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What to do if your periods are scanty. Causes of scanty brown periods

Scanty menstruation, or hypomenorrhea, is a reduced amount of bleeding during menstruation (50 ml or less). Hypomenorrhea refers to menstrual irregularities and can be a symptom of many diseases.

Normally, menstrual blood loss is 50-150 ml, duration is from 3 to 5 days, the menstrual cycle lasts 21-35 days, and there is no severe pain.

Scanty periods are often combined with oligomenorrhea (shortened menstruation - less than 3 days), opsomenorrhea (rare menstruation, once every 2-3 months) and spaneomenorrhea (2-3 times a year).

Types of hypomenorrhea

There are primary and secondary hypomenorrhea. They talk about primary hypomenorrhea when a young girl’s periods are scanty from the very first arrival and remain so even after a year.

Secondary hypomenorrhea is indicated by a decrease in menstrual blood loss in mature women after a period of normal menstruation.

Causes

A multifunctional system is involved in the regulation of the menstrual cycle: cerebral cortex – hypothalamus – pituitary gland – ovaries – uterus. Any failure at any level will lead to a disorder of the menstrual cycle, including scanty menstruation. Hypomenorrhea can be caused by both physiological and pathological reasons.

Physiological causes of scanty periods:

  • the formation of menstruation in adolescents throughout the year;
  • premenopausal period;
  • lactation.

All of these factors are associated with a physiological imbalance of sex hormones in the body, that is, in adolescence, the optimal production of estrogen and progesterone has not yet been established, and in premenopausal age there is a natural depletion of ovarian function. During the period when menstruation has resumed after childbirth, but the woman is still breastfeeding, hypomenorrhea can be observed in her due to the increased content of prolactin in the blood (the hormone prolactin is increased during lactation).

Pathological causes of scanty periods:

1) affecting the uterus and the functional (menstruating) layer of the endometrium:

  • abortions and curettage of the uterine cavity;
  • inflammatory diseases of the uterus and appendages;
  • tuberculosis of the genital organs;
  • operations on the uterus (removal of myomatous nodes, partial removal of the uterus, cesarean section);
  • sexually transmitted diseases;

2) disrupting the production of sex hormones in the ovaries:

  • injuries and surgeries on the pelvic organs (for example, removal of part of an ovary with a cyst);
  • endocrine diseases, including PCOS and obesity;
  • autoimmune diseases;
  • genital infantilism and developmental defects;
  • occupational hazards (radiation, chemicals);

3) leading to an imbalance of sex hormones released in the pituitary-hypothalamic system (brain):

  • intoxication and poisoning;
  • sudden and significant weight loss (anorexia, dieting, excessive exercise);
  • lack of vitamins, anemia;
  • mental trauma, constant stress, depression;
  • brain tumors and injuries;
  • autoimmune diseases;
  • influence of hormonal contraception;
  • major bleeding during traumatic childbirth;
  • improper functioning of other endocrine organs.

Manifestations of scanty periods

The main symptom of hypomenorrhea is small, spotting or drop-shaped bloody discharge of a dark brown color.

Scanty periods may also be accompanied by a shortening of the duration, that is, their duration may be no more than 2 days. Collectively, this is called hypomenstrual syndrome.

In some cases, scanty periods occur against the background of pain. Women complain of pain in the lower abdomen, lower back, “shooting” in the rectum area, and sacrum. This is especially typical for adhesions in the uterine cavity and fusion of the cervical canal.

Low-grade fever (long-lasting slightly elevated body temperature up to 37-37.5 degrees) may indicate a connection between scanty menstruation and the current infectious process in a woman.

If the cause of scanty or rare menstruation is associated with disturbances in the secretion of hormones by the ovaries or pituitary gland, hypothalamus, or thyroid gland, then a woman may observe signs of premature skin aging, dryness and itching in the vagina, decreased sexual desire, irritability, tearfulness, and a tendency to depression.

Signs of improper functioning of the thyroid gland and hypothalamus (in the brain) can be weight gain in a woman simultaneously with the appearance of scanty periods, the appearance of milky discharge from the nipples, dull complexion, puffiness, drowsiness, and apathy.

Diseases that accompany hypomenorrhea

Synechiae (fusions, adhesions) in the uterine cavity

This condition is called “Asherman's syndrome” in gynecology. Numerous abortions and uterine curettages lead to the formation of intrauterine adhesions, during which the walls of the uterus were injured. Sometimes this may be just one abortion or a single curettage (for example, for the remnants of placental tissue after childbirth), but under conditions of infection. Trauma and inflammation lead to the formation of adhesions in the uterine cavity and cervix.

Women complain that before abortion or curettage they had a regular menstrual cycle, but now menstruation is scanty, usually sharply painful. In some cases, menstruation may stop altogether, and the adhesive process will progress in the uterine cavity and cervical canal.

Sex hormones in this case are produced by intact ovaries, and when examining the level of sex hormones in the blood, their compliance with the norm will be determined.

Ultrasound in the uterine cavity describes adhesions and adhesions between the walls, the uterine cavity is narrow, the mucous layer of the endometrium is insufficient in height. In conditions of adhesive and inflammatory process, the endometrium is not able to menstruate and accept a fertilized egg. Therefore, in addition to hypomenorrhea, a woman is diagnosed with infertility or recurrent miscarriage.

Fusion (atresia) of the cervical canal of the cervix

This condition is observed after operations on the cervix, during which the wall of the cervical canal is injured. For example, after removal of the vaginal part of the cervix due to the initial stage of cancer (cervical amputation according to Sturmdorff), after diathermoexcision of the cervix due to dysplasia.

After injury and inflammation, an adhesive process also develops in the wall of the cervix, making the outflow of menstrual blood difficult.

Women complain of painful cramping and nagging pain in the lower abdomen, scanty discharge, sometimes with a stagnant odor. In this case, menstruation can last for a long time - “smear” for up to 2-3 weeks, until the uterus empties through a narrow opening. If the adhesive process has led to complete overgrowth of the uterus, then hematometra occurs - a sharply painful condition in which a large number of menstrual clots accumulate in the uterus. With a hematometer, there may be a rise in temperature up to 38 degrees.

