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?

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

In an incredibly fast paced and unhealthy lifestyle of the modern world, irregular menses aren t exactly an unusual situation. The length of a monthly cycle may either last longer than usual or end earlier than usual, only to begin in a short while again, accompanied by greater abdominal pain and blood loss. Irregular cycles may vary from 8 to 21 days or more. The variation of 21 days or more is considered highly irregular and abnormal. A woman may face some menstrual irregularities at both ends of menstrual life, (onset- menarche and end of cycle- menopause) which is normal and in most of the cases, it is self-establishing. 

Causes of Irregular Menstrual Cycle: 

The cause of irregularities in menstrual cycle is basically hormone imbalance. The altered levels in the body lead to irregular cycles. There are many factors in routine life which affect hormonal balance. Some of them are: 

Poor diet or wrong dietary habits 
Stress and anxiety, thoughts and emotions
Lifestyle: Lack of physical activity and exercise, too much physical exertion, stress and strain during menses. 
Illness: Long-term illness like fever, tuberculosis, thyroid problem etc. 
Medication: Certain medicine if taken for a long time, like oral contraceptive pills, hormonal therapy etc., alters hormonal balance. 
Imbalance of Tridosha (vatta, pitta and kapha) in body, leads to irregularities of reproductive system. 
As per Ayurveda, Vatta is the main culprit in menstrual irregularities. 

How To Deal With Menstrual Irregularities:

With the sudden acceptance of eastern concepts of yoga and organic and indigenous medicines around the world, Ayurveda has gained importance in treating irregular menses, gynecological and obstetric problems. 

Lifestyle and Food- There is no alternative for lifestyle and food habits correction. Eating healthy and nutritious food, regular exercise, yoga, physical activity, outdoor games lead to good physical health. 
Meditation and Breathing: Exercise is good for taming hormones. It keeps a person physical and mentally healthy. 
Avoid heavy physical work during menses. 
A good oil massage over body keeps Vatta in balance (one of the important tridoshas of body: vatta, pitta and kapha). 
Ayurveda has proven to be much helpful in regulating the menstrual cycles. According to certain studies, Ayurveda came in rather handy while tackling PCOS, a disease distressing 1 in 3 women today. It is certain that Ayurveda medicines work better in certain scenarios and definitely have fewer risks in comparison to allopathic medicines and surgeries. Over a period of time, they have proven much more beneficial in overcoming the irregular menses and the irritation along with the accompanying pain and PMS symptoms. Ayurvedic medicines use herbs and roots and almost everything found in nature to discover a rather organic cure for diseases. Certain plants like Shatavari are used to reduce the much spoken about mood swings or PMS symptoms during periods which can only worsen in case of an irregularity. The bark of the Ashoka tree has proven to be quite helpful in relieving menstrual pain and excessive bleeding. Other plants and their parts like the Lodhra, Guggul, Guduchi and Amlaki, Jatamansi etc. are useful in regulating periods and reducing the stress and irritation accompanied by it. 

Panchkarma- Basti therapy (Enema- administration of medicines through rectal route). In this treatment, decoction of different herbs and medicated oils are used for giving enema. Basti has proven its efficacy since centuries, for treating Vatta. A course of 5, 8, 15, 30 or 60 basti, as per person s requirement can be given for menstrual problems. Irregular periods, although are faced by a large chunk of women, pose different symptoms for different people and hence individualized treatment is advised.

Irregular Periods - Ayurvedic Home Remedies to Treat It

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

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

Bloating, cramping, headaches, nausea are very common during menstruation painful symptoms women go through when during their monthly cycle. During this time, women tend to crave salt, desserts, caffeine or liquor. One should look out for different alternatives to prevent menstrual cramps and satisfy their cravings.

Menstrual cramps cause a great deal during the menstrual cycle since the withdrawals interrupt the blood stream to the wall of the uterus. Stomach aches, lower back pain and leg cramps are some common and basic side effects. Here are a few ways yoga can cure the problem:

Janu sirsasana (head-to-knee forward bend): Go down on the floor in a sitting position with your legs stretched out forward. Twist the right knee outward to a 90 degree angle and press the right foot into the insides of the left thigh. Get the left shin or foot, breathe in, tighten the hips, and place the stomach over the straight leg. Breathe out, and broaden the spine and stretch out the chest. Straighten your back.
Pasasana (noose pose): Come into a full squat position with you feet together and drop your hips down towards your heels. In case your heels do not reach the floor, put a pillow underneath. Breathe in and twist your knees to one side as you turn your abdomen to one side. Breathe out, touch the back of your upper left arm with the outside of your right leg and reach the left lower arm to touch the foot.
Ustrasana (camel pose): Bow on the floor with the knees and hips. Turn your thighs inside and press your shins and feet firmly into the floor. Lay your hands on the back of your hips. Breathe in, lift your chest, and press your shoulders down towards the ribs. Breathe out, push the hips forward as you stretch the front of the body and bend backwards. Keep your hands on the back of your hips or on the back of the heels. In case you put your hand on the heels, press your toes into the floor to lift the heels higher.
Supta padangusthasana (reclining big toe pose): Lie on your back with your arms by your sides and stretch the legs. Lay your head on the floor, breathe in, bend the right knee, and hold the toe with the right fingers. Put your left hand on top of the upper left thigh to put the left leg down.
Towel hook: Breathe out and stretch the right leg to the extent your body permits. You can likewise use a towel or belt to wrap around the right foot to help. Breathe in; lift your head up towards the right leg and hold the left leg down.


Menstrual Pain - 5 Yoga Asanas To Help You Relieve The Pain!

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