Female Sexual Anatomy Basics

In male and female anatomy, many bodily functions are similar. The circulatory system and digestive system, for example, function in much the same ways in both male and female bodies. The biggest differences between male and female anatomy are in the reproductive system. The female sexual anatomy and its composite parts allow women to become pregnant and bear children.

The female reproductive system actually is designed to carry out several functions. It produces the female egg cells necessary for reproduction, called the ova or oocytes. The system is designed to transport the ova to the site of fertilization. Conception, the fertilization of an egg by a sperm, normally occurs in the fallopian tubes. The next step for the fertilized egg is to implant into the walls of the uterus, beginning the initial stages of pregnancy. If fertilization and/or implantation does not take place, the system is designed to menstruate (the monthly shedding of the uterine lining). In addition, the female reproductive system produces female sex hormones that maintain the reproductive cycle.

Female External Genitalia

The function of the external female reproductive structures (the genitals) is twofold: To enable sperm to enter the body and to protect the internal genital organs from infectious organisms. The proper name for the outer female genitals is the vulva.

The main external structures of the female reproductive system include:

Mons Veneris

The mons veneris, Latin for "hill of Venus" (Roman Goddess of love) is the pad of fatty tissue that covers the pubic bone below the abdomen but above the labia. The mons is sexually sensitive in some women and protects the pubic bone from the impact of sexual intercourse.

Labia Majora

The labia majora are the outer lips of the vulva, pads of fatty tissue that wrap around the vulva from the mons to the perineum. These labia are usually covered with pubic hair, and contain numerous sweat and oil glands, and it has been suggested that the scent from these are sexually arousing. Literally translated as "large lips," the labia majora are relatively large and fleshy, and are comparable to the scrotum in males.

Labia Minora

Literally translated as "small lips," the labia minora are the inner lips of the vulva, thin stretches of tissue within the labia majora that fold and protect the vagina, urethra, and clitoris. The appearance of labia minora can vary widely, from tiny lips that hide between the labia majora to large lips that protrude up to 2 inches wide. The most common metaphor for the labia minora is that of a flower. Both the inner and outer labia are quite sensitive to touch and pressure.

Clitoris

The clitoris is a small body of spongy tissue that is highly sexually sensitive. Only the tip or glans of the clitoris shows externally, but the organ itself is elongated and branched into two forks, the crura, which extend downward along the rim of the vaginal opening toward the perineum. Thus the clitoris is much larger than most people think it is -- about 4" long, on average. The clitoral glans or external tip of the cltoris is protected by the prepuce, or clitoral hood, a covering of tissue similar to the foreskin of the male penis. During sexual excitement, the clitoris may extend and the hood may retract to make the clitoral glans more accessible. On some women the clitoral glans is very small; other women may have large clitoris that the hood does not completely cover.

Urethra

The opening to the urethra is just below the clitoris. It is not related to sex or reproduction, but is instead the passage for urine. The urethra is connected to the bladder. Because the urethra is so close to the anus, women should always wipe themselves from front to back to avoid infecting the vagina and urethra with bacteria.

Hymen

The hymen is the area between the labia minora, a membrane that partially covers the opening. The hymen is the traditional "symbol" of virginity, although being a very thin membrane, it can be torn by vigorous exercise or the insertion of a tampon.

Perineum

The perineum is the short stretch of skin starting at the bottom of the vulva and extending to the anus. The perineum in women often tears during birth to accommodate passage of the child, and this is apparently natural. Some physicians may cut the perineum preemptively on the grounds that the "tearing" may be more harmful than a precise scalpel, but statistics show that such cutting in fact may increase the potential for infection.                                                                 

Female Internal Organs

Key organs for female reproduction are protectively located deep within the body. These include:

Ovaries

A woman normally has a pair of ovaries that resemble almonds in size and shape. They are home to the female sex cells, called eggs, and they also produce estrogen, the female sex hormone. Women’s ovaries already contain nearly 400,000 undeveloped eggs at birth, but the eggs are not called into action until puberty. Those are all ova female will ever have, but that is far more than she will need, since during an average lifespan she will go through about 500 menstrual cycles. Roughly once a month, starting at puberty and lasting until menopause, the ovaries release an egg into the fallopian tubes a journey of three or four days - this is the period during which a woman is fertile and pregnancy may occur. When fertilization does not occur, the egg leaves the body as part of the menstrual cycle.

