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Hypomenorrhea is a condition where women experience very little bleeding during their menstrual periods. It can be caused by benign factors such as genetics, hormonal contraceptives, or uterine surgery, or by more serious factors such as hormonal imbalances. It may affect fertility, but not always. Women should discuss any concerns with their doctor.
When women have hypomenorrhea they have menstrual periods that involve very little bleeding. This bleeding is considered substandard, hence the prefix hypo, which means less or less. This condition can have completely benign causes, which do not require any treatment. Other times it may indicate ongoing problems that should be addressed. Understanding the cause determines whether treatment or investigation of the problem is necessary.
Some benign causes of hypomenorrhea include genetic predisposition, use of hormonal contraceptives, and previous uterine size reduction surgery. By genetic predisposition, we simply mean that some women have very light periods, and this could be seen in their family history, where several generations of women have experienced a similar light flow. Provided light periods do not interfere with fertility and no other menstrual problems are present, this should not be treated.
Birth control pills and other hormonal methods of contraception such as the patch can cause periods to become extremely light. Some hormonal contraceptive methods are marketed to reduce the total number of periods per year and cause light flow. As this is a desired side effect of these pills, it is not a cause for concern. Uterine surgery that reduced the size of the uterus is generally considered a likely explanation for hypomenorrhea, and the condition could only be investigated if it created further problems.
There are other causes that aren’t exactly benign, but don’t usually indicate a serious problem unless they’re ongoing. High levels of stress can cause an occasional light spell, or a succession of them. Persistent eating habits that include fasting or near starvation can also reduce menstrual flow. Most of the time, if these are the causes, they are transient and might only affect one or two periods. If intense stress continues or extremely poor nutrition is always present, these conditions require the guidance of a doctor to help manage stress, discuss issues with nutrition, or plan a more nutritious diet.
Another cause of hypomenorrhea that deserves investigation and medical attention is an imbalance of different types of hormones. These can be major “female” hormones such as estrogen or progesterone, or they could be hormones such as thyroid hormones, which help regulate many of the body’s systems. Doctors can assess hormone levels by doing blood tests.
Sometimes this condition makes it difficult to get pregnant because the body doesn’t create enough uterine lining each month to sustain a pregnancy, but this matter is a bit confusing. Some women with this condition are able to become pregnant and have children. However, women not on treatments such as hormonal birth control should not assume that a light period is related to low fertility levels.
It’s important to mention conditions like hypomenorrhea at yearly gynecological exams where doctors can determine if further investigation is needed. If your light periods are accompanied by other unusual symptoms or if your periods subside completely, waiting a full year is not recommended. Women should talk to their doctors first in these cases.
