Hypomenorrhea is a menstrual disorder. The bleeding is very light and usually lasts less than two days.
What is hypomenorrhea?
Menstrual bleeding is very weak in hypomenorrhea. It rarely lasts more than two days, in rare cases the bleeding lasts only a few hours. See AbbreviationFinder for abbreviations related to Hypomenorrhea.
Hypomenorrhea is a term used to describe missed, weak or infrequent menstruation. Menstruation is monthly bleeding from the uterus. If an egg is not fertilized during the cycle, the uterine lining is broken down and shed with the menstrual period. Normally, a woman’s menstrual cycle lasts around 28 days, with a cycle being defined as the time from the first day of menstruation to the last day before menstruation.
A cycle length of 25 to 35 days is considered normal. The bleeding lasts an average of four days. During menstruation, a woman loses between 65ml and 200ml of fluid. This consists not only of blood, but also of other secretions and mucous membrane residues. In hypomenorrhea, bleeding usually lasts less than two days. The bleeding is only very light, so that the blood loss is often less than 25 ml. One also speaks of spotting. The cycle time is unaffected by the disturbance.
Causes of hypomenorrhea can be organic or hormonal. A common cause is atrophy of the uterine lining. Atrophy is tissue wasting. This can be constitutional or caused by repeated scrapings of the uterus, so-called curettage. Long-term use of progestins (corpus luteum hormones) can also have a negative effect on the endometrium.
Progestins are part of contraceptives such as the pill. Consequently, if the lining of the uterus does not grow properly during the cycle, it cannot be shed. This results in less bleeding. Especially overweight women and women suffering from anorexia can be affected by hypomenorrhea. The reason for this is ovarian weakness.
The ovaries do not produce enough hormones as a result of malnutrition. This prevents the lining of the uterus from growing properly. This in turn leads to a reduced breakdown of the mucous membrane in the second half of the cycle. Stress is also a factor affecting menstrual bleeding. Mental stress, professional or private stress and even strong climate changes such as on vacation have an impact on the menstrual cycle and can cause hypomenorrhea.
Gynecological diseases such as ovarian cysts, endometriosis or cancer of the ovaries and uterus should also be considered as possible causes of hypomenorrhea. The same applies to metabolic and hormone disorders such as diabetes mellitus or thyroid dysfunction.
Symptoms, Ailments & Signs
Menstrual bleeding is very weak in hypomenorrhea. It rarely lasts more than two days, in rare cases the bleeding lasts only a few hours. The amount of blood is rather small, usually there is only spotting. In contrast to hypermenorrhea, i.e. very heavy menstrual bleeding, hypomenorrhea usually does not cause any other symptoms.
A general feeling of illness, weakness or pain is not observed in the majority of cases. Hypomenorrhea is actually rather harmless, some women may even be grateful for the rather weak bleeding. Hypomenorrhea only becomes problematic when those affected want to have children. However, the problem is not the low menstrual period, but rather the weak lining of the uterus, which is the cause of hypomenorrhea.
A prerequisite for pregnancy is that ovulation takes place and that enough lining of the uterus has built up so that the fertilized egg can implant itself. Hypomenorrhea can be an indicator that one or both of these conditions are not met.
Diagnosis & course of disease
The foundation of the diagnosis is a detailed anamnesis with precise documentation of the course of the menstrual cycle and the amount of bleeding. A gynecological examination of the ovaries and uterus follows. A uterine endoscopy measures the thickness of the lining of the uterus. A blood test should also be carried out to further clarify the cause.
Hormones such as estrogen, progestin, progesterone and testosterone are determined in the blood. Hormone diagnostics via the saliva is also possible. If more serious causes such as cancer are suspected, imaging methods such as ultrasound or CT can be used. If a metabolic or thyroid disorder could be the cause of the hypomenorrhea, blood sugar and/or thyroid hormones must be tested.
If you wish to have children, the cycle will be examined even more closely. It must be determined whether ovulation is still taking place at all or whether the hypomenorrhea is only due to a weak lining of the uterus. To do this, the woman has to measure her basal body temperature over a longer period of time every morning immediately after waking up. The temperature curve within the cycle then shows whether ovulation is taking place.
As a rule, hypomenorrhea does not lead to any particular complications or symptoms. Due to hypomenorrhea, the bleeding during a woman’s period is very light and only lasts for a very short period of time. It mainly comes to the so-called spotting. However, there are no other symptoms, so the patient does not feel ill and does not suffer from pain.
