Is it normal to have less blood during menstruation?

We all know that women’s menstruation can actually help us eliminate toxins from the body and help us detoxify and maintain our beauty. So menstruation can also be said to be a barometer of our health. If menstruation is abnormal, it also means that there may be some problems with your health. Some friends have very little blood during menstruation. What causes this phenomenon? Is it normal?

This disease is equivalent to dysfunctional uterine bleeding, polycystic ovary syndrome, premature ovarian failure, or uterine adhesions after abortion or heavy blood loss in Western medicine.

The causes and pathologies of oligomenorrhea include both deficiency and excess. Deficiency is mostly due to physical weakness, serious illness, long-term illness, blood loss, or diet and fatigue that damage the spleen, or sexual fatigue that damages the kidneys, which leads to deficiency of the blood sea and reduced menstrual volume; excess is mostly due to blood stasis in the body, or phlegm and dampness stagnation, which block the meridians, poor blood circulation, and reduced menstrual blood.

【Diagnosis points】

1. The menstrual cycle is basically normal, but the menstrual volume is significantly reduced, or even stops with a few drops. This is the key point for the diagnosis of this disease, and it is often seen in the late menstruation period.

2. Some drugs can cause oligomenorrhea, such as contraceptives, antipsychotic drugs, anti-tumor drugs, and drugs for the treatment of endometriosis (such as tamoxifen, danazol, and nemethicone). In addition, drugs such as tripterygium wilfordii tablets and bromocriptine can also cause oligomenorrhea. During clinical consultation, detailed medical history should be inquired.

3. Multiple abortions or rough operations that damage the basal endometrium of the uterus or uterine adhesions can cause oligomenorrhea, so it is also necessary to inquire about the abortion surgery. Postpartum hemorrhage sometimes first manifests as oligomenorrhea, followed by amenorrhea.

4. Simple oligomenorrhea in anovulatory functional uterine bleeding is relatively rare and is sometimes a precursor to anovulatory amenorrhea. Polycystic ovary syndrome can also be seen in oligomenorrhea, often accompanied by late menstruation, weight gain, and then amenorrhea. Patients with premature ovarian failure also first experience oligomenorrhea and then amenorrhea.

5. For patients with scanty menstruation and late menstruation, miscarriage or ectopic pregnancy should be ruled out first. Urine, blood pregnancy tests and B-ultrasound can be used for identification.

To diagnose and differentiate the above diseases, the following contents can be used as reference:

(1) Carefully inquire about the patient's medical history: past menstrual history, history of amenorrhea, fertility history, history of abortion, history of chronic diseases or medications that affect menstruation, history of gynecological diseases, etc.

(2) Gynecological examination: Check whether there are any special abnormalities in the internal and external genitalia. If it is polycystic ovary syndrome, the ovaries on both sides are slightly enlarged. If it is endometriosis, one or both ovaries are enlarged and cystic, adhered to the uterus, and the uterine body is fixed and tilted backwards, and nodules can be felt in the isthmus of the uterus.

(3) Pelvic B-ultrasound (or vaginal B-ultrasound): It has reference value for diagnosing miscarriage, ectopic pregnancy, endometriosis, polycystic ovary syndrome, intrauterine adhesions, etc. (see the diagnosis of each disease for details).

(4) Blood endocrine examination: Examination items such as T, PRL, FSH, LH, E2, P, etc. are of reference value for the diagnosis of polycystic ovary syndrome, premature ovarian failure, anovulatory functional uterine bleeding, etc. (see relevant chapters). Taking sex hormone drugs may affect the results of blood endocrine report.

Through the detailed introduction above, we know that if the amount of blood during menstruation is relatively small, it is best to go to the hospital for examination, because if the amount of menstrual blood is small during adolescence, it can easily lead to amenorrhea. If the amount of menstrual blood is relatively small for people in menopause, it can lead to menopause. No matter which situation it is, it is relatively serious, so it must be handled with caution.