Fallopian tubes

These are narrow tubes that are attached to the upper part of the uterus and serve as tunnels for the ova (egg cells) to travel from the ovaries to the uterus. Conception, the fertilization of an egg by a sperm, normally occurs in the fallopian tubes. The fertilized egg then moves to the uterus, where it implants into the lining of the uterine wall.

Uterus

The uterus is located in the pelvis of a woman’s body and is made up of smooth muscle tissue. Commonly referred to as the womb, the uterus is hollow and holds the fetus during pregnancy. Each month, the uterus develops a lining that is rich in nutrients. The reproductive purpose of this lining is to provide nourishment for a developing fetus. Since eggs aren’t usually fertilized, the lining usually leaves the body as menstrual blood during a woman’s monthly period. The uterus is lined with powerful muscles to push the child out during labor.

Cervix

The lower part of the uterus, which connects to the vagina, is known as the cervix. Often called the neck or entrance to the womb, the cervix lets menstrual blood out and semen into the uterus. The cervix remains closed during pregnancy but can expand dramatically during childbirth.

Vagina

The vagina extends from the vaginal opening to the cervix, the opening to the uterus. The vagina serves as the receptacle for the penis during sexual intercourse, and as the birth canal through which the baby passes during labor. The average vaginal canal is three inches long, possibly four in women who have given birth. This may seem short in relation to the penis, but during sexual arousal the cervix will lift upwards and the fornix (see illustration) may extend upwards into the body as long as necessary to receive the penis. After intercourse, the contraction of the vagina will allow the cervix to rest inside the fornix, which in its relaxed state is a bowl-shaped fitting perfect for the pooling of semen.

At either side of the vaginal opening are the Bartholins glands, which produce small amounts of lubricating fluid, apparently to keep the inner labia moist during periods of sexual excitement. Further within are the hymen glands, which secrete lubricant for the length of the vaginal canal.

 "G-Spot"

The word is in quotes because there is still some debate as to the existence or purpose of the G-spot. In the illustration above, what is indicated as the g-spot in fact points to a region known as the Skenes glands, the purpose of which are unknown. Despite the controversy, one fact remains - there are many women who claim that pressure on this region of the vagina is extremely pleasurable. Also, because the Skenes glands are alongside the bladder, some women may found that the increased pressure makes them feel as if they need to urinate.

Sources and Additional Information:

http://www.everydayhealth.com/sexual-health/female-reproductive-organs.aspx

http://www.webmd.com/sex-relationships/guide/your-guide-female-reproductive-system

http://www.luckymojo.com/faqs/altsex/vulva.html

http://www.scarleteen.com/article/body/anatomy_pink_parts_female_sexual_anatomy

http://www.seekwellness.com/womensexuality/female-anatomy.htm

Are you interested in simple blood test to predict your menopause age

If you do, wait and see. Researchers have developed a blood test they say can predict how long of a reproductive life a woman has before menopause.

The blood test measures levels of a hormone called anti-Mullerian Hormone (AMH), which is produced by the cells in women’s ovaries and is a marker for ovarian function. The test could tell women as young as 20 when they would enter menopause. Sixty-three women reached menopause during the course of the study, and the test was able in most cases to predict the age within about four months of the woman’s actual age; the maximum margin of error was between three and four years.

The AMH is a hormone produced by the granulosa cells of the early developing antral follicles. These are the immature eggs that wake up from their dormant state and develop into mature eggs. As a woman runs out of eggs, the number of these small antral follicles decline in number and as a result the serum Anti-Mullerian hormone falls. This is why serum Anti-Mullerian hormone testing is a good estimate of residual egg number.

Study author Fahimeh Ramezani Tehrani, president of the Reproductive Endocrinology Department of the Endocrine Research Centre and a faculty member and associate professor of Shahid Beheshti University of Medical Sciences in Tehran, Iran, reported her findings at the European Society of Human Reproduction and Embryology in Rome.

The findings could have implications on how women approach family planning. Researchers said it is one of the first population-based studies to provide a statistical model for predicting age at menopause.

