To determine women's health in reproductive age can be on the menstrual cycle.
Deviations from the norm can be interpreted as a normal phenomenon, if it is insignificant, or a pathological symptom, with the development of some disease.
In this case, monitor the regularity of their flow, intensity, color, profusion, pain, accompanying them.
Are the first menstrual periods after childbirth scarce as a deviation from the norm, or should it be by nature or is it an alarming signal and you should immediately visit a gynecologist? The reasons for this phenomenon may be several, we will examine each in detail.
Hypomenorrhea - what is this pathology
Scanty discharge during menstruation in medicine is called hypomenorrhea. The main symptom of this phenomenon is inflammation or dysfunction of the menstrual cycle.
Hypomenorrhea is characterized by a decrease in the duration of discharge and a small amount of blood secreted by the body. To clearly understand whether this is considered a serious pathology and evidence that a serious restructuring or development of any diseases occurs in a woman's body, it is necessary to understand which periods are considered scarce.
Scanty is considered to be discharge in the form of a slight trace or droplets of a brown color (can be light brown or dark brown).
Normal menstruation is bright red. Normally, the loss of female menstrual blood is 50-150 ml, with hypomenorrhea only 50, sometimes even less.
In fact, every woman is obliged to keep a calendar of beginning and end of menstruation, this allows you to monitor women's health, especially if you plan to become pregnant in the future.
What should be considered a pathology, and what is the norm
Gynecological standards of the menstrual cycle in the normal range:
- Painless at all or slightly painful
- Last no more than 5 days
- Intermediate time interval between cycles of 21-35 calendar days
To deviate from the norm include:
- Rare monthly (Opsomenorrhea) - 1 time in 1.5 or 2 months
- Scantiness of discharge - 50 ml and less
- Shortened (oligometry) - 3 days
- Non-permanent (Spanimenorrhea) from 2 to 4 times a year
The scarcity of secretions can talk about the onset of menopause - this phenomenon is considered natural and is not a deviation from the norm. It occurs mainly at the age of 45, although there have been cases when the extinction of childbearing functions occurs in the period from 38 to 40 years.
Causes of poor monthly
Prerequisites of hypomenorrhea are hormonal imbalance disorders and their regulation in cyclical changes. Factors of this manifestation are:
- The presence of toxic substances.
- Infectious diseases: influenza, tuberculosis, other viral diseases.
- Endogenous intoxication, where the body itself produces toxins.
- Unbalanced diet for weight loss
- Acute vitamin deficiency.
- An excess of adipose tissue in the body (this is an endocrine organ that negatively affects ovarian function).
- Brain injury.
- Anemia, neoplasms affecting the central nervous system.
- The result of exposure to the body of radiation energy, including x-rays.
- Inflammation in the body of the uterus or its appendages.
After birth, scanty periods appear
Woman after childbirth
Postpartum bleeding is called lochia in medicine.
They are moderate, reminiscent of a monthly cycle of 4 or 5 days.
Continue up to 10 days, after being modified into a mucous and blood form.
After 14 days, they are generally transformed into whites.
When examining such contents under a microscope, it is clear that there are no red blood cells in it, and they consist only of desquamated epithelial cells from the inside of the uterus.
Sometimes, it is extremely rare, lochia can be prolonged, right up to 42 days from the moment of birth of the child with a gradual decrease in the blood released. According to WHO, postpartum hemorrhage is a condition in which a woman has to change the gasket more times in an hour.
In this case, the woman should immediately notify the doctors, being in the hospital, or go there after discharge. This phenomenon cannot be considered normal, the danger for women in such cases is very great.
The first periods after childbirth scant lactation during lactation is considered the norm. Since the body of a nursing mother, besides milk, produces prolactin, it is considered to be the main factor of hypomenorrhea. Against this background, menstruation can be scanty and irregular.
