Concerns About Reduced Menstrual Flow and Fertility at 37

Decreased menstrual flow?

I am 37 years old, and for the past three to four months, my menstrual flow has decreased to only lasting three days.
I am very worried and anxious.
I would like to ask the doctor if this will affect my fertility.
I have not had any sexual intercourse since I was 29, not even a one-night stand, but I did have a boyfriend in the past and underwent a dilation and curettage (D&C) procedure.
Recently, my menstrual flow has been about two pads of heavy absorbency per day, and I no longer need to use overnight pads.
By the third day, one heavy absorbency pad is completely full.
Although I currently do not have a boyfriend, I still hope to get married and have children one day, so I am very anxious that this change in my menstrual flow might affect my fertility.
Could you please advise me on what tests I should undergo at the hospital?

Xixiya, 30~39 year old female. Ask Date: 2016/03/21

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, if your menstrual cycle is still regular, you can observe it for now.
If there is no improvement, it is recommended to see a gynecologist.
Wishing you good health.

Reply Date: 2016/03/21

More Info

It's understandable to feel concerned about changes in your menstrual flow, especially when considering future fertility. At 37 years old, experiencing a significant reduction in menstrual flow can be alarming, but it doesn't necessarily mean that your fertility is compromised. Let's break down your concerns and provide some guidance on what steps you can take.

Firstly, a decrease in menstrual flow can be attributed to various factors, including hormonal changes, stress, weight fluctuations, and underlying health conditions. Since you mentioned that your menstrual cycle has changed to only lasting three days with significantly reduced flow, it would be wise to consult with a healthcare provider. They can help determine if this change is related to hormonal imbalances or other medical issues.

Given your history of undergoing a dilation and curettage (D&C), it's possible that this procedure could have impacted your menstrual cycle. D&C can sometimes lead to changes in the uterine lining, which may affect menstrual flow. However, it's essential to note that many women continue to have normal menstrual cycles after such procedures.

Regarding your fertility concerns, while menstrual flow can provide some insight into reproductive health, it is not the sole indicator of fertility. Factors such as ovulation, egg quality, and overall reproductive health play crucial roles in your ability to conceive. Since you have not engaged in sexual activity for several years, it may be beneficial to assess your overall reproductive health, including ovarian reserve and hormone levels.

To address your concerns, I recommend scheduling an appointment with a gynecologist or a reproductive endocrinologist. During this visit, you can discuss your menstrual changes and fertility goals. The doctor may suggest several tests, including:
1. Hormonal Blood Tests: These can assess levels of hormones such as estrogen, progesterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH). These hormones play vital roles in regulating your menstrual cycle and ovulation.

2. Ultrasound: A pelvic ultrasound can help visualize your ovaries and uterus, checking for any abnormalities such as cysts, fibroids, or changes in the uterine lining.

3. AMH Test: Measuring Anti-Müllerian Hormone (AMH) levels can provide insight into your ovarian reserve, which is the number of viable eggs you have left.

4. Hysterosalpingography (HSG): This test evaluates the condition of your fallopian tubes and uterine cavity, which is essential for conception.

While it’s natural to feel anxious about your fertility, remember that many women successfully conceive later in life, even with changes in their menstrual cycles. If you are considering starting a family, it may also be helpful to discuss your options with a fertility specialist, who can provide tailored advice based on your individual circumstances.

In summary, while changes in menstrual flow can be concerning, they do not automatically indicate infertility. Consulting with a healthcare provider can help clarify your situation and guide you on the necessary steps to take for your reproductive health. It's essential to stay proactive about your health and seek the support you need as you navigate these changes.

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