Much of the hubbub surrounds the tests implications: If a woman knew when her childbearing years would end, she could take better charge of her reproductive destiny. Perhaps she would get pregnant earlier—or freeze her eggs in her late 20s—if she knew menopause was going to strike at, say, 41 instead of the average age of 51. Or she might stay off the mommy track a bit longer if her fertility was going to last until 57.

“We developed a statistical model for estimating the age at menopause from a single measurement of AMH concentration in serum from blood samples,” Ramezani Tehrani says. “Using this model, we estimated mean average ages at menopause for women at different time points in their reproductive life span from varying levels of serum AMH concentration. We were able to show that there was a good level of agreement between ages at menopause estimated by our model and the actual age at menopause for a subgroup of 63 women who reached menopause during the study.”

Predicting Menopause with a Blood Test

The study results are based on blood samples from 266 women aged 20 to 49 who were part of the larger Tehran Lipid and Glucose Study, which began in 1998 and continues today. Blood samples were repeatedly collected from the study participants every three years, and the researchers also collected data about the women’s socioeconomic backgrounds and reproductive histories. The average age of beginning menopause was about 52.

Ramezani Tehrani and her team found that:

• AMH levels of 4.1 ng/mL or less predicted early menopause (before age 45) in 20-year-olds
• AMH levels of 3.3 ng/mL predicted early menopause in 25-year-olds
• AMH levels of 2.4 ng/mL predicted early menopause in 30-year-olds

Women who had AMH levels of at least 4.5 ng/mL at age 20, 3.8 ngl/mL at age 25, and 2.9 ng/mL at age 30 could expect menopause to begin after they turned 50.

“The results from our study could enable us to make a more realistic assessment of womens reproductive status many years before they reach menopause,” says Ramezani Tehrani. “For example, if a 20-year-old woman has a concentration of serum AMH of 2.8 ng/mL, we estimate that she will become menopausal between 35-38 years old.”

Ramezani Tehrani says more studies are needed to validate these findings, but the blood test could be an important diagnostic tool to evaluate one’s reproductive life and could provide a more accurate response than chronological age.

William Ledger, a fertility expert at the University of Sheffield in England, who was not involved with the research, told the Associated Press: “This is not something we could start rolling out tomorrow. But if it really does work, it could be immensely useful to young women who are making choices about whether to work or have a family.”

Some experts, however, say the menopause test is still far away from being used in clinical practice. Thats partly because of some uncertainty in determining standard levels of this hormone and whether these levels vary from woman to woman. For example, no one knows yet whether levels of AMH differ among racial and ethnic populations. Perhaps a low level in an Iranian woman is in the normal range for an African-American. Previous studies have also shown that obese women tend to have lower levels than women of normal weight, though they may not go into menopause any earlier.

Still, the AMH test has so far proven useful in clinical practice for predicting the success of certain infertility procedures, like in vitro fertilization. (A higher level means more eggs are likely to be retrieved from the ovary, though it doesnt seem to predict the quality of the eggs.) Ovarian cancer patients may also undergo the test to determine whether chemotherapy has affected their fertility.

But whether this hormone test will eventually be widely used to pinpoint the age of menopause remains a big unknown. If it does prove predictive, many women will no doubt be eager to learn just how long their biological clocks will keep on ticking.

Sources and Additional Information:

http://www.webmd.com/menopause/news/20100628/blood-test-helps-predict-menopause

http://health.usnews.com/health-news/managing-your-healthcare/womens-health/articles/2010/06/28/test-to-predict-menopause-helpful-or-a-lot-of-hype-test-to-predict-menopause-helpful-or-hype

http://healthomg.com/2011/05/18/blood-test-may-one-day-predict-menopause-researchers-say/

http://www.independent.co.uk/news/science/blood-test-to-predict-age-of-menopause-2012302.html

http://www.women-health-info.com/228-Anti-Mullerian-hormone.html

Does male female hormonal differences influence behaviors and attitudes

Its time to root out the imposition of gendered behavior stereotypes from all aspects of our lives. Ending gender oppression means encouraging our children to experiment with alternative gender expressions...

- Nancy Nangeroni, a transsexual activist quoted in Transgender Warriors

It is fundamental that individuals have the right to define, and to redefine as their lives unfold, their own gender identity, without regard to chromosomal sex, genitalia, assigned birth sex, or initial gender role.