PCOS: polycystic ovary syndrome

Constant or periodic pain in the lower abdomen, increased temperature during an exacerbation, menstrual flow with an unpleasant odor.

Periodic aching pain in the groin areas, increased temperature during exacerbation, heaviness and adhesions in the appendage area, which are determined during a gynecological examination, infertility.

Sexually transmitted diseases

STDs include:

More often they are asymptomatic or with minor complaints (discharge from the genital tract with an unpleasant odor, itching and burning in the perineum, pain during sexual intercourse, signs of chronic endometritis and/or adnexitis).

In inflammatory diseases of the pelvic organs, it is usually always possible to identify a connection with a provocative factor: with a change of sexual partner, with the occurrence of active inflammation after an abortion or other manipulation of the uterus, with hypothermia.

Ovarian wasting syndrome and resistant ovarian syndrome

In this case, the uterus and endometrium remain healthy, but there are not enough sex hormones for a normal menstrual reaction. Disturbance in the production of sex hormones occurs at the ovarian level. In the body of a woman with these diseases, premature menopause occurs at a young age (at 35-40 and less than 35 years).

For ovarian wasting syndrome (OSS) the hormone-producing tissue in them is replaced by connective tissue. This sometimes occurs due to hereditary factors, sometimes after inflammation in the ovaries, after a toxic effect on the body. A woman who has previously menstruated and may even have given birth notices that her periods become more and more scanty, and then gradually stop altogether. When examined by a gynecologist, the uterus and ovaries are reduced in size. Follicles in the ovaries are not visualized at all on ultrasound. An analysis of anti-Mullerian hormone in the patient's blood may show that there is no supply of follicles and eggs left in the ovaries.

For resistant ovarian syndrome (ROS) in a young woman, menstruation also gradually becomes scanty and stops due to the lack of a sufficient amount of sex hormones in the blood. With this disease, the ovarian tissue retains the required number of follicles and eggs and is not replaced by connective tissue.

Here the cause of the disease is a failure of regulation in the brain. The ovary becomes insensitive to stimulation by hormones from above (from the pituitary gland-hypothalamus). The body signals that there is a deficiency of estrogen in the blood, but the ovaries remain insensitive to FSH (follicle-stimulating hormone) and LH (luteinizing hormone).

The clinic also observes scanty periods with their gradual complete absence and the inability to conceive. The difference between SOC and SUS: when the ovaries are resistant, follicles remain in them, and the symptoms of menopause are less clinically pronounced.

Psycho-emotional stress, excessive sports or study (“excellent student syndrome”), sudden weight loss, difficult working conditions can disrupt the release of hormones that control the ovaries by the pituitary gland and hypothalamus. Here, menstruation becomes scanty or disappears completely with a healthy uterus and ovaries. Control of the production of sex hormones is also disrupted by tumors, injuries to the pituitary gland and hypothalamus, brain infections and after hemorrhages in the brain.

Diagnostics

In order to find out the reason for scanty periods, the patient goes to see a gynecologist. What a gynecologist can see and assume at the first appointment:

  • When examined on a chair, reduced size of the uterus and ovaries, dry and reddened mucosa with contact bleeding may indicate a lack of sex hormones in the body.
  • When questioned, the woman herself may say that her sex drive has decreased, describe the signs of premature menopause, and complain about skin aging.
  • Enlarged, dense ovaries may be a sign of PCOS.
  • Increased growth of coarse hair on the face, linea alba, inguinal folds, legs and skin condition suggests an excess of male sex hormones in the blood.
  • When examining the mammary glands, you can notice galactorrhea (discharge of milk secretion from the nipples) with hyperprolactinemia.
  • At the appointment, the patient takes a smear to determine the degree of purity from the vagina, which may show an “senile” type of smear (as during menopause), signs of chronic inflammation.
  • During the conversation, a woman can talk about previous weight gain, an abortion with an infectious complication, surgery, traumatic childbirth, chronic infections, meningitis, the fact that she was recently diagnosed with an autoimmune disease - a lot of information about the provoking factor.

Important! It is advisable to come to the appointment with a “menstrual calendar”, that is, mark in advance in red on the calendar your recent periods (so as not to painfully remember at the appointment!).

After a conversation and examination of the patient, the doctor can already roughly assume that the cause of scanty periods is in the uterus, or in the ovaries, or dysfunction of other organs must be excluded.

What examinations can a gynecologist prescribe:

    Ultrasound of the pelvic organs: you can see a picture of scleropolycystic ovaries or, conversely, reduced ovaries with the absence of follicles, a decrease in the size of the uterus, identify a hematometra with obstruction of the cervical canal, a picture of adhesions (synechias) in the uterine cavity, “bald” endometrium in the uterus insufficient for the second phase of the cycle.

    Blood tests to determine hormonal status: estrogens , progesterone, testosterone, prolactin, adrenal hormones and thyroid gland , FSH And LH, and others.

    Tests for the presence of ovulation in the cycle. This may be the old method of measuring basal temperature: the body temperature in the rectum is measured every morning, the values ​​are entered into a chart; When ovulation occurs, the basal temperature rises, which is reflected in the graph. The method requires time and self-control, but there is no monetary cost. When monitoring the presence of ovulation in the ovary using ultrasound performed several times in a row (we observe the growing and bursting follicle) and urine tests for ovulation, the woman will not experience the difficulties of daily measuring the basal temperature in the rectum, but will spend money on tests and ultrasound.

    Anti-Mullerian hormone - indicates the supply of follicles and eggs in the ovaries and the patient’s prospects for childbearing and the resumption of menstruation. With premature menopause, it is practically zero.

    Blood sugar and glucose tolerance test with 100 g of glucose (for impaired insulin sensitivity).

    Visit to a phthisiatrician (if indicated, if there is a suspicion of genital tuberculosis).

    Smear tests and PCR diagnostics for sexually transmitted diseases.

    Cervical smear for oncocytology.

    X-ray of the sella turcica and examination by an ophthalmologist (to exclude a pituitary tumor);

    Consultation with an endocrinologist, ultrasound of the thyroid gland and ultrasound of the adrenal glands to exclude hormone-producing tumors in these organs.

