Some women have very light periods, with very little bleeding; in some cases no more than spotting and this is known as hypomenorrhea. There could be a variety of reasons for this and often it is the symptom of an underlying problem, possibly serious and which should be resolved in order to resolve the problem of light or less bleeding during periods as well.
The factors that could underlie a woman’s hypomenorrhea are most often as follows-
Genetics
For some women, a very light period is just normal; and it could be her genetic makeup that determines the lightness of her period.
It may well be that close female relatives of the woman, such as her mother, grandmother or sister also have very light periods.
So long as the lighter periods do not have any negative consequences such as infertility this may not be any reason to worry and no treatment may be required.
Asherman’s syndrome
A condition that manifests in intrauterine adhesions or scars due to fibrosis could also cause the symptom of very light menstrual bleeding.
Hypomenorrhea is usually the only outward sign of these adhesions, which are most commonly caused by procedures such as a D &C (dilation and curettage) as an abortion, after a miscarriage and even after cesarean section deliveries or any other procedure that could cause uterine scarring.
Eating disorders
Sometimes the hypomenorrhea could be a sign of an underlying eating disorder that involves severe restriction of calories, over exercising and so on. Eating disorders that involve very small caloric intake such as anorexia nervosa can cause not only very light periods, but also irregular or absent periods and reduced fertility.
Similarly bulimia, which is the cycle of binging and purging, can also mean that a woman in has an intake of fewer than required calories and nutritional imbalances that results in lesser bleeding during menstruation.
Structural abnormalities of the uterus
The surface of the inside of the uterus which sheds the lining and consequently causes bleeding during menstruation may be less due to a reduction of the area in the endometrial cavity. This could be due to a surgical procedure or in rare cases due to uterine hypoplasia.
Hormonal imbalance
Scanty periods can occur at the time of perimenopause or as a woman approaches menopause or at the beginning of her reproductive life when she first starts her periods. Thyroid disturbances may also cause scanty menstruation because low levels of the thyroid hormone could cause anovulation. Disturbances in levels of androgen, high levels of insulin and also higher prolactin levels could cause hypomenorrhea.
Hormone based contraceptive
Long term oral contraceptive use is also associated with atrophy of the endometrial lining in the uterus which is turn causes lighter periods.
Other reasons
Sometimes the underlying cause for lighter periods could be as simple as anemia or they could have an emotional or psychological reason for it. A life changing event, a stressful period of life or bereavement could all be enough of an upheaval in a woman’s life that her periods could be scanty for a time. This situation could resolve with time.
Since scanty periods are usually a symptom, a definitive diagnosis for the underlying reasons for the hypomenorrhea should be determined before starting treatment.
