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?

Infections of the vagina, cervix and uterus

Vaginal problems are very common and a little awareness can enable women to take care of this delicate region of their body. Vaginal infections are the most irritable and hurtful and lack of education on the same makes it difficult to prevent them; from burning and itching to unpleasant odour, most women have faced these infections at some point of their lives.

Here are few points you must know about to stay clear of these infections.

1. Vaginal infections: vagina contains bacteria and yeast which are good and maintain the health of the area. However, things like change in levels of hormones, poor hygiene, pregnancy, sexual contact, antibiotics, disturb the balance of health, thus causing infections. Most common types of vaginal infections are: bacterial infections, yeast infections, trichomonas vaginitis. While there exist over-the-counter cure for these infections, it is best to visit your gynecologist and get the infections diagnosed &amp; treated.

2. Cervix inflammation: infection or inflammation in the cervix is called cervicitis. It is pretty common and is influenced by a number of factors like allergies, infections or irritations - it is important to know the cause of cervicitis because in the long run, it could pose a problem with fertility. Symptoms of cervicitis include foul smelling vaginal discharge, pain during passing urine, pelvic pain, abnormal bleeding like bleeding after sexual contact or between periods. Cervicitis is treated with the help of anti-fungal medications, antibiotics and anti-viral medications depending upon the evaluation of the underlying cause.

3. Pelvic and uterine infection: infection in the uterus and pelvis is also a matter which should not be left untreated. It can present with pain lower abdomen, pain during intercourse, frequent and painful urination. The infection can be caused by various organisms which can lead to pelvic inflammatory disease which in turn can spread to the uterus, ovaries and the fallopian tubes.

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Infections Of The Vagina, Cervix and Uterus: Facts You Must Know.

Recurrent pregnancy loss refers to the situation when three consecutive pregnancy loss takes place. A pregnancy loss is a clinically defined pregnancy which ends before twenty weeks.

Causes of recurrent pregnancy loss

Major cases of pregnancy loss occur due to genetic abnormalities and chromosomal abnormalities. The abnormality may occur from the sperm, egg or the early developed embryo.
Recurrent pregnancy loss may occur in a woman due to ascending maternal age. This happens because of poor quality of the egg, which further leads to chromosomal abnormalities. In some cases, the pregnant mother or the father can have some gene irregularities. In such cases, the would-be-born infant is affected, and this causes pregnancy loss or miscarriage.
Uterus abnormalities also lead to recurrent pregnancy loss. This may happen because of poor supply of blood to the uterus. Abnormalities in the uterus are in-born in some women and in others these may develop over time.
Women having a poor immune system are likely to suffer pregnancy loss. Abnormalities in hormone secretion like thyroid or diabetes may also cause pregnancy loss in women.
If a woman suffers from abnormalities in blood clotting, the chances of miscarriage are enhanced.
Testing for recurrent pregnancy loss
Several tests and examinations should be carried out for detection of pregnancy loss. 

Karyotype analysis of the woman and her male partner has to be conducted. Karyotype refers to the genetic or chromosomal constituents of an individual and this test is carried out to detect abnormalities in genes and chromosomes of the parents, which cause miscarriage when passed on to the developing infant.
Another test includes the evaluation of the uterus and the uterine cavity. This is done by ultrasound, saline ultrasound, MRI, hysterosalpingogram X  ray or by hysteroscopy. These tests help to get information on the uterus shape, about fibroid presence, detect abnormalities within the uterus and observe the opening and closing of the tubes. Tests to detect the functioning of hormones are also carried out.
Treatment
The treatment for women with recurrent pregnancy loss depends upon the underlying causes of the pregnancy loss.

