Decreased Menstrual Flow: Causes and Concerns

Decreased menstrual flow?

Hello, Doctor: I have noticed that my menstrual flow has gradually decreased over the past few months.
My menstrual period lasts about 4-5 days, and usually by the fifth day, there is only brown discharge left.
In the past, the first and second days of my period were heavy, to the extent that the tampon would be fully saturated and needed to be changed frequently.
However, in recent months, I often find that the tampon is not fully saturated when I change it, especially this time, as there was hardly any blood by the third day of my period.
I have never been pregnant or had a miscarriage, and I have been taking the oral contraceptive pill (Diane-35) for about two years.
Is this situation normal? Thank you, Doctor.

Mochi, 20~29 year old female. Ask Date: 2020/07/20

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it should be normal; just observe.
Wishing you good health.

Reply Date: 2020/07/20

More Info

Decreased menstrual flow, also known as hypomenorrhea, can be concerning for many women, especially when there is a noticeable change from their usual menstrual pattern. In your case, you have observed a gradual decrease in menstrual blood flow over the past few months, which is significant given your previous experience of heavier periods.
There are several potential causes for decreased menstrual flow, and understanding these can help you determine whether this change is normal or if it warrants further investigation.

1. Hormonal Changes: Since you have been taking the oral contraceptive pill Diane-35 for over two years, it is important to note that hormonal contraceptives can significantly alter menstrual patterns. Diane-35 contains estrogen and progestin, which can lead to lighter periods or even missed periods in some women. If your body has adjusted to this medication, it may result in decreased menstrual flow.

2. Stress and Lifestyle Factors: Stress, significant weight changes (either loss or gain), excessive exercise, and changes in diet can all impact menstrual flow. High levels of stress can disrupt the hormonal balance necessary for regular menstruation, leading to lighter periods.

3. Underlying Medical Conditions: Conditions such as polycystic ovary syndrome (PCOS), thyroid disorders, or other hormonal imbalances can also lead to changes in menstrual flow. If you have any symptoms such as weight gain, hair loss, or changes in skin texture, it may be worth discussing these with your healthcare provider.

4. Age and Menstrual Transition: Depending on your age, you may be approaching perimenopause, a transitional phase before menopause where menstrual cycles can become irregular. However, this typically occurs in women in their late 30s to 40s.

5. Medication Effects: Besides hormonal contraceptives, other medications can also affect menstrual flow. If you are taking any other medications, it’s worth reviewing them with your healthcare provider.

Given your situation, it is advisable to consult with your healthcare provider to discuss your symptoms in detail. They may recommend a physical examination, blood tests to check hormone levels, or an ultrasound to rule out any underlying conditions. It is essential to ensure that there are no significant health issues contributing to the changes in your menstrual cycle.

In summary, while decreased menstrual flow can be a normal variation, especially with hormonal contraceptive use, it is crucial to monitor any additional symptoms and consult with a healthcare professional for personalized advice. They can help determine if your experience is within the normal range or if further evaluation is necessary.

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