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Menopause Health Feed

Postmenopausal Bleeding - Is It Normal?

Postmenopausal Bleeding - Is It Normal?

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 :

- Physical exam
- Transvaginal ultrasound
- Endometrial biopsy
- Hysteroscopy
- 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 ayear of menopause, do not ignore it.  

Menopause - How Homeopathy Can Manage It?

Menopause - How Homeopathy Can Manage It?

The disruption of the normal female cycles of menstruation and ovulation after the age of 45 and the loss of her ability to conceive naturally is known as menopause. The associated symptoms of menopause are heat flushes, insomnia, weight gain, depression, nausea and fatigue. While hormone replacement therapy is the most common procedure to provide relief from menopausal symptoms, natural homeopathic remedies can also be used for the same. These remedies are completely safe as opposed to hormone replacement therapy which has a number of side effects. The following homeopathic medicines and remedies can be used to treat menopause:

1. A balanced diet which provides you with optimal nutrition can be helpful in treating menopausal symptoms. When you get enough vitamins and minerals, the physical discomfort caused by the symptoms can be reduced greatly.
2. Phosphorus can help with migraines, extreme sweating, numb hands, fast pulse, memory problems and dry and itchy skin. Foods high in phosphorus content are meat, fish, cheese, nuts and seeds of pumpkins, sunflowers etc.
3. Excessive deposition of fat can interfere with the hormonal cycles and cause imbalances in the level of estrogen and progesterone. So, regular yoga and exercise can be helpful.
4. Amylenum nitrosum can provide relief from profuse sweating, shortness of breath and palpitations.
5. Phytoestrogen or dietary estrogen is a compound found in foods such as soybeans, oats, barley, carrots, fenugreek, rice etc. Phytoestrogen can provide natural relief from menopausal symptoms.
6.  Aurum metallicum is used to get the tissues and organs to function normally again and control feelings of anxiety and claustrophobia.
7. Aconitum napellus (wolf's bane) is a flowering plant and its extracts can reduce panic attacks, heat flushes, over excitability and depressive symptoms.
8. Argentum nitricum is a nitrate compound of silver which is used to control excessive bleeding in the pre-menstrual stages.
9. Belladonna (deadly nightshade) is beneficial for a large number of symptoms such as headaches, fatigue, insomnia, frequent urination, osteoporosis, abnormal weight gain and other nervous disorders.
10. Bryonia alba, a flowering plant, is used as a remedy for vaginal infections, rashes and vaginal dryness that are common during menopause.
11. Natrum muriaticum, in small amounts, helps to reduce stress. Stress can cause problems in thyroid function, cognitive functioning, digestive system functioning and it can elevate blood pressure levels rapidly.
12. Nux vomica (strychnine) is a common homeopathic medicine for nausea, vomiting and indigestion. These problems are seen frequently in menopausal women, especially after meals at night.

 

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Postmenopausal Bleeding - How Dangerous Is It?

Postmenopausal Bleeding - How Dangerous Is It?

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 gynaecological 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 an area along the uterine tract could lead to occasional bleeding
Cancers - Though only 1 in 10 PMB cases turns 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:
- Physical exam
- Transvaginal ultrasound
- Endometrial biopsy
- Hysteroscopy
- Dilatation and Curettage

Treatment:

Needless to say, this would depend on the diagnosis.

For very minor cases with a 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.  

1 person found this helpful

Menopause - Know Its Impacts On Your Body!

Menopause - Know Its Impacts On Your Body!

Menopause is characterized as the absence of menstrual periods for 12 months. It is the time in a woman’s life when the ovaries stop functioning. The periods then stop forever. The normal period of menopause is 51 years of age, however, menopause may happen as ahead of schedule i.e. as early as 30s or as late as the 60s. There is no solid lab test to determine when a lady will encounter menopause.