In case of patients with karyotypic abnormalities, genetic counselling is recommended, where a specialist is consulted to know about chromosomal abnormalities.
Prenatal genetic studies are carried out by some couples to know about the offspring s genetic make-up. This is done with chorionic villus sampling or with amniocentesis. A process known as in vitro fertilization can be carried out.
In case of uterine abnormalities, a surgery may be performed and medications for reducing blood clot are used if antiphospolipid syndrome is detected.
Recurrent pregnancy loss may happen due to various reasons and proper tests, and treatment procedures should be carried out for curing pregnancy loss. This phenomenon affects a woman and her partner deeply.

Recurrent Pregnancy Loss - Know the Reasons Behind it!

Miscarriage is a spontaneous abortion that occurs around the first to second trimester of pregnancy; wherein the foetus is automatically expelled from the uterus due to its inability to survive because of environmental influences or chromosomal abnormalities.

Unless the miscarriage occurs due to a severe health issue, the fertility of the woman may not necessarily be compromised. Studies show that one miscarriage doesn t predict the possibility of a future one. Once the bleeding and pain subside, it is the emotional trauma that must be addressed to begin with which poses a greater threat than the physical one.

The fertility of the woman remains unaltered and the body can be ready after the menstrual cycle returns to normal. However, it still requires some time for the woman to be physically and emotionally prepared to go through another pregnancy. The medical history and reasons behind miscarriage must be evaluated before the couple decides to try again.

Complications after miscarriage only occur if the woman is above 35 years of age or has a rather unhealthy lifestyle. The concept of fertility varies from person to person and it isn t possible to pass a common judgement about fertility in this scenario.

The gynaecologist mostly suggests couple therapy after the trauma of the miscarriage. The psychological loss is given more importance before considering another attempt by most doctors. The fertility loss only occurs with age and unhealthy lifestyle and it is widely accepted and proven that a miscarriage has little or nothing to do with it.

Ways to Increase Fertility

If a couple is certain they are ready to conceive again, there are a few things a woman can do to help her chances of becoming pregnant-

The first thing to do is to stop any unhealthy habits. These include smoking, drug use, or alcohol abuse. It s reported that high consumption levels of caffeine are detrimental to conception so that should also be limited.
Eliminating stress can also help. Eliminating stress is one of the most important factors in having a successful pregnancy. So, it makes sense that getting over-stressed can reduce fertility levels.
Eat healthy. If depression was experienced due to the miscarriage, it s possible that the woman s diet has not been the healthiest. It s common for women who have experienced a miscarriage to have a loss of appetite and not eat enough or to eat out of sorrow, eating too much. More attention should be paid to the diet and more healthy foods added to meals.
Talk to a Doctor

If a couple is having issues with fertility after early miscarriage, they should talk to a doctor. There are many options available. More than likely, the first thing the doctor will do is to test fertility levels of both the man and the woman. If you don't want to visit a doctor for this, there is a new at-home kit available called Fertell. This test, retailing for approximately $100, measures fertility levels for both a man and a woman.

If it is found that there is a loss of fertility after early miscarriage, fertility drugs or therapies may be prescribed for a period of time.

The doctor may report that there are no issues with fertility. At this point, it would be a good idea to use an ovulation predictor in order to time effective intercourse. This isn't the most romantic idea, but it may well be one of the most logical ways for a couple to conceive.

Bottom Line

Fertility is not normally decreased after miscarriage. A woman's fertility levels return to normal as soon as her menstrual cycle returns. Fertility may be decreased due to emotional issues as a result of the miscarriage. However, if a couple is ready, both physically and emotionally, there should be no physiological hindrances to conception.

The decision to try again is not an easy one. However, fertility won't typically be an issue.

Pregnancy - Understanding Fertility After Early Miscarriage!

IVF is a useful process for people who want to become parents but have exhausted all other means of being so. However, the in-vitro fertilization method is definitely not suitable for everyone. Here are some facts you need to know about the procedure and they will help you determine whether you are suited for the program or not.