The truth is that during this period women have a high probability of a new pregnancy, especially when the hymen 6orea has come a little ahead of time. Any doubts can be checked with a pregnancy test or a gynecological examination by a doctor.
When should the first postpartum menstruation appear
During gestation, the endocrine system of the expectant mother intensively produced progesterone (pregnancy hormone). After childbirth, it is gradually rebuilt for normal operation, causing a delay in the outflow of blood that the body has spent (menstruation).
The temporary cessation of menstruation, after childbirth, is due to the restoration of hormonal balance after pregnancy.
After some time, the cycle is restored and appears according to the schedule. The recovery period depends on the subjective characteristics of women. Sometimes it can take up to 3 months.
No need to panic when between the first cycle and the second, not 28 calendar days pass, as usually happens, but 2 months. This is considered normal, especially if the woman in labor is breastfeeding the baby.
Do not be afraid if the monthly allocation will go ahead of the woman’s intended term. The fact that they will not go can be considered the lack of ovulation.
The final schedule of the offensive should be restored after the 3rd menstrual cycle. The rapidity of recovery of the cycle, the timing and intensity of periods are directly dependent on breastfeeding the baby.
After childbirth, the mother’s endocrine system produces prolactin, or milk hormone. It strongly suppresses the functioning of the ovaries, because ovulation may not come, the removal of the egg from the female ovaries is blocked, and therefore there are no monthly periods.
If a woman in labor refuses breastfeeding, her body stops producing prolactin and after 2 months the cycle is restored one hundred percent. Often the nature of the flow of postpartum menstruation is modified.
If, for example, before pregnancy they were accompanied by severe pain, then after it they do not cause discomfort at all, the cycle begins and passes less painfully. This is explained by the fact that in the generic process the bending of the uterus is eliminated, it was he who hampered the exit of blood from it, causing severe pain.
Natural cycle recovery process
Factors to help quickly restore menstruation schedule:
- Proper organization of the day regimen
- Full, healthy vacation
- Balanced diet
- Psychological calm
- No complications after childbirth
- Lack of chronic diseases
The primary cause of the phenomenon when the first menstrual periods after childbirth are scarce and prolonged is considered excessive production of prolactin due to:
- Benign tumor - prolactinoma responsible for milk production
- Pathological changes of the endocrine system
All this together increasing the production of milk or prolactin, which significantly suppresses the synthesis of other hormones that are important in the recovery process, in particular those that regulate menstruation.
Why is the first menstruation after childbirth painful
Sometimes its appearance after the birth process is accompanied by severe pain, gynecologists explain this:
- Endometrial function impairment
- Weak rejection of endometrial tissue from uterine tissue
- Glut of prostaglandins
- High pain threshold
Pain localized in the lower abdomen, throughout the area or in the middle of it, is undulating, resembling weak prenatal contractions, in nature. In some women, menstrual cramps are given in the area of the federicorectal.
Postpartum menstruation may be accompanied by headache, dizziness, nausea, or abdominal cramps.
There are many means to reduce the physical suffering of a woman during this period, you can use them or motivate yourself for any intellectual activity. Volitional switching often helps to reduce pain, or rather to distract from it.
When it is necessary to see a gynecologist
It is necessary to visit a gynecologist if:
- After the cessation of feeding the baby immediately after birth, the period did not occur
- In the discharge (blood) there are clots of medium and large sizes
- The color of the monthly blood bright bright
- There is severe pain in the uterus.
- Menstruation is very abundant and long-lasting - more than 7 days.
It is recommended to use pads, covered with an absorbent mesh, or tampons after a full recovery of the menstrual cycle. Swabs impede the normal outflow of blood, and this is a very undesirable phenomenon after birth.
Mesh pads can cause irritation to the mucous membranes, especially if it is slightly injured or there are postpartum sutures on the perineum. In this case, it is more expedient to use gaskets having a smooth surface and a soft inner part. Change them every 4 hours.
