Low Menstrual Flow: Causes and Concerns for Women

Q: Low Menstrual Flow: Causes and Concerns for Women

A reduced menstrual flow may be indicative of issues related to the uterus or ovaries. <br>Initially, uterine problems should be considered. <br>If there has been a history of dilation and curettage (D&C), it is possible that the endometrial surface has been damaged, leading to a

Menstrual flow is very light?

Dear Dr.
Lu,
I would like to ask you a question.
I am 30 years old and have never given birth.
My menstrual cycle is generally normal, with intervals of about 28-30 days.
However, this past year, the volume of my menstrual blood has decreased significantly (I can't quite remember if it's been around six months).
Previously, although the flow was not heavy, it would last at least 3-4 days before tapering off.
Now, it seems that by the second day of my period, it is almost finished.
I only need about two regular pads a day (which are not fully saturated), and even the first night pad does not hold much; by the second night, I don’t need to use a night pad at all, and the daytime use is minimal.

I am concerned if this could be a sign of early menopause and whether it might affect my ability to conceive.
Previously, I visited a gynecologist who mentioned that I have a 4 cm fibroid at the back of my uterus (but it should not be a problem).
Isn’t it common to have heavy menstrual bleeding with fibroids? Additionally, my doctor suggested that I visit on the second day of my period to get medication to regulate my cycle, but I was unable to go yesterday due to working late.
Today is the third day (and it feels like it’s almost over >_<).
Is it still okay to go and get the medication now? Do you have any other suggestions? Thank you.

AAA, 30~39 year old female. Ask Date: 2014/11/06

Dr. Lü Lizheng reply Obstetrics and Gynecology

A reduced menstrual flow may be indicative of issues related to the uterus or ovaries.
Initially, uterine problems should be considered.
If there has been a history of dilation and curettage (D&C), it is possible that the endometrial surface has been damaged, leading to a decrease in the amount of menstrual flow produced by the endometrium.
Additionally, a condition known as adenomyosis can be detected via ultrasound and may also contribute to reduced menstrual flow.

If the issue is related to the ovaries, it could be due to poor ovarian function, resulting in hormonal instability.
Hormonal blood tests related to ovarian function are recommended.
It is advisable to confirm the underlying cause before initiating treatment.

Sincerely,
Dr.
Li-Cheng Lu, Taoyuan Hospital

Reply Date: 2014/11/06

More Info

Understanding low menstrual flow can be a complex issue, especially for women in their reproductive years. At 30 years old, experiencing a significant change in menstrual flow can raise concerns about underlying health conditions, hormonal imbalances, or even the onset of perimenopause.
Firstly, it is important to recognize that menstrual flow can vary widely among women and can change due to various factors such as stress, diet, exercise, and hormonal fluctuations. A decrease in menstrual flow, known as hypomenorrhea, can be caused by several factors:
1. Hormonal Imbalances: The menstrual cycle is regulated by hormones, primarily estrogen and progesterone. An imbalance in these hormones can lead to lighter periods. Conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders can disrupt hormonal levels.

2. Uterine Fibroids: You mentioned having a 4 cm fibroid. While fibroids can sometimes cause heavier menstrual bleeding, they can also lead to lighter periods depending on their location and size. Fibroids can interfere with the normal shedding of the uterine lining, potentially leading to changes in flow.

3. Stress and Lifestyle Factors: High levels of stress, significant weight loss or gain, and changes in physical activity can all impact menstrual flow. Stress can affect the hypothalamus, which plays a crucial role in regulating the menstrual cycle.

4. Age and Perimenopause: Although 30 is relatively young for perimenopause, it can begin in the late 30s to early 40s. Symptoms may include irregular periods, changes in flow, and other menopausal symptoms. However, it is less common for women in their 30s to experience these changes unless there are other underlying factors.

5. Medical Conditions: Conditions such as endometriosis or adenomyosis can also affect menstrual flow. These conditions can cause changes in the uterine lining and lead to variations in bleeding patterns.

Regarding your concerns about fertility, lighter menstrual flow does not necessarily indicate a reduced ability to conceive. However, if there are underlying hormonal imbalances or structural issues within the uterus, it could potentially affect fertility. It is advisable to monitor your menstrual patterns and consult with a healthcare provider if you have concerns about your ability to conceive.

As for your doctor's recommendation to take medication to regulate your cycle, it is generally acceptable to start medication even if you are a few days into your period. However, it is best to follow your doctor's specific instructions regarding the timing and dosage of any medication. If you are unable to see your doctor immediately, consider reaching out to them for guidance on how to proceed.

In summary, while changes in menstrual flow can be concerning, they are not uncommon and can be influenced by a variety of factors. It is essential to maintain open communication with your healthcare provider, especially regarding any changes in your menstrual cycle, symptoms you may be experiencing, and your overall reproductive health. Regular check-ups and discussions about your menstrual health can help address any concerns and ensure that any necessary evaluations or treatments are initiated promptly.

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