- From The International Bill of Gender Rights, approved by the International Conference on Transgender Law and Employment Policy, 1993

Are men and women different? Theyre different anatomically, of course, but are they different in any other ways? Do their hormonal differences influence their behaviors and attitudes? Do they process information differently?

Feminists and gay theorists often say "no" to these questions. They maintain that the differences between men and women are mostly the result of socialization in male-dominated societies, and that it is patriarchal oppression that has relegated women to feminine gender roles. Biology is said to have little to do with abilities or sex roles in our society. Some feminist writers actually believe that the idea of "two sexes" (male and female) is a myth. Dr. Anne Fausto- Sterling, writing in "The Five Sexes: Why Male and Female Are Not Enough," says that western culture is defying nature by maintaining a "two-party sexual system," for "biologically speaking, there are many gradations running from female to male; and depending on how one calls the shots, one can argue that along the spectrum lie at least five sexes--and perhaps even more."

Professor Steven Goldberg, Chairman of the Department of Sociology at City College of New York, has written a book with the provocative title, Why Men Rule--A Theory of Male Dominance. In the book, he debunks much of the feminist mythology surrounding the issue of differences between males and females.  Goldberg maintains that although males and females are different in their genetic and hormonally-driven behavior, this does not mean that one sex is superior or inferior to another. Each gender has different strengths and weaknesses. However, he believes the neuro-endocrinological evidence is clear: The high level of testosterone in males drives them toward dominance in the world, while the lack of high levels of this hormone in women creates a natural, biological push in the direction of less dominant and more nurturing roles in society.

 It is true, that when investigations about male/female brain differences began, many scientists were also skeptical about the role of genes and of biological differences, because cultural learning is very powerful and influential among humans. Are girls more prone to play with dolls and cooperate among themselves than boys, because they are taught to be so by parents, teachers and social peers, or is it the reverse order?

But now, after many careful controlled studies where environment and social learning were ruled out, scientists learned that there may exist a great deal of neurophysiologic and anatomical differences between the brains of males and females.

Role of evolution

According to the Society for Neuroscience, the largest professional organization in this area, evolution is what gives sense to these gender differences. "In ancient times, each sex had a very defined role that helped ensure the survival of the species. Cave men hunted. Cave women gathered food near the home and cared for the children. Brain areas may have been sharpened to enable each sex to carry out their jobs".

The advantage of women regarding verbal skills also makes evolutionary sense. While men have the bodily strength to compete with other men, women use language to gain social advantage, such as by argumentation and persuasion.

Interestingly, when we deliberately change sex-role behavior -- say, men become more nurturing or women more aggressive -- our hormones and even our brains respond by changing, too.

What are hormones?

The definition of a hormone is a chemical substance produced by an endocrine gland that has a specific effect on the activities of other organs in the body. The major female and male hormones can be classified as estrogens or androgens. Both classes of male and female hormones are present in both males and females alike, but in vastly different amounts. Most men produce 6-8 mg of the male hormone testosterone (an androgen) per day, compared to most women who produce 0.5 mg daily. Female hormones, estrogens, are also present in both sexes, but in larger amounts for women. Estrogens are the sex hormones produced primarily by a females ovaries that stimulate the growth of a girls sex organs, as well as her breasts and pubic hair, known as secondary sex characteristics. Estrogens also regulate the functioning of the menstrual cycle.

Role of hormones

Sex hormones play a significant role in developing a male or female differentiated brain. This lies in the mother’s hormone levels during pregnancy. Studies in lab animals have proved that altering hormone levels during pregnancy can produce brains with male or female traits depending on the type of hormone added to the pregnant female.

For instance, if testes of newborn male rats are removed, they tend to develop thicker left hemispheres than rats whose testes are still intact. This is a female trait. If a pregnant female monkey is injected with testosterone, the offspring will show one or more male traits. These traits are known as the five characteristics of the male-differentiated brain: aggression, competition, self-assertion, self-confidence, and self-reliance.

These characteristics are related to levels of testosterone whether in males or females. Men who act as if they have female differentiated brains, in fact have lower levels of testosterone, and women who behave with male differentiated brains possess higher levels of testosterone than normal. The male differentiated brain tends to be one that is aggressive, spatial, and math proficient. The female differentiated brain is one in which is nurturing, and verbose.

