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?

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?

Painful menstruation or menstrual cramp is termed as Dysmenorrhoea and refers to the discomfort or pain associated with menstruation. In 80% cases, cramps are an integral part of the preliminary dysmenorrhoea syndrome. Though this symptom is not deemed as a very serious clinical problem, the pain and its associated symptoms are acute enough to keep an affected woman from normal functioning for the first one or two days. These symptoms may take over one or two days prior to menses, reach their pinnacle on the first day and subside slowly with the passage of time. The pain can be typically depicted as being ached, cramping of the stomach and often reaching to the lower back portion.

There is probably no woman across the world, who has not undergone the painful menstrual cramps. But don't fret! Homeopathy treatment has a range of remedies to relieve you off this unease.

1. Cimicifuga: Normally menstruation cramps indicate a pain that flows across the pelvic region from one side to the other. This remedy will particularly be helpful in neuralgic and rheumatic cases as well as congestive cases where it works effectively with Veratrum Viride and Belladonna. It is also very efficient in combating headaches preceding menses, acute pains across abdomen, labor like pains and scanty flow.

2. Caulophyllum: This remedy is great for treating spasms and pain that flow downwards. The spasmodic periodic pains that need to be treated with Caulophyllum are mostly concentrated around the groin and radiate to other surrounding parts. Gelsemium can also be taken for treating neuralgic as well as congestive dysmenorrhoea when the pain bears down. The pains are often labor-like and spasmodic with flow of pale urine. In order to get faster relief, it can be taken along with hot bag press.

3. Belladonna: If you are afflicted with the congestive forms of menstrual cramps, then you may take Belladonna. In most cases, a pain and discomfort is felt prior to the flow and a feeling of something heavy around the vulva can be relieved if you sit up straight. This pain occurs and subsides all of a sudden making the flow clotted and restricted. This kind of dysmenorrhoea is extremely painful and makes the genital dry. In case the pain gets severe and cuts through the pelvis, then Veratrum viride can also be administered.

4. Zanthoxylum: This remedy is very effective in fighting dysmenorrhoea and uterine spasms. It is very effective when the pain is burning, agonising and extending down through the thighs making the limbs paralysed and numb. You can take this measure when the pain is affecting your ovaries as this medicine works closely for neuralgic form of menstrual cramps. Women with delicate nervous temperament can also take this remedy as it relieves from headache and eye pain caused from 
Menstruation.

Homeopathy has a huge range of medicines and it becomes difficult for a commoner to select an ideal one. Therefore, when you are deeply affected with menstrual cramps, you can always consult an expert before administering any medicine.

Pain During Menstruation

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!

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

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?

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