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

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?

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!

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?

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

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

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