During the period of lochia excretion, it is recommended to completely abandon hygiene gels when washing away, and, of course, from sexual intercourse.
Diagnosis of potential diseases
With scanty postpartum menstruation, diagnosis is needed to clarify the causes and extent of hypomenorrhea, indicating the safety of the complexatory properties of women's health. There are two degrees:
- The first is characterized by the reactive appearance of menstruation progested substances. It is evidence of a decrease in the synthesis of progesterone by the ovaries, the safety of estrogenic products.
- The second phase of hypomenorrhea. Here neither the presence of progesterone, non-esterogenes are not a reason for scanty menstruation. Their presence may indicate that pathological disorders occur in the body.
The second stage is diagnosed in the laboratory, where the task of the study is to determine the presence of a specific list of hormones:
- Luteinizing hormones
- Liberin hypothalamus
Based on the results of diagnostics, the third stage can be organized. It is necessary to establish the causes of deviations from the norm or the development of pathological changes in the body. Common causes of pathologies:
- Brain Inflammations
- Mental or psychological disorders
- Head injuries
- Metabolic disorders
- Violations in the vascular system
- Sclerocystic ovaries
- Abundant postpartum blood loss
- Dramatic weight loss
Measures used in the diagnosis:
- Ultrasound of the ovaries, appendages and uterus
- Roentgen turkish saddle
- The presence in the body of the uterus synechia he is Asherman's Syndrome
And other related or additional research.
Treatment of postpartum hypomenorrhea
Hormone therapy after childbirth
Therapy for scant menstruation is chosen based on the exact diagnosis and the degree of development of pathological changes.
Most often, gynecologists prescribe progesterone treatment, which is designed not only to normalize the menstrual cycle after childbirth, but also to correct the hormonal imbalance or their existing disorders.
Restorative progesterone therapy may not be necessary at all, since in a healthy woman a cycle violation occurs no more than once a year.
If similar episodes are observed more often or scanty puerperal menstruation is accompanied by an intense release of blood clots, then the doctors prescribe a special therapy for the patient based on the identified, if diagnosed, disorders:
- When hyperprolactinemia shows therapy with dopamine blockers. Sometimes surgeons may need to intervene in treatment when tumors are found in the pituitary gland.
- With abundant postpartum hemorrhage (Sheehan syndrome) hormone replacement therapy is prescribed, designed to enhance the production of the desired hormone, the pituitary gland. And the sooner such treatment is applied, the faster and more efficiently the response of the peripheral organs to treatment will be achieved.
- Sclero-cystic ovaries accompany anovulation, so the doctors prescribe honey to stimulate her. drugs. At the same time, the adjustment of the menstrual cycle occurs.
- In Asherman's syndrome (the presence of synechiae inside the uterus), frequent curettage, abortions or inflammatory processes inside the body of the uterus are considered the dominant causes of poor menstruation. To treat such a violation is very difficult. Doctors recommend diagnosing pathology as soon as possible and proceeding immediately with cyclic hormonal treatment.
There were attempts to transplant a healthy endometrium into the patient’s place, but, unfortunately, they were ineffective and unsuccessful.
Prolonged absence of menstruation after childbirth and not only, severely painful or intense, sometimes with clots, or the presence of other symptoms listed above - a signal to quickly contact the antenatal clinic to diagnose dysfunction and health of the organs responsible for women's health. Any delay can aggravate the occurrence of hidden diseases, despite the fact that most of them are fraught with serious consequences.
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Diagnosis and treatment
Diagnostics by an experienced doctor will consist of several steps.
The first thing that the gynecologist will do is conduct a personal examination of the patient and frankly speak with her. You will also need to take a blood test, urine and a vaginal smear. Ultrasound examination of internal organs, MRI and biopsy of uterine tissues may be required. These studies should be carried out only after consulting a professional and personal prescription.
The method of treatment will be negotiated with the doctor only after a thorough diagnosis.
