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?

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

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?

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!

Menstruation is a healthy experience of a woman s life, and it must come habitually every 28 days, for a period of 3-4 days without coagulating, and the blood loss should correspond to about a quarter of a cup. For a woman, menstrual cycle is a virtuous indicator of her overall wellbeing. Some women get irregular periods that appear at longer intervals, an unpredictable discrepancy in the duration of the cycle and the normal twenty-eight day cycle is missing. Some women have very insignificant problems with menstrual cycles, while others experience a monthly torture.

Irregular menses is typical in early puberty and not generally perturbing. Women should be alarmed when periods are spaced out for more than two months, as this may suggest hormonal imbalance and ovulation problems. A woman s customary hormonal cycle is contingent upon a subtle equilibrium between different hormones. Several potential triggers can stimulate hormonal imbalance leading to irregular menses. If a woman fails to ovulate, her ovaries will not receive a signal to produce a hormone called progesterone. Progesterone is essential in regulating the Uterine lining called endometrium, which is discarded during menstruation. Without progesterone, the endometrium persistently grows until it starts to break down and is disposed off as a very heavy uterine bleeding. The endometrium may also shed partially and intermittently, and bleeding becomes irregular or prolonged.

Causes of Irregular Menses:

Puberty.

Birth control pills.

Stress.

Poor diet due to anorexia, bulimia can influence your hormones.

Excessive weight loss or gain.

Intense exercise.

Breast-feeding.

Anxiety regarding pregnancy.

Anemia.

Menopause.

Excessive production of Androgen (a steroid hormone such as testosterone that controls the development and maintenance of masculine characteristics).

Uterine fibroids, cysts, polyps.

Polycystic Ovarian Syndrome (in this condition the ovary does not make all the hormones needed for any egg to mature fully, due to which some follicles remain as cysts, ovulation does not occur and the hormone progesterone is not made. Without progesterone a woman s menstrual cycle is irregular or absent).

Endometriosis (this is a condition where cells similar to those found inside the uterus grow and are attached outside the uterus forming implants. This can lead to infertility and irregular menses).

Pelvic infection.

Ovarian cancer.

Inflammatory Bowel disease.

Thyroid disease.

Heart disease.

Symptoms of Irregular Menses:

Inconsistency in the length of menstrual cycle.

Acne.

Bloating.

Low energy levels.

Sore breasts.

Fever.

Chills.

Changes in sexual desire.

Infertility.

Depression.

Osteoporosis.

Uterine cancer.

Endometrial Hyperplasia (excessive cell growth in the inner lining of the uterus due to excessive estrogen production as a result of delayed ovulation).

Homeopathic Approach to Irregular Menses:

Homeopathy offers an extensive range of options than conventional medicine. Homeopathic treatment for Irregular Menstruation is very competent, non-invasive, safe and inexpensive. Homeopathy treats the patient as a whole and looks deeper into the problem, promotes the immune function and maintains uterine health by eliminating the causative factor. Homeopathic Constitutional treatment based on the holistic approach stimulates the natural hormonal balance without administering any harmful hormone preparations. The goal of this Homeopathic approach is to enliven the body's natural healing and self-repair ability to treat the underlying condition, to prevent it and to create the highest state of health and well-being.

Constitutional Homeopathic treatment with the management of an experienced and professional Homeopath is an excellent choice for Irregular Menstruation. Some Homeopathic remedies that are commonly used to treat Menstrual Irregularities are given below. These are just a few of the commonly used Homeopathic remedies and are mentioned only to create awareness about the effectiveness of Homeopathic medicines in Menstrual Irregularity. It is not advisable to resort to self-medication for any disease.

Homeopathic remedies for Irregular Menses:

Pulsatilla: Pulsatilla is one of the first remedies thought of, in affection, peculiar to women. It's essentially feminine disposition of gentleness timidity, mildness, docility    excellent thing in woman    is most characteristic of the drug; even tearfulness, another feminine attribute, strongly points to Pulsatilla. Then, we have fickleness, indecision and changeableness, which are certainly characteristic of Pulsatilla and of some women. Dark menses which are delayed and accompanied with this severe menstrual colic and the characteristic temperament will be the indications. The menses of Pulsatilla, besides being scanty, are quite apt to appear too late. 
Caulophyllum: This is a valuable remedy in treating irregular periods, difficulty becoming pregnant or slow childbirth due to weak muscle tone of the uterus. The patient feels menstrual discomfort with heavy bleeding and drawing pains in the pelvic region, thighs, and legs. These patients complain of habitual abortion due to uterine debility.
Cimicifuga Racemosa: This remedy is intended for irregular and painful menses, with shooting pains that go down the hips and thighs, or cramps similar to labor-pains that are felt in the pelvic area. Women become restless, fearful, and depressed before a menstrual period. These women are strong, talkative, depressed, they try to injure themselves, and have dreams of impending evil, with fear of riding in a closed carriage.
Lachesis: This remedy is suggested to women who are passionate, with a tremendous need for an outlet, both physically and mentally. The menstrual flow is irregular, heavy and brings relief of tension. These patients are very outspoken with strong feelings of suspicion or jealousy. They have an intolerance of restrictive clothing around the waist or neck.
Lycopodium: This is an outstanding remedy for delayed menses that follows a heavy flow lasting more days. These patients have a ravenous appetite with a strong craving for sweets. They complain of abdominal bloating and flatulence, and always have a worried look with lack of confidence, though they may be bossy with their family.
Murex Purpurea: This remedy works amazingly in Irregular Menstruation with large clots and feeling of protrusion. These patients feel very weak, are very conscious of a womb, and feel as if something is pressing on a sore spot in the pelvis. This sore feeling is worse on sitting, hence the patient always sits with legs tightly crossed. Least contact of parts causes violent sexual excitement in these women.
Secale Cornutum: This is a useful remedy for Irregular menses in thin, shriveled skinned women. Their whole body is pervaded by a sense of great heat and they have burning pains in the uterus. Menses is irregular, dark and at times, there is continous oozing of watery blood until the next period. Their pregnancy concludes in a threatened abortion in the third month
Sepia: This remedy is best suited to women who feel weary and dragged-out, and are indifferent to their own family members. She feels taken for granted and overworked, becomes irritable and sarcastic if demands are made. Menses is delayed with a feeling that the pelvic floor is weak, or as if the uterus is sagging.
Self-care measures for Irregular Menses:

Relax and ease stress.

Avoid exhausting physical exercise.

Eliminate any eating disorders.

Eat a balanced diet with lots of fresh fruits and vegetables.

Reduce your intake of salt and caffeine.

Hence, appreciate a natural way to a healthy uterus, convalesce healthy living and curtail the changes that happen during your menstrual years.

How To Effectively Treat Irregular Periods With Homeopathy?

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