Here are a few ways in which menopause affects a woman’s body:

  1. Skin: Consequences of menopause include dryness, loss of flexibility, thinning of the skin and expanded wrinkling. These symptoms result in poor recovery from injuries, hair loss and pigmentary changes. Unwanted hair growth and acne may likewise happen. Wrinkling is caused by excessive smoking and sun exposure. One should stay away from smoking and sun exposure.
  2. Hair: Hormonal changes incorporate hirsutism (undesirable facial hair) or alopecia. Most ordinarily noted is the loss of scalp hair. Lower leg, pubic and axillary hair loss may also take place. Hirsutism is commonly noted on the face. Oral Hormone Replacement Therapy (HRT) may control facial hair in a few ladies. Medicines for expanded facial hair incorporate suing depilatory creams, delicate techniques for hair removal, laser treatment andante-testosterone medicines. Scalp alopecia might be treated with minoxidil.
  3. Teeth: Menopause has been a cause for various dental/oral issues, including dry mouth and desquamative gingivitis. IHRT might be of advantage as a consequence of the part it plays in influencing oral bone and preventing the loss of teeth. The impacts of HRT seem to incorporate a reduction in bleedingand enhancing the flow of saliva.
  4. Vulva and vagina: The genital tract is exceptionally dependent on estrogen and body changes during the menopausal time and post-menopause may incorporate vaginal and vulvar dryness. Vulval dryness may worsen other vulval skin conditions (e.g. dermatitis) bringing about aggravation. Staying away from cleansers and body washes on the vulva can dial down the aggravation and dryness. Contrasting options to cleanser incorporate sorbolene with glycerine or low-aggravation purifying balms and lotions.
  5. Bladder: Urinary frequency and cystitis are very common around the time of menopause. Local estrogen creams may enhance incontinence in the short term, however, don't seem to do as such after treatment is stopped. Treatment for incontinence includes physiotherapy and even surgery.
  6. Joints and muscles: Joint and muscle pain are regular symptoms during menopause. Exercise is vital to get rid of these side effects. Joint and muscle pain may improve with the utilization of HRT.
  7. Weight changes: Between ages 45 and 55, ladies will gain a large portion of a kilo a year. This weight gain cannot be blamed on menopause entirely. The changes in hormonal status are connected with expanded body and stomach fat. This weight addition is connected with increased cardiovascular and metabolic hazard and changes in quality of life and sexual functioning.
  8. Lifestyle measures: Your diet and eating routine need to be established to keep up a solid body weight and to have a healthy lifestyle.
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Menopause - How To Handle It Well?

Menopause - How To Handle It Well?

While menstruation is definite proof that a woman can bear children, menopause is, as the name suggests, a pause in the fact. Meaning that the woman experiences a permanent stop in her periodic cycle and will further be unable to bear children. It is a difficult time for women, apart from dealing with the fact that they will not be able to reproduce further, there also arises a variety of complications. The realisation can hit hard and women often experience depressive episodes and numerous hormonal imbalances. Keeping that in mind, menopause is also different for different individuals and there is no one magic cure for it.

Every individual experiences a series of changes and requires different treatments because there are 3 different types of menopause and all of those require separate attention. That being said, there are a few common symptoms that show up and here are a few ways that you can deal with them:

  1. Hormone Replacement Therapy (HRT): This a slightly dicey method for the complications it may or may not carry in its wake but it is quite effective for a lot of people. Basically what this procedure entails is that your body will be supplied with hormones (oestrogen) the production of which has depleted, from the outside in the form of tablets or a gel so as to counter the hormonal imbalances. There are two kinds of HRTs; one is for women who have retained their wombs, it is called “Combined HRT”. The individual is supplied with two kinds of hormones, oestrogen, and progesterone. And the other kind is the “Oestrogen only HRT” which is for women who have had a hysterectomy. This treatment should be strictly observed by your gynaecologist and any discomfort felt should be reported back immediately.
  2. Dealing with hot flushes: This is something all women suffer from as soon as menopause hits or from even before as they are reaching towards it. It is also accompanied by night sweats. To deal with both, it is advised that you wear cotton or similarly light clothes, take cool showers, rest and relax as much as possible, include an exercise regime in your daily life or even yoga, hydrate yourself, and avoid drinking, coffee, and very spicy food items. They may act as triggers.
  3. Treating vaginal discomfort: If you experience vaginal discomfort such as dryness or excessive itching, contact your doctor immediately as you may have to start HRT or lubricants-containing oestrogen. Apart from that, to fend off dryness you could also use vaginal lubricants to soothe the painful sensations.
  4. Treating osteoporosis: Due to the lowered levels of oestrogen in the body, women who have reached menopause are more prone to suffering from weak and brittle bones, also known as osteoporosis. Taking vitamin supplements as well as including different kinds of fruits and vegetables and yoghurt in your diet is absolutely essential to combat this along with exercise.
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Menopausal Problems - Can Ayurveda Tackle Them?

