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Hypomenorrhea, also known as or related to hypomenorrhoea, scanty periods, and spotting at periods, is extremely light menstrual blood flow. It is the opposite of Hypermenorrhea which is more properly called Menorrhagia.

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.[1]

Contents

Causes

• Constitutional: In some women it may be normal to have less bleeding during menstrual periods. Less blood flow may be genetic and, if enquiries are made, it may be found that woman’s mother and/or sister also have decreased blood flow during their periods. Pregnancy can normally occur with this type of decreased flow during the period .The incidence of infertility is the same as in women with a normal blood flow. Constitutional scanty menstruation perhaps best explained by assuming the presence of an unusual arrangement, or relative insensitivity, of the endometrial vascular apparatus.

• Uterine: Scanty loss sometimes means that the bleeding surface is smaller than normal, and is occasionally seen when the endomaterial 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 betokens ovarian under activity, and this manifests itself by infrequent rather than scanty menstruation.

• Hormonal: Scanty menses or periods 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 endomaterial 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 other hormone can also cause scanty periods. Scanty menses can also occur after long-term use of oral contraceptive as a result of progressive endometrial atrophy.

• Nervous and emotional: Pyschogenic factors like stress due to exams, or excessive excitement about an upcoming event may cause hypomenorrhea. Such factors suppress the activity of those centers in the brain that stimulate ovaries during the ovarian cycle (to secrete hormone like estrogen and progesterone), and may result in low production of these hormones.

• Other causes: Excessive exercise and crash dieting can cause scanty periods. One of the causes of hypomenorrhea is Ashermn’s syndrome (intra uterine adhesions), of which hypomenorrhea may be the only apparent sign. The degree of menstrual deficiency is closely correlated to the extent of adhesion (R.Toaff and S.Ballus, 1978).

Diagnosis

• Blood Tests: Most of the common cause of decreased flow of blood during the menses can be detected by blood tests. Tests for the level of hormones like FSH, LH, estrogen, prolactin, insulin are important. In polycystic ovarian disease, there will be high levels of insulin and androgens.

• Ultra sonogram: An ultra sonogram can diagnose the thickness of the endometrium, size of the ovaries growth of follicles, ovulation and other abnormalities.

• Other tests: Tests like D & C and MRI scans are some times needed to find out the cause of scanty blood flow during the periods.

Treatment

Unless a significant causal abnormality is found no treatment other than reassurance is necessary. Treatment is a per cause in case of significant causal abnormality.

  1. ^ Toaff R, Ballas S (1978). "Traumatic hypomenorrhea-amenorrhea (Asherman's syndrome)". Fertil. Steril. 30 (4): 379–87. PMID 568569.  

References








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