Patient's question:
This month's menstrual flow is very light. Usually, I need four or five pads a day, but this time only two pads were enough to get through the day. I had a similar situation over a year ago. Is this a sign of a medical issue?Doctor's answer:
Hello:A normal menstrual cycle with bleeding lasting less than 2 days and a flow volume of less than 20 milliliters is typically considered hypomenorrhea. Hypomenorrhea, like menorrhagia, is an abnormal condition. The causes of hypomenorrhea are similar to those of amenorrhea, differing only in degree. The main reasons are as follows:
（1）Physiological: Due to genetic or environmental factors.
（2）Pathological:
① Congenital uterine underdevelopment, where the uterus is small and only a small amount of endometrium is shed, resulting in a reduced menstrual flow.
② Ovarian hypofunction: In endometrial cells, there is a special type of granule called a lysosome, which is related to menstrual blood volume and bleeding duration. If estrogen and progesterone levels are high, lysosome complexes form well, leading to more bleeding and a longer bleeding duration. Conversely, if the ovaries are underdeveloped and sex hormone production is low, lysosome complexes form poorly, resulting in less bleeding and a shorter bleeding duration.
③ Endometrial tuberculosis: The endometrium is damaged by tuberculosis bacteria, forming scars, which reduces menstrual flow.
④ Married women may experience hypomenorrhea after a D&C procedure, especially after multiple induced abortions, which cause endometrial trauma and lead to uterine adhesions. Mild cases result in hypomenorrhea, while severe cases can lead to amenorrhea.
Hypomenorrhea should be investigated for its underlying cause and treated promptly.