Menopausal Problems - Can Ayurveda Tackle Them?

The female body undergoes several changes during the different phases of menopause. Although these changes are both mental and physical, these are mostly caused because of fluctuation in the levels of the two hormones- progesterone and estrogen.

Menopause sets in after 40 years of age, and marks the end of one’s menstrual cycle.

During menopause, the ovaries stop producing eggs (ova) due to low production of the hormones progesterone and estrogen. These hormonal changes often result in- mood swings, hot flashes, pounding heart, insomnia, changes in urinary and sexual functions etc.

Common Menopausal Disorders-
Menopausal disorders refer to the problems related to menopause. The most common ones are-

  1. Cardiovascular disease- hormonal changes, especially due to low estrogen level, can increase the cholesterol level and blood pressure, which eventually leads to heart ailments.
  2. Osteoporosis- low levels of estrogen hormone and irregular menstruation can lead to loss of bone mass or low bone density. This eventually results in the development of osteoporosis.
  3. Vulvovaginal atrophy- occurs when the vaginal wall becomes thin due to a decrease in the level of estrogen.
  4. Dyspareunia- refers to severe, recurring pain within the pelvis or in the genital region during sexual intercourse.
  5. Urinary incontinence- during menopause, the vaginal tissues and the urethra begin losing their elasticity. This may result in sudden, frequent urges to urinate.

Ayurvedic Approach to Menopausal Disorders-
Ayurveda sees menopause as a natural effect of ageing process, and not as a disease. As per Ayurveda, good health rests on the perfect balance of the three doshas- kapha, pitta, and vata. Imbalance of any of these doshas can upset the natural state of your mind and disrupt your body’s harmony.

  1. Ayurveda links menopause and disorders related to it with ageing, which is dominated by the vata dosha. Treatment for this condition involves strengthening the overall reproductive system and improving the hormonal balance.
  2. Ayurvedic medicines prepared from herbs, and various therapies using essential oils are prescribed to regulate your hormones, improve digestion and calm your state of mind.
  3. General tonics are recommended to boost the immune system and rejuvenate your body.
  4. Herbs like Aswagandha, Guduchi, Punarnava and Black Cohosh are effective in treating Menopausal symptoms. 
  5. Ayurvedic Therapies like Takradhara ( Cooling buttermilk Therapy) is effective in hot flushes, sudden sweating, insomnia, anxiety and mood swings. 

Ayurveda also focuses on healthy diet and lifestyle changes such as- restraining from spicy foods, alcohol and caffeine, eating regular meals, practising yoga and meditation etc.

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Menopause - Know How To Manage It Well!

Menopause - Know How To Manage It Well!

Menopause is the time in your life when you naturally stop having menstrual periods. Menopause happens when the ovaries stop making hormones. Menopause marks the end of the reproductive years. The average age that women go through menopause is 51 years.

The years leading up to menopause are called perimenopause. Cycles may become longer than usual for you or become shorter. You may begin to skip periods. The amount of flow may become lighter or heavier. Although changes in menstrual bleeding are normal during perimenopause, you still should report them to your doctor. Abnormal bleeding may be a sign of a problem.

What are the other signs and symptoms of menopause?

Some women do not have any symptoms of perimenopause or have only a few mild symptoms. Others have many symptoms that can be severe. Common signs and symptoms include the following:

  • Hot flashes - A hot flash is a sudden feeling of heat that rushes to the upper body and face. It may last from a few seconds to several minutes or longer. Some women have hot flashes a few times a month. Others have them several times a day. Hot flashes that happen at night (night sweats) may wake you up and cause you to feel tired and sluggish during the day.