    Tests with the introduction of estrogens, progesterone, FSH and LH from the outside (the doctor prescribes a certain drug to the patient according to the regimen and observes whether a menstrual-like reaction appears in response to its introduction or withdrawal). With their help, the doctor determines which hormone is missing and whether the uterus is healthy (can menstruate at all).

    Hysteroscopy and endometrial biopsy. These are already invasive examination methods (mini-surgery). During hysteroscopy, the uterine cavity and cervix are examined from the inside with a video camera. You can see and dissect intrauterine adhesions, diagnose obstruction of the fallopian tubes in the initial sections, scrape the endometrium for analysis (based on the results of the scraping, morphologists can describe hormone deficiency, chronic endometritis), etc.

    Laparoscopy with examination and biopsy of the ovaries is sometimes prescribed to women who are being evaluated for scanty or absent periods and infertility before undergoing IVF. During laparoscopy for infertility, signs of tuberculosis and other infectious lesions of the pelvis can be detected.

Treatment of scanty periods

Treatment of hypomenorrhea depends on the cause that caused it.

If gynecological diseases are the causative factors in the occurrence of scanty periods, then therapy is carried out by a gynecologist. In case of tuberculosis infection, treatment is carried out by a TB doctor. In case of endocrine pathologies, treatment is carried out by an endocrinologist; in case of mental disorders, joint supervision of the patient by a gynecologist and a psychologist is recommended, and, if indicated, by a psychiatrist.

Treatment of hypomenorrhea lasts for more than one month.

Dissection of intrauterine synechiae, fusion of the cervical canal and emptying of hematometers is carried out by hysteroscopy or hysteroresectoscopy under anesthesia. After the surgical stage of dissection of adhesions, the stage of hormonal therapy necessarily follows. A combination of estrogens and gestagens (not COCs) is usually prescribed. Against the background of hormone replacement therapy, it is necessary to achieve the growth of normal endometrium.

For PCOS, the treatment regimen includes weight loss, taking medications that improve insulin sensitivity, correction of hyperandrogenism, and surgery (incisions on the ovaries, making it possible to release and ovulate eggs). Surgical treatment is performed for infertility and the patient’s desire to conceive.

In case of hyperprolactinemia, its correction is carried out (drug “bromocriptine”, “Dostinex”). If there is a lack of thyroid hormones, they are introduced into the body for replacement purposes.

Replacement therapy with sex hormones is also carried out for the syndrome of exhausted ovaries and resistant ovaries. Without the introduction of hormonal drugs from the outside, a woman’s body will develop premature menopause.

For chronic adnexitis and endometritis, antibiotics and anti-inflammatory drugs, resorption therapy and physiotherapy are prescribed. In chronic endometritis, endometrial insufficiency is usually always present. In order for a woman to be able to menstruate and bear a child in the future, rehabilitation is prescribed after anti-inflammatory therapy. Its goal is to improve blood flow in the pelvis, restore the functional layer of the uterus, and prevent sclerotic changes in the ovaries after inflammation. The woman is recommended to undergo laser blood purification, ozone therapy, and stimulation of endometrial growth through the use of hormonal drugs and stem cell preparations.

If you are overweight or underweight, it is corrected and vitamins are prescribed according to the phases of the menstrual cycle.

Complications and prognosis

Undiagnosed and untreated diseases that cause scanty periods can lead to the following complications:

  • decreased libido, frigidity;
  • secondary amenorrhea(complete or almost complete absence of menstruation);
  • premature menopause with early consequences - osteoporosis and pathological fractures, cardiovascular and other metabolic disorders, urogenital disorders);
  • infertility;
  • habitual miscarriage;
  • with chronic pelvic inflammatory diseases, the risk of ectopic pregnancy and chronic pelvic pain syndrome increases;
  • the development of type 2 diabetes mellitus, uncontrolled obesity, “metabolic syndrome”, in which the functions of the endocrine system of the body as a whole are disrupted.

The prognosis for the restoration of menstruation to regular and moderate in most cases is favorable if treatment is carried out in a timely manner and in full.

After correction of abnormalities due to imbalance of hormones (sex, prolactin, thyroid), both the normal cycle and reproductive function can be restored. After surgical and comprehensive treatment for PCOS, women conceive on their own and with the help of IVF.

Even in the complete absence of the release of sex hormones in the syndrome of exhausted and resistant ovaries, they can be replaced externally with the help of drugs. Menstruation will come on time, cyclically. Symptoms of estrogen deficiency are relieved. Hormone replacement therapy is carried out over a long period of time, from the moment of diagnosis until the age of normal postmenopause. But the prognosis for conceiving on your own in this case will be unfavorable.

After the examination, they find out whether there is a supply of eggs left in the ovaries. This determines whether IVF can be performed with a woman’s egg. In most cases, childbearing with SIO and SOC becomes possible only with the help of IVF with a donor egg.

After dissection of intrauterine adhesions, long-term treatment is required; the prognosis for pregnancy is in rare cases favorable (if the process is not advanced).

Hypomenorrhea or scanty periods- this is one of the variants of the condition of the reproductive system, in which there is an incomplete separation of the normal volume of blood during menstruation. In this case, the woman loses no more than 50 ml over the entire period.

What amount of discharge is considered normal?

The volume of discharge is a rather individual parameter. On average, it is believed that the volume of discharge should be from 100 to 200 ml. This volume depends on the size of the uterus, as well as a history of childbirth and diseases.

Symptoms

The main signs of scanty periods are discharge from the genital tract, which has a small volume. At the same time, menstruation will not always have a characteristic color; it is acceptable to change scanty menstruation to a brown tint or pink.

Many women may mistake the discharge of only a few drops of blood for a scanty period..

Of the general symptoms, no signs may appear and only sometimes there is a deterioration in general health, accompanied by pain in the lower abdomen, headaches, etc.


First scanty periods

One of the manifestations of menstruation in adolescents is scanty periods that are small in volume and do not correspond to the clinical picture. A girl may complain of severe pain in the lower abdomen, feeling unwell, etc., but the discharge will be quite small.