There can be a relationship between body asymmetry and gender behavior. The amount of androgens and estrogens in the body can affect both gender behavior and body asymmetry. These hormones are passed from mother to newborn during the embryonic stage of life.

For example: if a female embryo receives an excess of androgen during pregnancy, she is likely to have a male appearance, behavior and male differentiated brain. On the other hand, if a male embryo receives an excess of estrogen. Male appearance, and behavior is prevalent, but with a female differentiated brain. When a female embryo is subjected to a large amount of estrogen, she has an excessive female appearance and behavior. The same is true for males when they receive large amounts of androgen during pregnancy. They tend to be a super male with lots of hair and very aggressive.

Various events can cause this to happen during pregnancy. The unborn child can be subjected to various hormones during crucial periods during pregnancy. Mutations in the chromosomal matter may cause one of the events to occur. Major or sustained stress levels will suppress testosterone levels; renal dysfunction will produce too much testosterone. Injections for diabetes will cause an increase in estrogen, barbiturates, and exercise. Spurt exercise will cause an increase in testosterone, while sustained exercise like a long run or jogging will lower the amount. While the brain is immersed in hormones during pregnancy, the true affect does not appear until puberty begins and the brain becomes activated due to the full immersion of the hormones in the body.

Scientific Evidence

(1)     Girls who were exposed to high levels of testosterone because their pregnant mothers had congenital adrenal hyperplasia seem to have better spatial awareness than other girls and are more likely to show turbulent and aggressive behavior as kids, very similar to boys.

(2)      There was a time when women were prescribed a synthetic female hormone (diethylstilbestrol), in an attempt to prevent repeated spontaneous miscarriages. Boys born to such women are likely to show more female-typical, empathizing behaviors, such as caring for dolls.

(3)      Male babies born with IHH (idiopathic hypogonadotrophic hypogonadism) have very small testes (and therefore low levels of testosterone) and they are worse at spatial aspects of systemizing, relative to normal males.

(4)      Other male babies born with androgen insensitivity (AI) syndrome (testosterone is an androgen) are also worse at systemizing.

Review the empathizing – systemizing (E-S) theory in more details on our previous post: http://menopause-aid.blogspot.com/2011/01/behavioral-differences-between-men-and.html

Interestingly, the brain areas that were found to differ between men and women are ones that in animals contain the highest number of sex hormone receptors during development.

After all, males and females differ only by one Y chromosome, but this makes a real impact upon the way we think, feel, behave and react to so many things.

Sources and Additional Information:

http://www.tarleton.edu/Faculty/sanderson/Male%20Female%20Differences.doc

http://www.narth.com/docs/york.html

http://healthguide.howstuffworks.com/estrogen-and-testosterone-hormones-dictionary.htm

http://www.time.com/time/magazine/article/0,9171,942519-5,00.html

Trend eyebrow embroidery look good but is it safe

Eyebrow embroidery is an emerging beauty trend in Canada but one that has already become wildly popular in Asia, Australia and even the U.S. Read on to learn more about the procedure and find out whether or not it’s safe for you
What is eyebrow embroidery?

Eyebrow embroidery is also known as eyebrow hairline stroke in Canada, according to Susan Aujla, managing director of New Serenity Cosmetics & Esthetics in Burnaby, British Columbia. Aujla has also had the procedure done herself. Unlike eyebrow tattoos, it is semi-permanent and can last up to two years. By adding coloured pigment to the skin, this technique fills in empty spots on your brows to give them a full and flawless look.

With a feathering technique, this procedure can produce a natural look since it uses pigments perfectly matched to your actual eyebrow colour.
After tracing out the area where the desired brow should be, the entire area is filled in with hair-like pigments. Eyebrow embroidery is also great for thickening existing eyebrows or darkening them and making them more apparent.
How is eyebrow embroidery done?

First, a technician will clean up your brow line by removing strays. Then, an anaesthetic cream will be applied to reduce the sensation of pain. Once the desired brows are traced, the technician will use a small blade to cut very small pieces of the top of layer of the skin away and apply the new colour in its place. Aujla says the blade is similar to that of an Exacto knife, so it’s very thin and sharp. There may be some redness and minor swelling, but that should disappear within a few hours to a couple of days. The colour will likely fade by about 50 to 70 percent in the first two weeks so a follow-up session will be required. It is important to avoid scrubbing the brow area or picking off any scabs that may form, in order to protect the new eyebrows. Because this treatment is semi-permanent, it will require touch-ups from time to time as long as you choose to have them.
Is it safe?