Of the general recommendations, the doctor may advise to normalize your weight to the desired level - to recover or lose weight. It is also worth mentioning the benefits of proper nutrition, an active lifestyle and the destructiveness of bad habits (smoking, alcohol, a large amount of coffee, harmful foods, lack of sleep).
Of the drugs should pay attention to the soothing, vitamin complexes and products containing iron in large quantities. When inflammations are found in the body, the doctor will prescribe drugs that have anti-inflammatory effects, as well as antibiotics and painkillers.
If the problem is hidden in the perception, it makes sense to seek help from a psychologist or psychotherapist. It will be useful to use such methods as: yoga and stretching, meditation, soothing herbal teas (a good choice is mint, chamomile, rose, sage and lavender), melodies for relaxation and sound sleep.
Norm or disease?
Some women do not attach any importance to the features of their cycle. And very vain. If you want to have children and maintain health for many years, you need to be attentive to the features of the critical days. Violations of the menstrual function gynecologist fixes, if the woman’s cycle deviates from such norms:
- no pain or little pain during menstruation
- duration of critical days at least 3 days
- the interval between menstruation is from 21 to 35 days
- during menstruation, 50 to 150 ml of blood is excreted.
It is advisable to create a special table for entering the start dates of critical days, the duration of the monthly cycle and other factors that were mentioned above. You can also measure basal temperature to know if your ovarian function is normal. Basal temperature is usually measured by those who suspect infertility, or those who want to get pregnant soon.
Hypomenorrhea - monthly, in which an unusually small amount of blood is released. It may be traces or drops of blood. In shade, they can be light brown or dark brown. And this is not the norm. Hypomenorrhea indicates the presence of a particular pathology that needs to be detected.
Scanty periods are not pathological only when becoming and at the end of the cycle. These are two periods in the life of a woman / girl. With menarche, menstruation is scanty. The cycle is set in about a year. Its unevenness cannot be considered a deviation in puberty.
Types of scanty periods:
- opsomenorrhea (cycle duration from 1.5 to 2 months)
- hypomenorrhea (blood discharge less than 50 ml)
- oligomenorrhea (the duration of critical days is up to 3 days)
- Spanimenorrhea (monthly come only 2-4 times a year)
Угасание репродуктивной функции называется в медицине пременопаузой. Как уже отмечалось выше, скудность месячных в этом период — норма. Меняется соотношение уровня гормонов в организме. A woman enters the premenopausal period at the age of 45 years and older. But in recent years, more and more "young" cases of premenopause have been recorded.
Primary register when the girl never had the usual critical days. Secondary means that menstruation was normal, and once became scarce. Primary hypomenorrhea may be in the presence of congenital pathology of the genital organs. But these are extremely rare cases. The reason for the first scanty critical days may be in the abnormal development or underdevelopment of the female genitals. Or it is a variant of the norm, and in a few months the cycle will already be stable, and the discharge will be in sufficient quantity.
With scanty periods, there may be no pain. But in some cases, the woman feels a lot of pain. Also, menstruation may vary in intensity and duration. Scanty periods are often noted by women after a delay. In this case, the ICP is very pronounced. And there are such accompanying symptoms:
- lower back pain and breast
- lower abdominal pains caused by uterine cramps
- bowel disorders
In rare cases, poor menstruation is accompanied by bleeding from the nose. Since the level of estrogen is reduced, sexual desire can be very low. If at the reproductive age, the patient had normal periods, and then there were irregularities, you need to assign additional research methods to establish the cause.
Scanty period after childbirth
Often, a small amount of menstruation or cycle disorders may occur after the woman has given birth, if lactation is absent. Then the menstruation is fixed 6-8 weeks after delivery. Also in such cases, menstruation can be abundant, there is no regularity. The first discharge on critical days after birth may be brown. After birth, the hormones again change their relationship, and the cycle is normalized gradually, over several months.