Early scanty periods

Often young girls are faced with such a problem before the arrival of their periods as the appearance of a small amount of discharge, which has a characteristic brown tint and can resemble menstruation.

This type of discharge may be a signal of the body’s preparation for the onset of menstruation and a reaction of endometrial tissue to changes in hormonal levels.

Prolonged scanty discharge

This condition can occur in women of any age, and in this case the cause may not always be pathological.

However, sometimes scanty discharge for a long time can be a sign of an inflammatory process or a characteristic feature of a woman’s body.

Causes

After childbirth

Often after the birth of a child, a woman faces such a problem as scanty periods.

Let's take a closer look at this condition:


Discharge rate:

  1. The duration should not exceed two weeks and normally no treatment is required.
  2. Such discharge may be accompanied by slight pulsating sensations in the lower abdomen. This is due to contraction of the uterine cavity.
  3. An increase in volume may indicate pathology.

After an abortion

Almost every woman may experience scanty periods that occur after a medical termination of pregnancy:

  • This is especially pronounced after curettage of the uterine cavity with a surgical instrument - a curette. As a result, an extensive knapsack surface is formed, which requires some time to recover.
  • The cause of scanty menstruation can also be the remainder of the fertilized egg or chorionic villi. In the latter case, an inflammatory process occurs, which can aggravate the situation.

Normally, after an abortion, the duration of such scanty periods can be up to 10 days, on average about one week. If this time increases or signs such as an unpleasant odor, the presence of purulent contents, or a deterioration in general health appear, you should not delay visiting a specialist, as this may be an unfavorable prognostic sign.

As a rule, menstruation shifts and the next cycle begins from the moment the abortion and curettage are performed.

During pregnancy

Many women are sure that pregnancy is a period when, from the moment of fertilization, menstruation ceases.

In reality, under normal hormonal conditions, this is what should happen, but in reality it turns out that sometimes a woman notices menstruation, and later finds out about pregnancy.

Causes of menstruation during pregnancy:

Scanty periods after curettage

This is a fairly common problem that can be encountered by representatives of the fair sex aged 40-50 years, who have undergone diagnostic curettage of the uterine cavity.

In this case, the entire mucous membrane of the organ is removed to the maximum, and it may take a long time to restore its functional activity at this age.

In such situations, scanty periods can last for several cycles and a truly pathological reason should not always be sought for this; it may be a completely physiological condition.

Hypothyroidism

Characteristics of the disease:

  1. Insufficient functional activity of the thyroid gland leads to inadequate functioning of the ovaries. This is explained by the complex interconnected work of these endocrine structures.
  2. As a result of a lack of thyroid hormones, the follicle in the ovary does not mature. In response to such a mechanism, adequate maturation of the endometrium does not occur.

Menstruation with hypothyroidism:

  1. Menstruation with this type of pathology is prone to delays, which can last up to several months and can only be caused by hormonal support.
  2. In addition, after the onset of menstruation, they are scanty and have the character of a spot with a brown tint.
  3. Their duration usually does not exceed two or three days. In addition to cycle disruption, symptoms such as unmotivated weight gain, etc. may appear.

Anorexia and underweight

This process is usually associated with rapid loss of body weight and a decrease in the reserves of all nutrients. The body currently receives fewer substances necessary not only for the normal functioning of organs, but also of the ovaries in particular.

As a result, these structures become depleted. They decrease in size, the follicular apparatus will not be mature and their full work will not occur.

This condition may manifest itself either as a complete absence of menstruation, and the duration can reach half a year. This will be considered an unfavorable pathological symptom, since subsequently they may not begin at all and infertility will be irreversible, since atrophy of all structures will occur. Menstruation, even if it begins, becomes scanty, its duration is short, and the volume of blood lost is negligible; it becomes more like a daub.

This is a disease of the reproductive system, which is associated with menstrual dysfunction.

Characteristics and features of the disease:

  1. It is expressed by the fact that the body, as a rule, has a hormonal imbalance; this may primarily be hyperandrogenism.
  2. The follicular apparatus of the ovaries is represented by a large number of large, but defective elements.
  3. In this case, ovulation does not occur, as well as endometrial maturation.
  4. Menstruation is regularly delayed; the duration of such delays can reach several months.
  5. Unlike typical delays, which are characterized by heavier menstruation, with polycystic menstruation, menstruation is scanty and painful. Women may experience disruption of the endocrine glands, which is manifested by hypoandrogenism, increased hair growth, and increased body weight.


Having increased body weight

  1. If there are a large number of fat cells in the body, there is an increased formation of female sex hormones, as a result of which the estrogen component increases. It is this disorder that leads to a relative deficiency of the progesterone component, which is the reason for the defective maturation of endometrial tissue.
  2. Menstruation becomes scanty, their color may not differ from normal, but the duration is sometimes prolonged, which causes obvious discomfort in the woman.
  3. In addition, such a reason can lead not only to the appearance of scanty periods, but also to the development of infertility. This may also be the reason for an increase in the production of androgens, leading to a complete imbalance in the functioning of a woman’s endocrine organs.

Disturbances in the functioning of the reproductive system organs

When there are disturbances in the functioning of the organs of the reproductive system, their formation is defective. Sometimes, when the ovaries are not working properly, when too little estrogen is produced by the body, the female genital organs do not grow sufficiently.

The main target in this case will be the uterus; it does not reach large sizes, as a result it cannot fully perform its function, so with uterine hypoplasia, the endometrial tissue is not fully formed, and menstruation becomes scanty.

In this case, women may never fully begin to have full periods, which will only manifest themselves as brown smudges from the genitals for 1-2 days.

Stress

Prolonged nervous overstrain, as well as the effects of stress on the body.

Such situations very often lead to the woman’s body becoming depleted, nutrient reserves becoming minimal, and this leads to inadequate ovarian function and menstrual dysfunction.

As a rule, during a prolonged stressful situation, there is insufficient production of estrogen, and endometrial tissue does not grow in the required volume. During these periods, a woman may notice a delay in menstruation, as well as their appearance in scanty quantities. The duration also does not exceed several days.

