Hypomenorrhea or hypomenorrhea, also known as short or scanty periods, is extremely light menstrual blood flow. It is the opposite of hypermenorrhea which is more properly called menorrhagia.
Hypomenorrhea can occur normally at the extremes of the reproductive life that is, just after puberty and just before menopause. This is because ovulation is irregular at this time, and the endometrial lining fails to develop normally. But normal problems at other times can also cause scanty blood flow. Anovulation due to a low thyroid hormone level, high prolactin level, high insulin level, high androgen level and problems with another hormone can also cause scanty periods.
Causes of Hypomenorrhea
- One cause of hypomenorrhea is Asherman’s syndrome – (intrauterine adhesions), of which hypomenorrhea (or amenorrhea) may be the only apparent sign. The degree of menstrual deficiency is closely correlated to the extent of the adhesions.
- Uterine – Scanty loss sometimes means that the bleeding surface is smaller than normal, and is occasionally seen when the endometrial cavity has been reduced in size during myomectomy or other plastic operation on the uterus. However, it rarely indicates uterine hypoplasia because the presence of this condition in a uterus which is responsive to hormones indicates ovarian under-activity, and this manifests itself by infrequent (oligomenorrhea) rather than scanty menstruation.
- Nervous and emotional – Psychogenic factors such as stress or excessive excitement may cause hypomenorrhea. Such factors suppress the activity of the centers in the brain that stimulate the ovaries during the ovarian cycle (to secrete hormone-like estrogen and progesterone), and may result in low production of these hormones.
- Low body fat – Excessive exercise and crash dieting can cause scanty menstrual periods when the proportion of body fat drops beneath a certain level. It may cause a total absence of periods (also called amenorrhea).
- While there are many causes associated with menorrhagia, the most common causes include the following:
- Hormonal imbalance
- Uterine fibroids
- Miscarriage and other forms of abnormal pregnancy
- Pelvic inflammatory disease (PID)
- Tumors or infections in the pelvic cavity
- Platelet or bleeding disorder
- High concentration of endothelin
Symptoms of Hypomenorrhea
The American College of Obstetricians and Gynecologists estimates that 85% of women experience at least one symptom during their reproductive age. Even though symptoms may vary in individuals, the most common ones include the following:
- Headaches
- Depression, irritability and anxiety
- Fluid retention (evidence from swelling of feet and fingers)
- Acne and other skin conditions
- Fainting
- Vertigo
- Muscle spasms
- Allergies
- Heart palpitations
- Vision problems and eye infections
- Reduced sex drive
- Lack of appetite
Most forms of PMS do not require medical treatment. Simple changes to one’s lifestyle can also reduce or eliminate the intensity of the symptom. These could include:
- Getting adequate rest
- Exercising at least three times per week
- Maintaining a balanced diet which includes vegetables, fruits, and whole grains but with less caffeine, sugar or alcohol
Diagnosis of Hypomenorrhea
- Blood Tests – Most of the common causes of decreased flow of blood during the menses can be detected by blood tests. Tests for the level of hormones such as follicle-stimulating hormone, luteinizing hormone, estrogen, prolactin, insulin are important. In polycystic ovarian syndrome, there will be high levels of insulin and androgens.
- Ultra sonogram – An ultrasonogram can diagnose the thickness of the endometrium, size of the ovaries growth of follicles, ovulation, and other abnormalities.
- Other tests – Tests such as dilation and curettage and MRI scans are sometimes needed to determine the cause of scanty blood flow during the periods.
Treatment
Unless a significant causal abnormality is found no treatment other than reassurance is necessary. Otherwise, treatment is determined by the diagnosis of any significant causal abnormality.
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