Hypomenorrhea

Definition - What does Hypomenorrhea mean?

Hypomenorrhea is a menstrual disorder with regularly timed, but scant or light menstrual bleeding, with more than a 20% decrease in volume from a previous normal period. Normal menstrual bleeding lasts between 3 to 7 days. In hypomenorrhea, there is a continuous reduction in the menstrual flow and the bleeding lasts for less than 2 days for repeated cycles. Hypomenorrhea is a symptom that indicates an underlying condition that could be affecting the fertility of a woman and her ability to carry a pregnancy to term.

FertilitySmarts explains Hypomenorrhea

The menstrual cycle is fine tuned by an interplay between a number of hormones, the main being estrogen and progesterone. Estrogen is the hormone responsible for the growth of the uterine lining, which is shed off as the menstrual flow. In case of a hormonal imbalance if the uterine lining does not grow adequately, it could result in a light menstrual flow. The common underlying causes affecting the growth of the uterine lining include:

  • Ovulatory disturbances including some medications that can affect the normal release of estrogen and progesterone.
  • Long-term use of oral contraceptives pills without a break can cause anovulation and a thin endometrium.
  • Chronic medical problems such as diabetes mellitus, and a high insulin level, or disorders of the liver, kidney, thyroid gland, pituitary or adrenal glands are some of the medical problems that can affect the production and metabolism of estrogen and progesterone.
  • A low thyroid hormone level, and high prolactin hormone levels are the most common of these reasons for hypomenorrhea.
  • Prolonged use of intrauterine devices (IUD) which often result in the thinning of the uterine lining.
  • Any scar causing illness or surgery may cause damage to the tissues of the endometrium and also reduce the cavity of the uterine lining leading to scanty blood flow.
  • Asherman’s Syndrome, a condition that causes variable degrees of scarring of the uterine lining and within the cavity.
  • Emotional or physical stress as well as significant changes in body weight may prevent ovulation.
  • Structural abnormalities of the reproductive system, like benign (non-cancerous) lesions of the uterus such as polyps, fibroids (myomas), and adenomyosis (uterine thickening caused by endometrial tissue moving into the outer walls of the uterus), are usually associated with an increase in flow of menstrual blood, but hypomenorrhea could occasionally occur in association with these causes.

Women who experience hypomenorrhea should be evaluated by a physician. A medical history, discussion of possible contributing factors, and a detailed physical exam are indicated. A variety of diagnostic techniques like blood tests (general health and hormonal) and imaging studies like a hysterosalpingogram (HSG), an ultrasound, rarely a Magnetic Resonance Imaging (MRI) and procedures like a hysteroscopy (telescopic examination of the uterine cavity) are available for diagnosing abnormalities of the uterus and endometrium. A hysteroscopy may allow the physician to identify specific areas of the endometrium that may be biopsied or removed with special instruments.

Treatment: Hypomenorrhea can usually be corrected with surgery or medication. The individual therapy recommended to you by your doctor will be tailored to the specific cause of abnormal bleeding.

  • Medication to correct the underlying medical or hormonal problems like hypothyroidism and hyperprolactenemia are often effective in reversing the problem.
  • Structural abnormalities of the reproductive tract such as fibroids, polyps, or scar tissue often can be treated during hysteroscopy.
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