Hello
Thank you for your query.

Hypomenorrhea or hypomenorrhoea, also known as short or scanty periods, is extremely light menstrual blood flow. It is considered significant if the menstrual bleeding is less than 2 days. It is not considered a major thing to worry about, if the cycles are regular. In some women it may be normal to have less bleeding during menstrual periods. Less blood flow may be genetic and, if enquiries are made, it may be found that woman’s mother and/or sister also have decreased blood flow during their periods. Pregnancy can normally occur with this type of decreased flow during the period, and you need not worry if this runs in the family.

In other instances, Reduced menstrual flow is a common side-effect of hormonal contraception methods, such as oral contraceptive pills, IUDs that release hormones (such as Mirena), or hormonal implants such as Depo-Provera.

Scanty menses or periods can occur normally at the extremes of the reproductive life that is, just after puberty and just before menopause.

However certain other conditions cause this type of menstrual bleeding :
Anovulation due to a low thyroid hormone level, high prolactin level, high insulin level, high androgen level and problems with other hormones can also cause scanty periods. This picture is commonly seen in the syndrome called Polycystic Ovarian Syndrome. This may impact fertility and also lead to other medical complications.

Another common reason is Asherman's syndrome (intrauterine adhesions), of which hypomenorrhea (or amenorrhea) may be the only apparent sign. Adhesions maybe caused due to previous uterine surgery or handling, but sometimes, these adhesions appear for no reason. Genital tuberculosis , particularly in India, is a leading cause of scanty menses, and can also lead to intra uterine adhesions.

Scanty loss sometimes means that the bleeding surface is smaller than normal, and is occasionally seen when the endometrial cavity has been reduced in size during myomectomy or other plastic operation on the uterus. It might also be seen in cases where the uterus is genetically small , the condition is called hypoplastic uterus.

Psychogenic factors such as stress due to exams, or excessive excitement about an upcoming event may cause hypomenorrhoea. Excessive exercise and crash dieting can cause scanty menstrual periods

Most of the common cause of decreased flow of blood during the menses can be detected by blood tests. Tests for the level of hormones such as follicle-stimulating hormone, luteinizing hormone, estrogen, prolactin, insulin are important. In polycystic ovarian syndrome, there will be high levels of insulin and androgens. An ultra sonogram can diagnose the thickness of the endometrium, size of the ovaries growth of follicles, ovulation and other abnormalities.
Tests such as dilation and curettage and MRI scans are sometimes needed to determine the cause of scanty blood flow during the periods.
Hysteroscopy maybe needed to visualize the interior of the uterine cavity.

Unless a significant causal abnormality is found no treatment other than reassurance is necessary. Otherwise, treatment is determined by the diagnosis of any significant causal abnormality.

Hence, I advise you to consult a Gynaecologist, particularly if you are married, and are having difficulty in conceiving.

Take care, and feel free to ask for further clarifications.

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