  • Sleep problems - You may have insomnia (trouble falling asleep), or you may wake up long before your usual time. Night sweats may disrupt your sleep.

  • Vaginal and urinary tract changes - As estrogen levels decrease, the lining of the vagina may become thinner, dryer, and less elastic. Vaginal dryness may cause pain during sex. Vaginal infections also may occur more often. The urethra can become dry, inflamed, or irritated. This can cause more frequent urination and increase the risk of urinary tract infections.

What types of bone changes can occur after menopause?

During the first 4–8 years after menopause, women lose bone more rapidly. This rapid loss occurs because of the decreased levels of estrogen. If too much bone is lost, it can increase the risk of osteoporosis. Osteoporosis increases the risk of bone fracture. The bones of the hip, wrist, and spine are affected most often.

What do other health risks increase during perimenopause and menopause?

The estrogen produced by women’s ovaries before menopause protects against heart attacks and stroke. When less estrogen is made after menopause, women lose much of this protection. Midlife also is the time when risk factors for heart disease, such as high cholesterol levels, high blood pressure, and being physically inactive, are more common. All of these combined factors increase the risk of heart attack and stroke in menopausal women.

What is hormone therapy?

Hormone therapy can help relieve the symptoms of perimenopause and menopause. Hormone therapy means taking estrogen and, if you have never had a hysterectomy and still have a uterus, a hormone called progestin. Estrogen plus progestin sometimes is called “combined hormone therapy” or simply “hormone therapy.” Taking progestin helps reduce the risk of cancer of the uterus that occurs when estrogen is used alone. If you do not have a uterus, estrogen is given without progestin. Estrogen-only therapy sometimes is called “estrogen therapy.”

How is hormone therapy given?

Estrogen can be given in several forms. Systemic forms include pills, skin patches, and gels and sprays that are applied to the skin. If progestin is prescribed, it can be given separately or combined with estrogen in the same pill or in a patch. With systemic therapy, estrogen is released into the bloodstream and travels to the organs and tissues where it is needed. Women who only have vaginal dryness may be prescribed “local” estrogen therapy in the form of a vaginal ring, tablet, or cream. These forms release small doses of estrogen into the vaginal tissue.

What are the benefits of hormone therapy?

Systemic estrogen therapy (with or without progestin) has been shown to be the best treatment for the relief of hot flashes and night sweats. Both systemic and local types of estrogen therapy relieve vaginal dryness. Systemic estrogen protects against the bone loss that occurs early in menopause and helps prevent hip and spine fractures. Combined estrogen and progestin therapy may reduce the risk of colon cancer.

What are the risks of hormone therapy?

Hormone therapy may increase the risk of certain types of cancer and other conditions:

  • Estrogen-only therapy causes the lining of the uterus to grow and can increase the risk of uterine cancer.

  • Combined hormone therapy is associated with a small increased risk of heart attack. This risk may be related to age, existing medical conditions, and when a woman starts taking hormone therapy.

  • Combined hormone therapy and estrogen-only therapy are associated with a small increased risk of stroke and deep vein thrombosis. Forms of therapy not taken by mouth (patches, sprays, rings, and others) may have less risk of causing deep vein thrombosis than those taken by mouth.

  • Combined hormone therapy is associated with a small increased risk of breast cancer.

  • There is a small increased risk of gallbladder disease associated with estrogen therapy with or without progestin. The risk is greatest with oral forms of therapy.

Can plant and herbal supplements help with menopause symptoms?

Plants and herbs that have been used for relief of menopause symptoms include soy, black cohosh, and Chinese herbal remedies. Only a few of these substances have been studied for safety and effectiveness. Also, the way that these products are made is not regulated. There is no guarantee that the product contains safe ingredients or effective doses of the substance. If you do take one of these products, be sure to let your doctor know.

Can vaginal moisturizers and lubricants help with menopause symptoms?

These over-the-counter products can be used to help with vaginal dryness and painful sexual intercourse that may occur during menopause. Vaginal moisturizers replace moisture and restore the natural acidity of the vagina and can be used every 2–3 days as needed. Lubricants can be used each time you have sexual intercourse.

What can I do to stay healthy after menopause?

