Normal menstrual bleeding lasts between 3 to 7 days and the volume of the blood may range between 30 to 80 ml per cycle. If you experience continuous reduced menstrual flow and the bleeding lasts for less than 2 days for repeated cycles, it is considered a menstrual disorder and medically termed as Hypomenorrhea. This condition is also known as scanty menstruation, scanty bleeding or scanty discharge. Sometimes hypomenorrhea may result in infertility because there is not enough uterine lining each month to sustain a pregnancy. Scanty menstruation in itself is not a disease as long as ovulation is taking place regularly. However, there are certain medical conditions that may cause hypomenorrhea and diagnosing and treating those disorders is vital to maintaining good health.
What causes hypomenorrhea?
Most often scanty bleeding is not a serious medical condition, yet, it is important to diagnose the underlying cause to avoid future complications.
Hereditary: In few cases, hypomenorrhea may run in families. If the disorder is due to constitutional reasons, it normally does not affect fertility of the woman.
Hormonal imbalance: The menstrual cycle largely depends upon two important female hormones, estrogens and progesterone. Any imbalance in the production of these hormones gives rise to menstrual disorders. Estrogen is responsible for creating the inner lining of the uterus and low levels of this hormone causes very thin womb lining leading to hypomenorrhea. Likewise excess release of a male hormone called testosterone also contributes to the Hypomenorrhea.
Hormonal balance goes awry with continuous use of oral contraceptives. Prolonged use of pills or IUDs often results in endometrial atrophy leading to scanty bleeding during periods. Hypothyroidism, one of the causes for hormonal imbalance, occurs when the pituitary gland does not function to its full potential and fails to secret the required TSH hormone. Most often hypothyroidism causes anovulation resulting in hypomenorrhea.
Uterine problems: Thickness of the uterine lining or endometrium determines the amount of blood flow, insufficient thickness of uterine lining causes scanty flow. Any scar, surgery or illness may cause damage to the tissues of the endometrium and also reduces the cavity of the uterine lining leading to scanty blood flow. Asherman's Syndrome, a rare uterine disease leads to adhesions on the endometrium and can be a likely cause for hypomenorrhea.
Excessive exercise: Working out or intense physical exercise for long duration on a regular basis and losing weight drastically also results in short and light periods. Excess exercise may drop the fat content abnormally and disturbs the hormone production causing light periods.
Psychological reasons: Hypomenorrhea can also be associated with emotional disturbances and extreme stress. Such mental state for a prolonged period disturbs the pattern of blood flow. Stress hormones block the release of the luteinizing hormone; a precondition for normal bleeding.
Other causes of scanty bleeding
- In most women, there might be light bleeding during initial months of pregnancy. So if you are trying to conceive, consult a medical practitioner to confirm pregnancy.
- Malnutrition and anemia caused by eating disorders like anorexia can also reduce the blood flow leading to hypomenorrhea.
- Certain kidney diseases also give rise to hypomenorrhea.
- Woman nearing menopause and undergoing perimenopause experience scanty discharge for few months before total cessation of menstrual cycle. This is a natural process associated with menopause and does not need any medical attention.
- Polycystic ovarian syndrome (PCOS) and blocked fallopian tubes also lead to scanty menses.
- Another serious condition that may lead to light periods is ectopic pregnancy. If you are in a child bearing age and begin to experience light periods, rule out chances of an ectopic pregnancy.
Dealing with scanty menstruation
Blood tests include tests for the level of hormones like FSH, LH, estrogen, progesterone, thyroid hormones, prolactin, insulin and androgen. Abdominal and trans-vaginal sonogram is usually carried out to determine the health and functioning of the endometrium. In some cases, MRI and D&C are also conducted for biopsy and examination of the endometrium.
Treatment for scanty bleeding depends on the underlying cause. If the blood tests reveal hormonal imbalance, check the need for hormonal supplementation. If fertility is an issue, then aggressive hormonal treatment might be required. The family history, age, previous menstrual record and nutritional levels of the patient must be considered. Hypomenorrhea occurring due to genetic reasons does not usually require any medical attention.