In most cases, hypomenorrhea is actually a desired effect, since bleeding is reduced and there is no particular pain. However, hypomenorrhea can also be a sign that fertilization has not taken place and that the person concerned is not pregnant.
This often leads to psychological problems when the couple’s desire to have children cannot be fulfilled. The partner also suffers from mental illnesses. Hypomenorrhea is usually not treated and will go away on its own. For this reason, there are no further complications. Changes in life circumstances often help to influence hypomenorrhea.
When should you go to the doctor?
If the menstrual period is repeatedly very weak, the gynecologist should be informed. Bleeding that lasts only a few hours or days indicates hypomenorrhea, which must be clarified by a doctor in any case. If this is accompanied by a general feeling of illness or a feeling of weakness, the gynecologist must be consulted on the same day. Although the disease is relatively harmless, it can indicate infertility. Therefore, if you have hypomenorrhea, you should always go to the doctor, even if the mild bleeding may even be perceived as pleasant.
Women suffering from endometrial atrophy are particularly prone to developing hypomennorrhea. Long-term use of the pill can also cause menstrual cramps. Affected women should have a physical examination and talk to their doctor about changing their medication. Patients suffering from hypomenorrhea associated with a gynecological condition such as ovarian cysts or tumors should speak to their doctor. If you feel very unwell, you should go to a hospital.
Treatment & Therapy
Hypomenorrhea often normalizes on its own. Especially if the trigger is psychological, the hypomenorrhea can disappear on its own if you change your circumstances, for example by reducing stress. In principle, therapeutic treatment is only necessary if the causes of the hypomenorrhea endanger the patient or if there is a desire to have children.
The therapy is usually carried out with hormone preparations. If hypomenorrhea is due to underlying causes such as cancer or endometriosis, surgical procedures may be necessary to treat hypomenorrhea.
Since stress can have a negative effect on the menstrual cycle, hypomenorrhea can also be prevented by reducing stress. Relaxation methods such as autogenic training or gentle endurance sports can be helpful here. Weight normalization also has a positive effect on hypomenorrhea.
This applies to both underweight and overweight women. A balanced diet and avoiding stimulants such as alcohol or nicotine can also prevent hypomenorrhea. Regular check-ups at the gynecologist make sense as part of general prevention.
When the condition returns to normal after hypomenorrhea, some follow-up advice is available for affected women. Among other things, avoiding stress can help to improve living conditions and prevent the disease in the future. Therapy may also make sense, but is usually only an option for patients for whom the health risk is quite high or who wish to have a child.
Depending on what triggers the menstrual cramps, the doctor may prescribe long-term medication. These are used for aftercare and prevention at the same time. Relaxation techniques are also helpful, as are gentle exercise methods such as yoga. The normalization of body weight also plays a role after successful treatment.
This applies to both overweight and underweight women. In connection with the renunciation of nicotine, alcohol and other stimulants, those affected strengthen their body awareness. With proven medicinal plants and household remedies, it is possible to carry out the aftercare consistently.
In general, patients can avoid strong drugs with side effects if they choose the gentle method. In addition to these self-help measures, regular check-ups by the gynecologist are important to ensure that there is no serious reason for the disorders.
You can do that yourself
Hypomenorrhea usually returns to normal on its own. Various self-help measures and some household and natural resources promote recovery.
As with other menstrual cramps, warmth is the main remedy for hypomenorrhea. A hot bath relaxes the muscles of the uterus and reduces cramps and pain. Exercise—whether it’s biking, swimming, or jogging—releases pain-relieving endorphins and inhibits the production of prostaglandins, which trigger pain and inflammation. Support bras help with breast pain.
A suitable remedy from nature is vitamin B6. Taken as a dietary supplement, the substance helps against irritability and depression. Magnesium also promises quick help. Naturopathy mainly recommends magnesium phosphate C12 or C6. Alternatively, there are the preparations Nux vomica and Pulsatilla. Ginger and St. John’s wort are also proven remedies for menstrual cramps due to their soothing effect.
Changing your diet can also help with hypomenorrhea. Soy products in particular should be on the menu because they reduce pain and prevent new complaints. If the symptoms do not subside despite all measures, it is best to speak to the gynecologist again.