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?

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

What Causes Light Periods in Women?

Light periods refer to menstrual periods that have very light flow and are characterized by a lesser number of days than usual. Although the menstrual cycles vary from a woman to another, the duration for a normal period is around every 28 days. Each period lasts for approximately four to seven days. The amount of blood loss in a normal period is around 20 ml to 80 ml. However, loss of blood below 20 ml can be considered as light periods.

The causes of light periods can vary for different woman. Some of them are:

- An imbalance in hormone levels in the body like PCOD (polycystic ovarian disease).

- Light periods are most common in women who are approaching menopause. This is because, at this time, women tend to produce less estrogen, a hormone responsible for regulating menstrual periods.

- Light periods can be common in girls who have just started to menstruate.

- Excessive bouts of exercise, a thyroid condition or an eating disorder can be also responsible for light periods in women.

- Women who use hormonal or oral contraceptives may also have a chance of experiencing light periods.

- An important cause of scanty menses is implantation bleeding. That means sometimes, despite being pregnant, little amount of bleeding can happen at the expected time of menses in the first three months of Pregnancy. So it's important to rule out pregnancy at the earliest.

Certain symptoms usually follow light periods. These symptoms vary according to the underlying causes of this condition.

Some of the common symptoms which accompany light periods are:

- Abdominal pain
- Frequent infections, namely yeast and other fungal infections
- Painful sexual intercourse
- Missed periods

In some cases, light periods might turn out to be a sign of a fatal condition that should be immediately administered to. An example of such would be an ectopic pregnancy, which can cause light or heavy bleeding. Although light periods are rarely due to serious diseases, neglect can lead to heightened complications and irreversible damage.

Some of the complications can are:

- Serious discomfort and pain
- Difficulty in conception or infertility
- Osteoporosis and osteopenia



What causes light periods in women?

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?

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

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

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