1. IVF Takes Time
Even though most clinics may not tell you this, but the IVF procedure takes a bit of time to deliver the desired results. On an average, the treatment can take anywhere between four weeks to a couple of months to produce results, depending on the patient s ability to respond to the medicines used. The procedure involves artificially stopping the menstrual cycle of the woman. Next, the ovulation process is stimulated so that the healthy egg can be extracted from the womb. The eggs chosen are then fertilized and left to undergo embryo culture for another six days. After this, the eggs are implanted back into the mother s body.

2. The process Can Be Stressful
IVF treatment and pregnancy can be quite a stressful period of time for the parents in question. The mother needs to be constantly monitored to check for any abnormal response to the pregnancy. Regular checkups by the doctor along with blood tests may also be suggested. However, this stress has very little chance of affecting the quality of the pregnancy. So, do not worry that overstressing yourself will lead to complications for the embryo.

3. More Than One Cycle Needed For Pregnancy
IVF treatment occurs in cycles. Each cycle involves transplanting a fertilized egg into the womb. However, pregnancy, right after completion of the first cycle, is quite rare. In fact, almost all patients need to undergo several similar cycles in order to get pregnant. So, do not be disheartened if you do not get pregnant after undergoing the very first cycle of IVF treatment.

4. IVF Is Costly
Not everyone is able to afford the high cost of IVF. Others may be able to afford the cost of undergoing a couple of cycles of the same, after which the high costs can become a burden. Only a select few can bear to carry on with the treatment until the pregnancy arises. So, consider your financial condition prior to signing on for such a treatment option.

At any rate, consult with an expert to get an even better idea about the IVF procedure and the consequent pregnancy. 

All You Need To Know About The IVF Procedure!

Vitamin D is a crucial vitamin that is soluble in fat. Vitamin D is essential for the growth of your bone and it ensures increased flow of calcium into your bloodstream by promoting the process of its absorption from the consumed food. Poor concentration of vitamin D may result in the development of rickets in children and osteoporosis in adults. Vitamin D is important in maintaining the immunity of your system; deficiency of vitamin D gives rise to a number of health problems including cardiac disorders, arthritis, hypertension, diabetes and even cancer.

Daily exposure to mild sunlight helps to synthesize Vitamin D in body. Dietary sources include milk, cod liver oils, fish, meat, fortified dairy and food products.

The most reliable way to diagnose the deficiency of vitamin D is through blood test; it is the most effective method of measuring the level of vitamin D in your blood. The following are some dominant symptoms of vitamin D deficiency:

Influenza: According to studies, vitamin D acts a guard against the attack of a number of respiratory infections which are widespread in children. Hence, lack of vitamin D in children is responsible for the development of various respiratory tract infections and diseases.
Depression and Schizophrenia: The root cause of depression and various other psychiatric disorders have been linked to deficiency in vitamin D. It is extremely important for expecting mothers to maintain a sufficient level of vitamin D in their body, during the gestation period to reduce the risk of delayed brain development and other mental ailments in the new born babies.
Cardiovascular disease: Cardiovascular ailments are more prevalent among people, who tend to suffer from vitamin D deficiency. Patients who suffer from cardiac discomfort have responded well to vitamin D treatment.
Asthma: Intake of vitamin D supplements reduces the severity and discomforts that are associated with asthma and have also shown considerable reduction in the occurrence of asthma attacks.
Periodontal disorders: Lack of vitamin D may result in the formation of numerous harmful bacteria in your mouth and may give rise to several oral discomforts in form of painful gum inflammation, bleeding and loss of tooth. Vitamin D aids in the formation of cathelicidins and defensins, which are effective in maintaining the overall oral health.
Cancer: Types of cancer including prostate cancer, breast cancer and colon cancer are linked with Vitamin D deficiency. Supplements of vitamin D are helpful in controlling the growth and development of breast cancer, especially the estrogen sensitive breast cancer.

Vitamin D Deficiency - 6 Signs That You are Suffering from it 

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