Menopause

Women aged 50-55 years usually face the problem of menopause, but the situation can be ambiguous, since in some cases women’s periods end for various reasons much earlier than the expected age.

More and more women are turning to a specialist at the age of 40-45 years with complaints about menstrual irregularities, the appearance of scanty periods, as well as typical disorders associated with menopause.

Menopause symptoms:

  1. This condition is expressed by hot flashes, surges in blood pressure, gain of fat mass, etc.
  2. A woman, 1-2 years before the complete cessation of menstruation, notices that irregularities appear, regularity is lost, and with the usual large volume, menstruation becomes more scanty.

Consequences of surgical interventions

Some women face a problem in which the only treatment option is complete removal of the organ.

But after a certain time, especially if the ovaries were abandoned, the patient is faced with the phenomenon of the appearance of menstruation.

This can cause panic, since there is no organ from which endometrial particles should be removed.

But some may experience menstrual-like monthly bleeding due to a small piece of endometrium remaining in the cervix.

Before the onset of such discharge, there may be the same symptoms as before menstruation, such as engorgement of the mammary glands, changes in mood, etc.

In such a situation, the doctor needs to be more careful, since severe pathology may remain in the residual particles.

Diagnostics

When a woman has scanty periods, you should definitely look for the reason for the development of this condition. To do this, the first step is to contact a specialist.

After assessing the clinical picture, the doctor will decide what set of measures need to be taken to further establish the cause and select the correct treatment.

These include:

Treatment

Each individual reason for the appearance of scanty periods requires an individual approach to treatment, since in different cases there is a different pathogenesis of the condition:

Do I need to see a doctor?

Women who are faced with the problem of scanty periods need to consult a doctor. In this case, there is no role between the just beginning of menstruation in a teenage girl or the menopausal state.

In any case, additional diagnostic methods are required to eliminate pathological conditions or prevent the development of other problems.

Prevention

In order for a woman not to encounter the problem of scanty periods, as a pathological scenario, she should follow a number of rules aimed at maintaining the health of her reproductive system.

These include:

That is why, when scanty periods appear, it is recommended to consult a specialist for diagnosis and possibly to exclude pathology.

Heavy menstruation, which leads to the development of anemia, definitely needs to be corrected. But what if the bleeding is small? In each individual case, you need to look for your own reasons for scanty periods. After correct diagnosis, undergo a course of treatment, because reproductive function may depend on it.

A small amount of blood loss does not always indicate pathology. This can be considered a variant of the norm:

  • in adolescence;
  • in women awaiting menopause.

But even after menarche (first menstruation) there is a period during which menstruation should return to normal.

What is considered hypomenorrhea?

In gynecology, boundaries are defined that separate the concepts of normality and pathology. For menstruation, the duration of three to seven days refers to physiological phenomena. But if it shortens to two days, then this is considered a deviation. Hypomenstrual syndrome can manifest itself in the following types of disorders:

  • hypomenorrhea - a decrease in the volume of blood loss (less than 50 ml);
  • oligomenorrhea - menstruation lasts less than three days;
  • opsomenorrhea - rhythm disturbance, five to seven weeks pass between menstruation;
  • spaniomenorrhea - infrequent periods up to four times a year.

Often these states successively replace each other. At first, menstruation becomes less voluminous, then its duration decreases, and the interval increases. As a result, periods appear very rarely, and amenorrhea develops.

Hypomenstrual syndrome can develop primarily in adolescents (disorders occurred during the formation of menstruation). Secondary hypomenorrhea is a condition in which a woman had normal periods, but under the influence of certain factors, a malfunction occurred.

Reasons for scanty periods

Menstrual function in women is a system finely tuned to hormonal regulation. Any external or internal influence can lead to failure. The menstrual cycle is associated with the cerebral cortex. This means that emotions and stress can also cause deviations. Most often, very scanty periods are observed in the following cases.

  • The formation of menstruation. In adolescents, hormonal regulation by the pituitary gland is still imperfect. Even the first menstruation can be scanty. It usually takes a year for the cycle to establish itself. If after this time your periods have not stabilized, you need to be examined by a doctor.
  • Eating disorders. Strict diets, anorexia nervosa, hypovitaminosis and a lack of certain food groups and vitamins lead to cycle disruptions such as hypomenorrhea.
  • Stress. Mental stress, nervous exhaustion, problems at work and physical fatigue activate stress hormones, which results in inhibition of the production of gonadotropic and sex kinins.
  • Injuries and operations. If surgical interventions were performed on the genitourinary organs, then it is necessary that the swelling of the tissues and the inflammatory reaction decrease. Similar processes are observed after abortion and curettage of the uterine cavity.
  • Endocrine pathologies. Damage to the thyroid gland, which leads to its hypofunction, is accompanied by the phenomena of oligomenorrhea and opsomenorrhea. A cycle failure such as hypomenorrhea is observed with hypofunction of the adrenal glands. Rare menstruation becomes the norm with hyperprolactinemia.
  • Lactation. While breastfeeding, prolactin should suppress ovarian activity. This is accompanied by decreased estrogen levels. Usually the endometrium does not grow. But sometimes this becomes possible, in small quantities. Then scanty brown periods appear.
  • Pregnancy. A fertilized egg has a certain period of time for implantation. But sometimes it happens a little later. When the embryo is immersed in the thickness of the uterine wall, the endometrium and its vessels melt. The embryo finds itself in a bed washed with blood. Some of the blood may leak out during implantation. Then scanty periods appear ahead of schedule. But pregnancy may be at risk. Scanty periods after a delay will tell you this. To be sure, you need to take a pregnancy test or get tested for hCG.
  • Infections. Infection with sexually transmitted infections or a general infectious disease can also lead to cycle disruption. This is associated with the activation of inflammatory mediators and swelling of the uterine wall.
  • Iatrogenic influences. Some medications can affect the menstrual cycle. Most often these are antidepressants and hormonal contraceptives that are incorrectly selected. With medical termination of pregnancy after artificially induced bleeding, the first menstruation may be scanty. But if instead of menstruation you just get a spot, you need to see a doctor.

