should not be worn for more than 4 to 6 hours. Change your pads even if your pad does not look full once this time has passed. Along with menstrual blood, sanitary napkins also soak up sweat and bacteria. The groyne area is naturally moist and warmer than the rest of your body making it the ideal condition for bacteria to grow. Changing your pad regularly keeps these bacteria from multiplying.

Consider Alternatives: One of the main reasons pads cause rashes is because they rub against the skin and this friction irritates the skin. Hence, consider alternatives like tampons and menstrual cups that do not rub against the skin. You could also try cloth pads made using natural unbleached cotton.

Wear Right Underwear: Avoid synthetic underwear and use the only cotton while you are on your periods. This allows the skin to breathe and keeps moisture from building up inside the underwear. Also, ensure that your underwear fits well and can hold your pad in place.

Clean Well: Do not use wipes or tissue to clean your genital area but instead wash gently with water a few times a day. Once washed, dry the skin thoroughly before putting your underwear on. Do not use any type of soap, body wash or scents in the area. Also, avoid bubble baths and saunas.

See a Doctor: In some cases, a rash can also be a symptom of herpes or a vaginal yeast infection. If you alternate between pads and tampons, a rash could also be a sign of toxic shock syndrome. Hence, if the rash persists for a few days, consult a doctor. Your doctor can prescribe a topical cream to be used to relieve the itchiness and inflammation depending on the rash. You could also use an anti-chafing cream on your bikini line. Diaper rash cream is an over the counter cream that usually works well in such cases.

How To Deal With Rashes Due To Periods?

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!

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!

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

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

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