A healthy lifestyle can help you make the best of the years after menopause. The following are some ways to stay healthy during midlife:

  • Nutrition—Eating a balanced diet will help you stay healthy before, during, and after menopause. Be sure to include enough calcium and vitamin D in your diet to help maintain strong bones.

  • Exercise—Regular exercise slows down bone loss and improves your overall health. Weight-bearing exercise, such as walking, can help keep bones strong. Strength training strengthens your muscles and bones by resisting against weight, such as your own body, an exercise band, or handheld weights. Balance training, such as yoga and tai chi, may help you avoid falls, which could lead to broken bones.

  • Routine health care—Visit your doctor once a year to have regular exams and tests. Dental checkups and eye exams are important, too. Routine health care visits, even if you are not sick, can help detect problems early.

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All About Post Menopausal Vaginal Bleeding!

All About Post Menopausal Vaginal Bleeding!

Most women attain menopause between the ages of the 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.

  1. 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.
  2. Endometrial atrophy - Also caused by lower hormone levels, the lining of the body of the uterus gradually thins down and can get inflamed.
  3. Polyps - Noncancerous growths in the uterus, cervix, vulva, or vagina can also lead to bleeding
  4. Infections - General infection of an area along the uterine tract could lead to occasional bleeding
  5. Cancers - Though only 1 in 10 PMB cases turns 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:

Treatment: Needless to say, this would depend on the diagnosis.

  • For very minor cases with a 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.  

Treating Menopause At An Early Age!

Treating Menopause At An Early Age!

Menopause is characterized by the absence of menstrual periods for 12 months. It is the time in a woman’s life when the ovaries stop functioning. The periods then stop forever. The normal period of menopause is 51 years of age, however, menopause may happen as ahead of schedule as the 30s or as late as the 60s. There is no solid lab test to determine when a lady will encounter menopause. Early menopause usually starts between the ages of 40 and 45. Untimely menopause begins significantly earlier, before the age of 40. Nevertheless, premature or early menopause is not that common with only about one percent of the women going through early menopause before the age of 40.

The signs and symptoms of early menopause are like the usual menopause. Some basic side effects include:

  1. Irregular periods (amenorrhea)
  2. Hot flashes
  3. Night sweats
  4. Vaginal dryness
  5. Mood shifts
  6. Mental fogginess
  7. Diminished sex drive

Your specialist will suggest a treatment depending on your individual circumstances. Some common ways to deal with premature or early menopause are as follows:

Hormone Replacement Therapy -
Supplements containing estrogen and progestin can help and replace some of your reproductive hormones in the body that can no longer make it all alone. They are frequently taken until the normal period of menopause (around 50) to help avoid bone loss. This treatment is not suggested for all ladies since it expands the danger of:

Supplemental Calcium and Vitamin D -
Supplementary calcium and vitamin D can help in preventing osteoporosis in case you are not getting enough of these supplements from your normal diet. Women between ages 19 to 50 need to consume 1,000 milligrams of calcium for each day through food or supplements. Ladies over age 51 need to consume 1,200 milligrams for each day. A prescribed day-to-day measure of vitamin D has not yet been built up. For grown-up females, most specialists prescribe 600 to 800 global units through food or supplements. One should get a prescription from a doctor before ingesting the medication.

Other strategies to deal with Infertility -
A few ladies with untimely menopause can at present get pregnant with no treatment. Ladies who want to have children, however, tend to become infertile after early or untimely menopause, need to consider in-vitro treatment, fertilization or even adoption.

Talk Therapy -
Numerous ladies discover that having a conversation with a therapist can be supportive to adapt to their anxiety. It helps them release their pent up emotions and gives clarity and satisfaction about their problems. Talk therapies like cognitive behavioral therapy are always beneficial since they help in addressing the symptoms and side effects that a woman may be going through emotionally when it comes to early menopause.

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Postmenopausal Bleeding - Can It Be Considered As Normal?

Postmenopausal Bleeding - Can It Be Considered As Normal?

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:

- Physical exam
- Transvaginal ultrasound
- Endometrial biopsy
- Hysteroscopy
- 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 ayear of menopause, do not ignore it.  

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