Hypomenorrhea or hypomenorrhoea, also known as short or scanty periods, is extremely light

menstrual The menstrual cycle is a series of natural changes in hormone production and the structures of the uterus and ovaries of the female reproductive system that make pregnancy possible. The ovarian cycle controls the production and release of eggs a ...

blood flow. It is the opposite of heavy periods or

hypermenorrhea Heavy menstrual bleeding (HMB), previously known as menorrhagia or hypermenorrhea, is a menstrual period with excessively heavy flow. It is a type of abnormal uterine bleeding (AUB). Abnormal uterine bleeding can be caused by structural abnorm ...

which is more properly called

menorrhagia Heavy menstrual bleeding (HMB), previously known as menorrhagia or hypermenorrhea, is a menstrual period with excessively heavy flow. It is a type of abnormal uterine bleeding (AUB). Abnormal uterine bleeding can be caused by structural abnor ...

Overview

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 is perhaps best explained by assuming the presence of an unusual arrangement, or relative insensitivity, of the endometrial vascular apparatus. Reduced menstrual flow is a common side-effect of

hormonal contraception Hormonal contraception refers to birth control methods that act on the endocrine system. Almost all methods are composed of steroid hormones, although in India one selective estrogen receptor modulator is marketed as a contraceptive. The origina ...

methods, such as

oral contraceptive Oral contraceptives, abbreviated OCPs, also known as birth control pills, are medications taken by mouth for the purpose of birth control. Female Two types of female oral contraceptive pill, taken once per day, are widely available: * The combi ...

pills,

IUD An intrauterine device (IUD), also known as intrauterine contraceptive device (IUCD or ICD) or coil, is a small, often T-shaped birth control device that is inserted into the uterus to prevent pregnancy. IUDs are one form of long-acting reversi ...

s that release hormones (such as

Mirena A hormonal intrauterine device (IUD), also known as a intrauterine system (IUS) with progestogen and sold under the brand name Mirena among others, is an intrauterine device that releases a progestogenic hormonal agent such as levonorgestrel int ...

), or hormonal implants such as

Depo-Provera Medroxyprogesterone acetate (MPA), also known as depot medroxyprogesterone acetate (DMPA) in injectable form and sold under the brand name Depo-Provera among others, is a hormonal medication of the progestin type. It is used as a method of bir ...

. The relatively low

estrogen Estrogen or oestrogen is a category of sex hormone responsible for the development and regulation of the female reproductive system and secondary sex characteristics. There are three major endogenous estrogens that have estrogenic hormonal ac ...

contained in most hormonal contraceptives reduces the growth of the

endometrium The endometrium is the inner epithelial layer, along with its mucous membrane, of the mammalian uterus. It has a basal layer and a functional layer: the basal layer contains stem cells which regenerate the functional layer. The functional layer ...

, so there is relatively little endometrium left to be shed during

menstruation Menstruation (also known as a period, among other colloquial terms) is the regular discharge of blood and mucosal tissue from the inner lining of the uterus through the vagina. The menstrual cycle is characterized by the rise and fall of ...

. Many women find this side-effect to be a benefit of hormonal contraceptive use. Scanty menses or periods can occur normally at the extremes of the reproductive life that is, just after puberty and just before

menopause Menopause, also known as the climacteric, is the time in women's lives when menstrual periods stop permanently, and they are no longer able to bear children. Menopause usually occurs between the age of 47 and 54. Medical professionals often d ...

. This is because

ovulation Ovulation is the release of eggs from the ovaries. In women, this event occurs when the ovarian follicles rupture and release the secondary oocyte ovarian cells. After ovulation, during the luteal phase, the egg will be available to be fertilize ...

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 other hormone can also cause scanty periods. Despite these common causes, hypomenorrhea is still technically an abnormality of the menstrual flow, and other underlying medical problems should be ruled out by a doctor.

Disorders causing scanty menstruation

* One cause of hypomenorrhea is Asherman's syndrome (intrauterine adhesions), of which hypomenorrhea (or

amenorrhea Amenorrhea is the absence of a menstrual period in a woman of reproductive age. Physiological states of amenorrhoea are seen, most commonly, during pregnancy and lactation (breastfeeding). Outside the reproductive years, there is absence of menses ...

) 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 The uterus (from Latin ''uterus'', plural ''uteri'') or womb () is the organ in the reproductive system of most female mammals, including humans that accommodates the embryonic and fetal development of one or more embryos until birth. The ...

. However, it rarely indicates uterine

hypoplasia Hypoplasia (from Ancient Greek ὑπo- ''hypo-'' 'under' + πλάσις ''plasis'' 'formation'; adjective form ''hypoplastic'') is underdevelopment or incomplete development of a tissue or organ.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 The ovary is an organ in the female reproductive system that produces an ovum. When released, this travels down the fallopian tube into the uterus, where it may become fertilized by a sperm. There is an ovary () found on each side of the body. T ...

during the ovarian cycle (to secrete hormone like estrogen and

progesterone Progesterone (P4) is an endogenous steroid and progestogen sex hormone involved in the menstrual cycle, pregnancy, and embryogenesis of humans and other species. It belongs to a group of steroid hormones called the progestogens and is the majo ...

), and may result in low production of these hormones. * Low

body fat Adipose tissue, body fat, or simply fat is a loose connective tissue composed mostly of adipocytes. In addition to adipocytes, adipose tissue contains the stromal vascular fraction (SVF) of cells including preadipocytes, fibroblasts, vascular e ...

: 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

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 such as

follicle-stimulating hormone Follicle-stimulating hormone (FSH) is a gonadotropin, a glycoprotein polypeptide hormone. FSH is synthesized and secreted by the gonadotropic cells of the anterior pituitary gland and regulates the development, growth, pubertal maturation, ...

luteinizing hormone Luteinizing hormone (LH, also known as luteinising hormone, lutropin and sometimes lutrophin) is a hormone produced by gonadotropic cells in the anterior pituitary gland. The production of LH is regulated by gonadotropin-releasing hormone (GnRH) ...

, estrogen,

prolactin Prolactin (PRL), also known as lactotropin, is a protein best known for its role in enabling mammals to produce milk. It is influential in over 300 separate processes in various vertebrates, including humans. Prolactin is secreted from the pi ...

insulin Insulin (, from Latin ''insula'', 'island') is a peptide hormone produced by beta cells of the pancreatic islets encoded in humans by the ''INS'' gene. It is considered to be the main anabolic hormone of the body. It regulates the metabolism ...

are important. In

polycystic ovarian syndrome Polycystic ovary syndrome, or PCOS, is the most common endocrine disorder in women of reproductive age. The syndrome is named after the characteristic cysts which may form on the ovaries, though it is important to note that this is a sign and no ...

, 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 such as

dilation and curettage Dilation (or dilatation) and curettage (D&C) refers to the dilation (widening/opening) of the cervix and surgical removal of part of the lining of the uterus and/or contents of the uterus by scraping and scooping ( curettage). It is a gynecologi ...

and

MRI Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes of the body. MRI scanners use strong magnetic fields, magnetic field gradients, and radio waves ...

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.

External links

Medicinenet Article on Vaginal Bleeding

References