Do not forget about the influence of occupational factors on the menstrual cycle (working with chemicals, gasoline vapors).

For those women who have chosen the Mirena hormonal system as contraception, scanty periods become the norm.

Additional signs

Hypomenorrhea is not always the only symptom. Depending on the causes of the disease, additional signs may appear:

  • discharge with an unpleasant odor;
  • temperature increase;
  • chest pain;
  • nagging pain in the lower abdomen;
  • nausea, diarrhea, or constipation;
  • decreased libido;
  • nose bleed.

In some women, scanty periods are accompanied only by nagging pain in the lower abdomen or associated symptoms are completely absent.

What examination is needed

Long, scanty periods should alert both the woman and her doctor. This can be observed with uterine fibroids, although the pathology is more characterized by heavy bleeding. To establish why there are scanty periods, a comprehensive examination is necessary, which includes the following steps:

  • examination by a gynecologist;
  • microflora smears;
  • general clinical studies;
  • blood test for hormones;
  • Ultrasound of the pelvis.

If it is necessary to clarify the clinical situation, the following is prescribed:

  • MRI of the pelvis;
  • X-ray of the brain;
  • Ultrasound of the thyroid gland, adrenal glands, liver.

If a smear shows an inflammatory process or, according to the results of an ultrasound, damage to the appendages is noticeable, then an examination for sexually transmitted infections is necessary. For a more accurate result, it is better to do this using the PCR method. Sometimes it is necessary to carry out bacterial culture to determine sensitivity to antibiotics.

Ways to normalize your cycle

Treatment for scanty periods depends on the cause that led to the failure. Sometimes it is enough to normalize your diet, sleep, and eliminate stress. But in some cases, therapy may take a long time.

  • Anorexia. Cycle failure that occurs against the background of anorexia nervosa is difficult to treat. In such a situation, treatment should be carried out jointly with a psychiatrist. It includes both restoration of body weight and a change in the perception of one’s own shell.
  • Endocrine reasons. This requires the help of an endocrinologist. For tumors in the pituitary gland with hormonal activity, treatment can be prescribed by a neurosurgeon in the form of surgery to remove the tumor.
  • Infections. For some pathogens, the absence of clinical symptoms of inflammation and a low titer in tests are an indication for watchful waiting. If there are clear symptoms of inflammation, as well as the detection of chlamydia, trichomonas, or gonorrhea, treatment is mandatory not only for the woman, but also for her sexual partner.
  • Pregnancy. If the cause of scanty periods is pregnancy, then this condition requires a special approach. In the post-Soviet space, pregnancies that are threatened with termination at a short term (up to 12 weeks) are sought to be preserved. Women are prescribed bed rest and hospitalized. Antispasmodics and progesterone preparations Duphaston and Utrozhestan are used for treatment. But often a miscarriage during this period is a natural process of getting rid of genetically defective offspring. Therefore, in many European countries and the USA, the threat of interruption up to 12 weeks is not treated with special measures, but is left to nature.

To normalize the cycle, birth control pills may be prescribed. They help the ovaries adjust to the desired rhythm of hormone secretion, which persists after discontinuation of the drug.

Treatment with folk remedies involves taking herbal remedies. Red brush and hog queen are often used. Reviews about this treatment are contradictory. But most women say that they first need to visit a doctor and undergo an examination, and then resort to “grandmother’s” methods and homeopathy.

Scanty discharge instead of menstruation is rarely within the normal range; the condition requires correction. But you can prevent disruption of the menstrual cycle: eat right, dose your exercise, avoid stress and infections.

During one menstruation, a woman loses up to 150 ml of blood. Depending on the characteristics of the body and the influence of external factors, this indicator changes. If the volume of blood released is less than 50 ml, then such periods are considered scanty. This is due to pathology and external influences. Only a doctor can identify the true causes of scanty periods.

Many women who have heard about scanty periods are interested in what kind of discharge it is and how it differs from normal menstruation. In fact, understanding this issue is quite simple.

Normally, the cycle is at least 21 and maximum 35 days. The duration of menstruation varies from three to five days. During this period, 50–150 ml of blood leaves the body.

If menstruation has become less abundant than usual, and its volume differs from the norm - less than 50 ml, then it is diagnosed, which is considered a cycle violation. As a rule, during menstruation there is very little discharge - just a few drops. They often have a smearing character and are brown, black or extremely light in color.

Secondary hypomenstrual syndrome is a condition in which scanty periods are observed. They go less, become short and may stop on the third day. In this case, the menstruation that appears differs from the previous one. The early menstruation was within the normal range, but the next ones dramatically changed their character. The reasons why blood loss is 30-50 ml during critical days are physiological and pathological.

To correctly assess hypomenstrual syndrome, it is necessary to clearly understand what a woman normally loses during menstruation. Read more about this in our article on the website.

Functional reasons

Scanty periods are often observed due to disturbances in the functioning of the ovaries or pituitary gland, which are responsible for the reproductive function. Failures of the endocrine system can also lead to similar changes in the menstrual cycle.

Ovarian diseases

Dysfunction of the ovaries has a direct impact on menstruation. The cycle becomes shorter, menstruation occurs without blood or with a minimal amount of brown discharge. The secretion of hormones is disrupted, and for this reason, a change in the nature of critical days is observed.

Impaired ovarian function can be caused by various diseases, including inflammatory processes, polycystic disease () and tuberculosis, which affects these organs.

Thyroid diseases

Pathologies such as diabetes mellitus and hyperfunction of the thyroid gland often lead to a decrease in the volume of blood lost during menstruation. In addition, the following clinical manifestations are noted:

  • weakness;
  • causeless weight loss;
  • excessive sweating and extreme thirst;
  • depression;

If your periods are not abundant and are accompanied by such symptoms, you need to go for a consultation with an endocrinologist.

Pituitary gland diseases

If there are abnormalities in the pituitary gland, which is responsible for regulating the menstrual cycle, very scanty periods are observed. Hormones are produced in an inappropriate amount, and as a consequence of this - insufficient uterine blood circulation and abnormal structure of the endometrium. For this reason, heavy periods are abruptly replaced by minor discharge.