As with any cosmetic procedure, eyebrow embroidery is safe just so long as you are careful about where you go. An average session can cost anywhere from $300 to $600. If you find a salon offering it for much less, ask questions to be sure it isn’t too good to be true. In order to make sure you get the best quality treatment and minimize your risk for infection, make sure your technician is qualified and certified by a reputable company. Also, ask about sterilization. It is very important that all tools used are completely sterile to avoid the transmission of infectious bacteria. “There is no reuse of needles or blades,” Aujla says. “The client should see the packages opened in front of them.”
Who is it for?

Aujla says eyebrow embroidery can be done on anyone but it is usually meant for people with thinning eyebrows, bald spots in their brows or people who have over-plucked. Eventually, brow hair stops growing back so if you plucked away your shape in a desperate attempt to achieve the once-stylish super thin brows, eyebrow embroidery could be the solution for you. Its also ideal for alopecia sufferers.
How do I make sure to get the best results?

Eyebrow embroidery is usually done for women with pale skin and light brow hair. The most common complaint is that the brow colouring is too dark. To make sure you get the best results possible, pre-select a colour with your technician. Keep in mind that the colour will lighten over the next two weeks. Another common problem is that the brows do not match the shape of the brow muscles so when they flex, the newly embroidered brow can look out of place. With a qualified technician, this is not likely to be the case, however, since the colouring will last for a couple of years, there’s no harm in being extra sure. Once the technician has drawn in a desired brow, check yourself out in the mirror before you go on with the appointment. Make funny face and flex those muscles around to see if you’re happy with the positioning. Once the procedure is done, it will be too late to make any changes so better to be safe than sorry.

credit besthealthmag

Postmenopausal Bleeding Treatment

Postmenopausal Bleeding and HRT

Treatment of postmenopausal bleeding depends on the cause.

It is common for women just beginning HRT (hormone replacement therapy). to experience some bleeding. Also, most women who are on cyclic HRT, taking estrogen along with progesterone, may experience monthly withdrawal bleeding; this is a normal side effect that does not require treatment. Continuous HRT regimens usually do not cause monthly bleeds.

But you should remember that postmenopausal bleeding during HRT can be due to the HRT itself, or due to underlying medical problems that have nothing to do with the HRT. Therefore be sure to observe closely the symptom occurrence, and do not simply assume that this occasional bleeding is fine. The pattern of bleeding during HRT depends on the type of HRT being taken.  For example, with continuous combined HRT, bleeding can occur unpredictably for up to 6 months or 1 year.  Therefore, unless bleeding continues for more than one year or is unusually heavy, diagnostic testing is often not necessary.  On the other hand, bleeding with cyclic HRT is usually regular and occurs after day 9 of the progesterone part of the HRT.  Therefore, with cyclic HRT, if bleeding occurs before day 9, or is at unexpected times, or is unusually heavy or prolonged, evaluation is needed.

You can see that what is considered abnormal depends on exactly what type of HRT you are taking.  Any bleeding during HRT needs to be reported to a doctor to see if the bleeding is expected or not, not only to guide testing and rule out uterine pre-cancers, but to see if an adjustment will help to decrease the annoying bleeding.

Minimizing Bleeding with HRT

Most women choose to take continuous HRT (estrogen and progesterone/progestin every day) if they have not had a hysterectomy because they do not desire to have menstrual periods. Since women who are closer to menopause often need higher doses of estrogen to control hot flashes and sleep disturbances, they will also need a proportionately higher progesterone/progestin level.