The cycle can begin to be established even for those who are breastfeeding, especially with the transition to supplemental foods. The hormone prolactin, without which lactation is impossible, is not produced. This allows the egg to mature and leave the ovary. Scanty periods after childbirth for several months are not considered pathological. But, if they are constantly such, you need to be examined for various pathologies.
Scanty period after scraping
Violations of the cycle can be triggered by any intrauterine intervention, be it an operation for polyps, curettage for diagnostic purposes, abortion with complications, etc. As a result of these operations, the ratio of hormones changes, which provokes the inferiority of the endometrial layer of the uterus.
If, after curettage, there are not only scanty periods, but also increased body temperature, abdominal pain, unpleasant smell from the genital tract, then it is urgent to go to the gynecologist for an appointment. In such cases, inflammation is likely. If abdominal membranes are not completely removed, the pathological process will also begin.
Causes of poor monthly
In women of reproductive age, poor monthly periods are mainly due to disorders in the pituitary and ovaries. They produce sex hormones that affect the characteristics of the cycle. Amenorrhea can be caused by the so-called Sheehan syndrome, that is, pituitary insufficiency.
Ovarian dysfunctions become a consequence of the influence of external factors, or changes in the level of hormones in the body, or inflammation. In case of inflammatory diseases of the genital organs, poor monthly periods also appear as one of the symptoms. These are sexually transmitted diseases, oophoritis, salpingoophoritis, etc. Inflammations of the female organs can occur in the treatment of something with douching at home, with strong cooling, and so on.
Other, not less frequent, reasons for poor monthly periods:
- physical and psychological exhaustion
- irrational mode of rest and work, nervous strain
- spontaneous miscarriage, medical abortion, minibus
- abnormal development of the uterus and the organ itself
- solarium abuse, prolonged exposure to the sun, climate change
- radiation damage, certain medications
- long courses of oral contraceptive pills
- mismatched oral contraceptives
- diseases of the thyroid gland, adrenal glands, diabetes
This is a rather rare cause of menstrual disorders. In ordinary clinics, doctors rarely suggest such a cause and rarely diagnose this serious illness. More often revealed tuberculosis of the female genital organs in the tuberculosis dispensaries. But today there is a serious problem in this industry - the lack of highly qualified phthisiatricians and gynecologists.
Tuberculosis of the genital tract can be even in young girls. There are no 100% diagnostic methods today, so it is very difficult to identify the disease. At the same time, the disease may be completely hidden, and the symptoms may be minimal. If the genitals are affected in a girl, then she may have hypomastia, amenorrhea, uterine abnormalities or obstruction of the fallopian tubes, there are menstrual disorders in the pubertal period and later. In reproductive age, she is diagnosed with persistent primary infertility.
With genital tuberculosis, an x-ray will not show you a lung injury, because it does not exist. As you know, mycobacterium can affect not only the respiratory tract, but also other organs and systems of the human body. Sometimes after surgery or childbirth, a woman may have acute transient genital tuberculosis. At the same time, the course of the disease is very heavy, the body temperature is very high.
A sluggish form of genital tuberculosis is likely, in which exacerbations alternate with remissions (a period when there are no symptoms and it seems that recovery has taken place). For many years, a woman may have tuberculous lesions of the genitals, which will cause infertility and various cycle disorders. General symptoms may also be present, and in such cases, doctors will think of inflammation of the uterine appendages. Common symptoms:
- low-grade temperature in the second phase of the cycle or in both phases
- allergic manifestations
- excessive sweating
- reduced appetite
- hysterical behavior, difficulty concentrating, nervousness
- salpingo-oophoritis and chronic salpingitis that are difficult to cure
- rare menstruation, amenorrhea and other violations of the cycle
Hypomenorrhea may be present in any diseases of the uterus and the uterus. In addition to inflammation, scanty periods can be triggered by:
- scars on the uterus after surgical interventions (cesarean section, partial removal of the uterus, etc.)
