Too little menstrual blood? Possibility of hypomenorrhea or hypermenorrhea! What is the purpose of going to the hospital?

In the case of hypomenorrhea, where the amount of menstruation is extremely small, many women tend to ignore it because it is easier for menstruation. However, if you are in your 30s or later and you are experiencing hypomenorrhea, it is not just a hormone imbalance. Without proper treatment, it may lead to infertility or dysfunction, so let's understand the difference from normal menstruation, when you need treatment, and when and where to see a doctor.

Find out in this article

  • What is menorrhagia? How is it different from normal menstruation?
  • What causes menorrhagia?
  • Should I go to the hospital for menorrhagia?
  • How to check and treat hypomenorrhea?

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What is hypomenorrhea

Hypomenorrhea is defined as abnormally low menstrual flow during menstruation. Normal menstruation is repeated in a cycle of 25 to 38 days, lasting for 4 to 7 days, and normal menstrual blood volume is said to be about 100 ml per menstruation. In general, menorrhagia is when menstrual flow is so low that it is not necessary to change pads. Menstruation that lasts for less than 2 days is called "hypershort menstruation".

The difference between normal menstruation and irregular menstruation

The Japan Association of Obstetricians and Gynecologists defines irregular menstruation as shown in the table below. It is rare that only one of these conditions applies, and in some cases, multiple cases such as “long menstruation” and “large quantity” → (prolonged menstrual period and excessive menstrual period) are recognized.

short/fast normal long/slow
menstrual cycle frequent menstruation 25-38 days Oligomenorrhea
menstrual days short menstrual period 3-7 days Prolonged menstruation
menstrual flow hypomenorrhea
(As much as you don't need to change napkins)
20ml~140ml menorrhagia
(Napkin does not last for 1 hour)
Periodic fluctuation Irregularity within 6 days Irregularity

Causes of hypomenorrhea

Hypomenorrhea, in which the amount of menstrual bleeding is abnormally low, can be caused by an imbalance of female hormones, abnormal secretion of female hormones, abnormalities and diseases of the uterus itself such as underdevelopment of the uterus and adhesion of the uterine lining. You can

female hormone imbalance

Estrogen, a female hormone, causes the lining of the uterus to thicken, and progesterone, another female hormone, causes the lining of the uterus to slough off, and the menstrual blood is expelled. Low menstrual flow is caused by hormonal abnormalities such as insufficient production of estrogen, which thickens the lining of the uterus, and insufficient progesterone, which has the effect of shedding the lining of the uterus. Female hormones are also disturbed, and it is said that there are many causes of daily stress and excessive diet.

Read the following articles together
How to adjust female hormones that are easily disturbed

Disorders that cause abnormal secretion of female hormones

Here are some of the most common disorders that cause female hormone imbalance.

  • Polycystic ovary syndrome (a disease of the ovaries)
  • Luteal insufficiency (ovarian disease)

Abnormalities in the secretion of female hormones are often caused by diseases of the ovaries. Although very rare, aside from abnormalities in the ovaries, another possible cause is the development of tumors that make it easier for the brain to secrete hormones.

disease of the uterus

Despite the fact that the secretion of female hormones is normal, there is also the possibility of diseases such as congenital uterine hypoplasia and endometrial adhesions. The lining of the uterus cannot thicken normally, and menorrhagia may be too light or too short.

If you are in your teens, menstruation may have just started and is not stable.

For women in their teens and 20s, the uterus is not yet mature and the ovaries are not fully developed. As a result, estrogen and progesterone secretion may be erratic or low. In this case, don't worry. As the uterus grows and ovarian function develops, menstruation usually becomes normal.

What is the guideline and timing to go to the hospital for hypomenorrhea?

Women in their 20s and younger who have just started menstruating and women in their 40s and 50s who are close to menopause tend to have hormonal imbalances and are prone to hypomenorrhea due to unstable menstrual flow. So in most cases it's nothing to worry about. However, a sudden decrease in menstrual flow and new pain in the lower abdomen, although previously stable, or light and short menstrual periods Be careful if it continues for months. It may be a sign caused by some disease, so don't ignore it and visit a gynecologist or obstetrician. Hormone secretion abnormalities from the ovaries or other thyroid diseases may be hidden.

What is the treatment if you visit a hospital for hypomenorrhea?

After an interview by a gynecologist, tests such as a pelvic examination, transvaginal ultrasound, blood tests to check for hormonal abnormalities, and urine tests are performed. The test is painless, so don't worry. Depending on the test results, we will proceed with appropriate treatment methods such as hormone therapy. If uterine fibroids are found, surgery may be required.


After an examination by a doctor,

  1. [Vaginal examination (palpation)]

    A finger is directly inserted into the vagina to check the shape and hardness of the uterus to see if there are any abnormalities.

  2. [Ultrasound test and hormone test (blood test)]

    Ultrasound exam: An ultrasound machine is used to check the uterus and ovaries for structural abnormalities.

    Hormone tests: Blood tests to check for abnormal levels of estrogen and progesterone.

hormone therapy

Diseases that cause oligomenorrhea include anovulatory disorders, hyperprolactinemia, thyroid dysfunction, and luteal insufficiency, which are endocrine disorders related to hormone secretion. If hypomenorrhea is caused by these factors, drug treatment with hormone drugs that normalize hormone secretion is performed. First of all, we will check how the hormone secretion is abnormal and treat it with drugs that promote or suppress hormone secretion.

If there is an abnormality in the uterus, surgery may be performed.

As a disease that causes oligomenorrhea, there is also an organic disease in which abnormalities are seen in the uterine and ovarian organs. Organic diseases include uterine malformation, intrauterine adhesions, and uterine hypoplasia. Depending on the disease, surgical treatment of the uterus, such as removing the abnormal part, is performed.

In surgery for uterine abnormalities as described above, hysteroscopic surgery, in which medical instruments such as a camera are inserted into the uterus, is generally performed. In addition, even if the symptoms are organic, if the symptoms are mild, it may be judged that surgical treatment is unnecessary. Hormone therapy may also be effective for organic diseases.


Poor menstrual flow in young teens and premenopausal women is caused by hormonal imbalance. In that case, no treatment is needed. However, if it is caused by an endocrine disorder or an organic disorder, drug treatment with hormones or surgical treatment may be necessary. If your menstrual period has suddenly decreased, or if your menstrual period has become shorter, please consult a gynecologist/obstetrician/gynecologist.

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