Decreased Menstrual Flow: Causes and Concerns

Menstrual flow gradually decreases?

Hello Doctor: My menstrual flow has gradually decreased over the past few years, lasting only three days for a while, but this year it has reduced to just one day.
I went to a gynecologist who said my ovarian function is poor.
I took ovulation medication for three months, and after finishing the medication, my period lasted three days and then stopped.
However, in my most recent cycle, there was only blood when I urinated, and there was no blood on the sanitary pad.
Why is this happening? What could be the reason? My menstrual blood is also sticky and has stringy clots.

Feichang fanlao, 30~39 year old female. Ask Date: 2014/07/23

Dr. Lin Wenbin reply Obstetrics and Gynecology

This is a decline in ovarian function.
Maintaining a regular lifestyle, exercise, and sleep can help slow down changes in ovarian function.
Ovarian function is one of the most easily affected functions in the body.
When lifestyle is irregular and stress increases, the heart, blood vessels, and brain must continue to function normally, while only reproductive function may decline; this is a protective mechanism of the body.

Reply Date: 2014/07/23

More Info

Decreased menstrual flow, or hypomenorrhea, can be concerning for many women, especially when it changes from a regular pattern to significantly lighter periods or even spotting. There are several potential causes for this condition, and understanding them can help you address any underlying issues.

Firstly, hormonal imbalances are one of the most common reasons for changes in menstrual flow. The menstrual cycle is regulated by a complex interplay of hormones, primarily estrogen and progesterone. If the ovaries are not functioning optimally, as indicated by your healthcare provider, it can lead to insufficient hormone production, resulting in lighter periods. Conditions such as polycystic ovary syndrome (PCOS), thyroid disorders, or perimenopause can also contribute to hormonal imbalances.

Another factor to consider is the use of medications, particularly hormonal contraceptives or fertility treatments. You mentioned taking ovulation-inducing medications, which can sometimes lead to changes in menstrual flow. After stopping these medications, it may take some time for your body to readjust and for your menstrual cycle to normalize.

Stress and lifestyle factors can also play a significant role in menstrual health. High levels of stress can affect the hypothalamus, the part of the brain that regulates the menstrual cycle, leading to lighter periods or missed cycles altogether. Additionally, significant weight changes, whether loss or gain, can impact hormonal balance and menstrual flow.
Regarding the consistency of your menstrual flow, you mentioned that it has been "sticky" and "stringy." This could indicate the presence of cervical mucus, which can vary in texture throughout the menstrual cycle. However, if you are experiencing unusual changes in your menstrual flow, such as a significant reduction in volume or changes in consistency, it is essential to consult with your healthcare provider. They may recommend further evaluation, including blood tests to check hormone levels or imaging studies to assess ovarian function.

It is also important to consider the possibility of underlying medical conditions. Conditions such as endometriosis or uterine fibroids can affect menstrual flow and may require further investigation. If you have any accompanying symptoms, such as pain, significant mood changes, or other unusual signs, these should be reported to your healthcare provider as they can provide essential clues to your overall health.

In summary, decreased menstrual flow can result from various factors, including hormonal imbalances, medication effects, stress, and lifestyle changes. It is crucial to maintain open communication with your healthcare provider, who can guide you through understanding the changes in your menstrual cycle and recommend appropriate interventions or treatments. If your menstrual flow continues to decrease or if you experience any concerning symptoms, do not hesitate to seek further evaluation. Your menstrual health is an important aspect of your overall well-being, and addressing any issues early can help prevent more significant problems in the future.

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