Regimens that can be evaluated for menopausal women who have not had a hysterectomy are:

1. Women ages 45-55 and within 6 months of beginning menopausal symptoms or women having moderate to severe estrogen deficiency symptoms

·         conjugated estrogens 1.25 mg, medroxyprogesterone acetate 5 mg

·         micronized estradiol 2 mg, micronized progesterone 200 mg (natural HRT)

·         transdermal (skin patch) estradiol 0.1 mg/day, norethindrone acetate 1 mg (orally)

2. Women ages 55-65 or 45-55 and not having many estrogen deficiency symptoms

·         conjugated estrogens .625 mg, medroxyprogesterone acetate 2.5 mg

·         micronized estradiol 1 mg, micronized progesterone 100 mg (natural HRT)

·         transdermal (skin patch) estradiol 0.05 mg/day, norethindrone acetate 140 mg

3. Women ages 65-80

·         conjugated estrogens .3 mg, medroxyprogesterone acetate 2.5 mg

·         micronized estradiol 0.5 mg, micronized progesterone 100 mg (natural HRT)

Doses are then regulated up or down depending upon bleeding, other side effects and sometimes body size because heavy women may have more endogenous estrogens that need to be countered with higher progestin doses.

Other Causes

Vaginal bleeding after post menopause is usually caused by the condition atrophic vaginitis, which is a state that makes sexual intercourse painful for women because their vaginais not sufficiently lubricated. Postmenopausal bleeding due to bleeding from the vagina or vulvacan be treated with local application of estrogen HRT.

Removal of tissue from the inside of uterus (curettage) may be all that is necessary to relieve postmenopausal bleeding.

Removal of polyps (polypectomy) will correct bleeding associated with their presence.

Cyclic progestin may be administered for treatment of overgrowth of the endometrium (simple endometrial hyperplasia), for up to 3 months. At completion of progestin therapy, a repeat D&C or endometrial biopsy will be performed to verify absence of hyperplasia. Then oral HRT with progestin may be given.

Hysterectomymay be necessary to treat endometrial hyperplasia with atypical cells, cancer of the uterus (endometrial), uterine fibroids, and bleeding that does not resolve with treatment (refractory) causing anemia due to chronic blood loss. Cancer of the uterus or cervix may require surgery and/or treatment with anti-cancer medications (chemotherapy) or radiation therapy.

Prognosis

Response to treatment for postmenopausal bleeding is highly individual and is not easy to predict. The out-come depends largely on the reason for the bleeding. Many women are successfully treated with hormones. As a last resort, hysterectomy removes the source of the problem by removing the uterus. However, this operation is not without risk and the possibility of complications. The prognosis for women who have various kinds of reproductive cancer varies with the type of cancer and the stage at which the cancer is diagnosed.

Complications

Profuse bleeding can cause anemia. Prolonged use of estrogen replacement therapy (ERT) that is not combined with progestin increases the risk of endometrial hyperplasia and endometrial cancer in women who have not had a hysterectomy. Cancer, both endometrial and cervical, can spread to other areas of the body.

Prevention

Postmenopausal bleeding is not a preventable disorder. In some cases, this kind of bleeding is inevitable. But for most hormonally related bleeding events, maintaining an appropriate weight, and engaging in healthy lifestyle, dietary and stress reduction habits will help. Preventing or minimizing a predominance of estrogen in the years before and after menopause is likewise helpful. This can be facilitated through gentle endocrine support, improved nutrition and supplementation, and reducing stress and exposure to xenoestrogens.

You can look at your post-menopausal bleeding as warning call and certain inspiration to devote yourself to some serious self-care:

• The first step, always, is to call your practitioner and make an appointment for an evaluation.
• The second step is to clean up your diet, add some high quality nutrients and exercise daily for better nutrition and weight control. This can be done immediately and simultaneously with your evaluation.
• The third step is to try some progesterone support if your evaluation indicates it is suitable for you.

Note that more adipose tissue (fat) a woman has on board, the greater her statistical risk for the precancerous thickening of the uterus called hyperplasia and some types of uterine cancer. It’s likely that excess body fat both generates excess estrogen and storesestrogen and estrogen-mimicking compounds, all of which over stimulates the uterine lining over the years. So gradually losing that weight is an important step toward balancing your hormones and wellness.

Sources and Additional Information:

http://www.healthline.com/galecontent/postmenopausal-bleeding#2

http://www.mdguidelines.com/postmenopausal-bleeding/treatment

http://www.womentowomen.com/menopause/postmenopausalbleeding.aspx

http://www.wdxcyber.com/nbleed10.htm

http://www.medicinenet.com/script/main/art.asp?articlekey=18463