Organic causes

The causes of scanty menstruation may lie in various pathologies affecting internal organs and systems. There is a certain relationship between the body as a whole and the reproductive system.

Thus, scanty periods are often caused by diseases or infections affecting the genital organs, obesity and liver disease.

Diseases of the genital organs

Weak periods are observed with the development of diseases of the uterus and other pathologies affecting the reproductive system, such as:

  1. Endometriosis. The structure of the mucous membrane changes. Over time, the vagina, cervix and abdominal cavity are affected.
  2. Endometrial hyperplasia. The mucous membrane of the uterus grows into the muscular walls, as a result, small vessels are damaged and a discharge similar to menstruation appears.
  3. Polycystic ovary syndrome. Cysts form on these organs, which causes hormonal imbalances. As a consequence of the development of the disease, women's menstrual flow becomes insignificant and irregular.
  4. . Growths form on the endometrium caused by hormonal imbalances. Initially, scanty discharge appears, which abruptly turns into bleeding.
  5. Infantilism of the reproductive system organs. In addition to the fact that the amount of discharge is significantly reduced, women experience severe stomach pain during menstrual periods.

Inflammation of the genital organs

In the presence of an inflammatory process in the genital area, reproductive function disorders often occur. The factor that provokes the penetration of infection into the genitals is non-compliance with the rules of intimate hygiene, unprotected sexual intercourse or hypothermia.

With sexually transmitted infections such as colpitis, vulvitis, cervicitis, candidiasis and vulvovaginitis, the volume of discharge does not change, but only at the early stage of the disease. If the uterus, tubes and ovaries are damaged, menstruation becomes light and painful.

Symptoms of the inflammatory process:

  • pain in the lower abdomen, independent of the menstrual cycle;
  • scanty discharge (their color, consistency and smell change);
  • hyperthermia;
  • vomiting and nausea;
  • pain in the lumbar region.

Inflammation can develop against the background of decreased immunity, taking antibiotics, excessive fatigue and emotional stress.

Obesity

Weak discharge is often observed in overweight women. This is due to the fact that hormones - estrogens - are deposited in fatty tissues. When too many of them accumulate, the activity of the endocrine system is disrupted, and as a result - a malfunction of the ovaries and adrenal glands.

Changes in hormone levels lead to changes in the frequency and nature of bleeding. They become scanty, sometimes accompanied by spasmodic pain and nausea.

Liver diseases

Liver pathologies can cause hypomenorrhea. In this case, long, scanty periods are observed. Nosebleeds are often observed during menstrual periods. In this case, a mandatory medical consultation is required. If a woman’s menstruation is scanty and accompanied by other unpleasant symptoms, then she immediately needs to go to a gynecologist for help.

Iatrogenic causes

Scanty periods can appear after taking medications and as a result of medical intervention. The reason for the change in the nature of discharge often lies in the use of hormonal contraceptives, abortive measures and other special procedures.

Taking medications

One of the common causes of scanty menstruation is the use of oral contraceptives. Such changes are considered normal in most cases, but should be monitored by a doctor.

Little discharge is also observed when taking antibiotics and hormonal drugs. As a rule, after their cancellation, the cycle and volume of menstruation become the same.

Medical interventions

As a result of operations in the uterine area and frequent curettages, scars form, and the area of ​​the endometrium that functions becomes smaller. No matter how gentle modern technologies are, tissue injury and thinning of the uterine epithelium cannot be ruled out. As a result, the volume of discharge is reduced. Menstruation occurs without blood, or rather with minor losses. With properly prescribed therapy, damage can most often be restored.

Other causes affecting the menstrual cycle

The explanation for why periods have become scanty could be various external factors:

  • frequent stress;
  • poor nutrition;
  • climate change;
  • severe physical fatigue;
  • mental stress;
  • sedentary lifestyle.

Sometimes they are observed in women, but they do not always indicate the presence of pathology. We recommend reading more about this in a separate article on our website.

Treatment

As soon as scanty periods appear, you should consult a doctor who will carry out the necessary diagnostic procedures and prescribe adequate therapy. To determine the dangers of changes in the menstrual cycle and the nature of discharge, visual inspection and additional research are required.

The gynecologist will examine the medical history, basal temperature chart, hormone levels (using blood and urine tests), and diagnose sexually transmitted infections (they are determined using a smear, bacterial culture and PRC). It is possible that you will need to do an ultrasound and take a tissue sample for a subsequent biopsy.

Treatment of scanty periods directly depends on the diagnostic results. In case of malnutrition, lack of psycho-emotional balance and excessive physical exertion, the provoking factor is first eliminated. In addition, vitamin complexes, hormonal and antimicrobial agents are prescribed.

If a pathology is detected, in addition to general strengthening actions, therapy for the underlying disease is performed. Additionally, physiotherapeutic and psychotherapeutic treatment may be required, with the help of which functional disorders can be eliminated.

A change in the volume of menstrual flow does not always indicate the development of pathology, but in any case, such disturbances cannot be ignored. Only after diagnostics can the cause of these changes be identified and the cycle normalized.

During one menstrual cycle, on average, a girl loses up to 150 ml of blood. This figure may vary, but the minimum amount is usually at least 50 ml. Otherwise, we are talking about so-called hypomenorrhea. Very scanty periods - reasons, what to do, and when is it time to sound the alarm?

What is hypomenorrhea?

Normally, the volume of blood lost during the menstrual cycle ranges from 50 to 150 ml. The concept of scanty periods is used when a girl loses less than 50 ml of blood during one menstrual cycle. In medicine, this concept is called hypomenorrhea.

Most often, hypomenorrhea is observed in women along with oligomenorrhea. This is a condition in which the length of the menstrual cycle decreases. The normal duration of menstruation is three to seven days. With oligomenorrhea, this period is reduced to two days or less.

In some situations, hypomenorrhea can become a precursor to amenorrhea - the complete absence of menstruation. This is usually observed in the preclimatic period.

But scanty periods are not always a pathological condition. Sometimes hypomenorrhea is considered by gynecologists as a natural physiological condition, for example, during puberty and the formation of the menstrual cycle. And this picture can be observed for two years after the appearance of the first menstruation. The same can happen in premenopausal women, which is explained by disruptions in the functioning of the ovaries due to aging.

Very scanty periods are a serious symptom that signals the development of some pathological process in the female body. This is the case if we are not talking about a normal physiological state, as listed above.

Etiological factors

The pituitary gland and ovaries are responsible for the process of menstruation in the female body. Due to various types of malfunctions in the functioning of these organs, a decrease in the concentration of blood in the uterus is possible.

Due to frequent diseases accompanied by the development of an inflammatory process in the uterine cavity and in the organs of the reproductive system, due to abortions, curettage, and simply due to deterioration in general health, the growth and development of the endometrium on the walls of the uterus may be disrupted.

The pituitary gland is an important organ responsible for the production of female sex hormones (estrogen and progesterone).

During the ovulation period, estrogen is produced, which affects further fertilization and the development of pregnancy. In the absence of fertilization, the egg is released and the level of estrogen concentration decreases. It is estrogen that is responsible for the stages and phases of the menstrual cycle.

The second hormone produced is progesterone. It is important for the development and maintenance of pregnancy.

Both of these hormones are, in a way, the engine of the female body, during which the development of the menstrual cycle, conception, and so on occur. If this motor malfunctions, many different disturbances occur, which begin with problems with the duration and abundance of menstruation.

During the development of the menstrual cycle, the endometrium grows, which, in the absence of conception, begins to be rejected by the uterus, leaving its cavity. This causes monthly bleeding. Their abundance is primarily affected by the amount of endometrium. And the amount, in due course, depends on the stability of the pituitary gland, ovaries and the entire reproductive system.

The main causes of hypomenorrhea:

  • sudden and significant weight loss;
  • metabolic disorders;
  • frequent stress, depression, overload, lack of proper rest and sleep;
  • diseases of the reproductive system, including infectious ones;
  • hormonal imbalances;
  • history of miscarriages, abortions and curettages;
  • injuries and operations on the genitourinary system and pelvic organs;
  • lactation period (menstruation may be absent altogether and this is the norm);
  • inflammatory processes inside the body (this may also apply to other systems and organs);
  • any radiation, especially in high doses;
  • intoxication of the body, for example, severe form of poisoning;
  • taking hormonal medications, including.

Long-term diets, stress, significant changes in body weight and overload of the body - all this can negatively affect the functioning of a woman’s reproductive system. Therefore, if you are losing weight by dieting and working out in the gym, then remember the measures that should be followed.

In addition to hypomenorrhea, the above symptoms can also cause the complete disappearance of menstruation, which is especially dangerous during childbearing years.

With prolonged stress and nervous strain, reproductive function can be suspended. This is explained by the fact that the female body sees danger and tries with all its might to avoid pregnancy so as not to harm the unborn fetus.

Hypomenorrhea can be caused by a variety of factors. Only a highly qualified gynecologist can accurately diagnose and find out the cause.

Video “Hypomenorrhea - why do you have scanty periods?”

Informational video with a detailed description of the problem of scanty periods.

Symptoms

It is important to pay attention to the accompanying symptoms that occur along with scanty periods. They will help the doctor make a more accurate diagnosis and prescribe the correct treatment.

With hypomenorrhea, the discharge may change color. So, the discharge may be lighter or even brown, reminiscent of blood. Moreover, they occur either on time or with a delay, but their duration ranges from several hours to two days.

If a woman has not previously experienced any discomfort or pain during menstruation, then with hypomenorrhea the following accompanying symptoms may be observed:

  • headache and pain in the lower abdomen;
  • nausea and even vomiting;
  • discomfort and aching pain in the lumbar region;
  • pain in the mammary glands;
  • Digestive problems.

If the cause of scanty discharge is an infectious disease, then most often there is an unpleasant odor, nagging pain in the lower abdomen, severe itching and burning in the vaginal area.

All of the above diseases can provoke damage to the endometrial vascular network, which causes scanty brown discharge, reminiscent of menstruation in nature.

Diagnosis and treatment

It is imperative that a girl, faced with the problem of scanty periods and any discomfort, should consult a doctor. Only a gynecologist can make a diagnosis based on a number of factors:

  • complaints and atoms of the patient;
  • examination with palpation and colposcopy;
  • taking a bacterial culture;
  • laboratory tests to determine the level of hormone concentrations in the blood;
  • if necessary, biopsy.

It is almost impossible to make an accurate diagnosis only after an examination, so gynecologists often prescribe an ultrasound examination of the organs of the reproductive system. This is the most accurate diagnostic method, allowing you to find out the exact cause of bleeding.

If the gynecologist suspects the development of a malignant process, he can take material for a biopsy and also refer the patient for a tumor marker test.

As for treatment, in some cases it is not required at all. For example, when scanty periods appear during puberty. If serious pathologies are not identified, then it will be enough to change your diet and lifestyle. A woman is recommended to spend more time in the fresh air, take more walks, and pay special attention to rest and sleep. If necessary, sedatives may be prescribed to relieve nervous tension, stress, and improve blood circulation.

When it comes to hormonal disorders, gynecologists prescribe medications that help restore hormone levels. If necessary, oral contraceptives can be prescribed, which are often used for therapeutic purposes.

Having discovered an infection or fungal infection in the patient, antibacterial, anti-inflammatory and antifungal drugs can be prescribed.

Summing up

When asking the question: why did your periods become scanty, first of all consult a doctor. Only he can accurately answer this question in your case. Many women do not pay attention to this symptom, believing that this is the norm. At the same time, they do not even suspect the development of serious pathologies inside the body.

Severe itching, burning, pain, discomfort, dryness and lack of libido are the safest consequences of ignoring such a symptom. Much more dangerous is the development of diseases such as cervical cancer or ovarian tuberculosis.

Don’t tempt fate, but rather seek the help of specialists in time. Pathology is identified in a timely manner - the path to a speedy recovery without serious consequences.

Video “Why do I get brown discharge instead of my period?”

An informational video in which a specialist will answer common questions about hypomenorrhea, and will also help you understand why brown discharge occurs instead of menstruation.