- inferiority of the endometrium due to intrauterine manipulations, including abortion
- oncology treatment
- cervical cancer
- tumors of the uterus or ovaries
- hormonal contraceptive use
As already noted, scanty periods can be triggered by low levels of sex hormones in women and hormonal contraception. There are also a number of hormonal disorders that are manifested by hypomenorrhea:
- Endocrine diseases
- Breastfeeding (there is a lot of hormone prolactin in the body, which prevents ovulation from occurring regularly)
The emotional or psychological factor affects not only the woman’s cycle, but also her immunity, the level of all hormones and overall health. Positive and negative emotions affect the part of the brain that stimulates ovarian function. Those, in turn, produce progesterone and estrogen, because the endometrium grows.
If there was strong stress (with a plus or minus sign), or you are constantly experiencing stress, then these centers in the brain do not work so actively, which affects the work of the woman’s ovaries. Therefore, if the level of estrogen falls, the monthly become scanty.
As already noted, there are a great many causes of hypomenorrhea. Others, besides the above, include:
- serious injuries
- strong physical exertion
- metabolic disease
- power supply change
- climate change
- drastic weight loss with strict diets or fasting
- severe infections with intoxication processes
- effects of radiation or chemicals at work
What is hypomenorrhea
Hypomenorrhea is characterized by scanty monthly periods. As a rule, it occurs as a result of inflammatory processes or in violation of the menstrual cycle. Therefore, after childbirth, hypomenorrhea occurs frequently. With this disease, the duration of discharge, as well as the amount of blood secreted, is significantly reduced.
To understand the issue of hypomenorrhea, it is necessary to understand what is meant by scanty monthly periods. If the discharge is smearing and is accompanied by several drops of blood, while the color of the discharge is brownish, then we can speak of a poor menstruation.
Normal allocation with monthly bright red. Blood loss ranges from 50 to 150 ml. When hypomenorrhea, this figure is 50 ml or less.
To make it easier to navigate in your menstrual cycle, it is best to keep a calendar of menstruation, especially for women who are planning the next pregnancy.
Lochia after childbirth
Lochia is a postpartum bloody discharge. They are often moderate, reminiscent of menstruation in recent days. They last 10 days, after which the discharge changes its appearance and transforms into a bloody mucous form. After 2 weeks, whites stand out. If you look at these secretions through a microscope, it turns out that red blood cells are already absent there. They consist of desquamated epithelial cells from the inside of the uterus.
In rare cases, lochia continues up to 42 days with a gradual decrease in the amount of blood secreted. Bleeding after childbirth is considered a condition where a woman is forced to change the pad every hour. In this case, it is necessary to inform the doctor as soon as possible, since this is not considered normal and can threaten not only the health, but also the life of the woman.
If the first scanty periods began during lactation, this is not a deviation. Poor menstruation is due to the fact that during lactation the woman's body produces prolactin, which inhibits secretion. Therefore, during this period, monthly scanty and irregular. But despite the hypomenorrhea during feeding, the probability of a new pregnancy increases. It is worth remembering this.
After what time does the first menstruation after childbirth
During pregnancy, the endocrine system of the expectant mother actively produced the hormone progesterone. It is also called the pregnancy hormone. After birth, the body is restructured in a new way. Therefore, there is a delay in the outflow of menstrual blood and there is a moderate cycle of menstruation.
The temporary cessation of menstruation is associated with hormonal changes. The recovery period takes place in each case individually. On average, its rate is three months.
You should not panic, if the interval between the first cycle and the second was not as usual 28 days, but dragged on for 2 months. After childbirth and during lactation, this often occurs.
The menstrual cycle is restored only after the third month. In addition, it still depends on the lactation of women. Produced prolactin inhibits the beginning of the cycle, and therefore scanty monthly. If breastfeeding is missing for some reason, then the menstrual cycle is restored after 2 months.
After childbirth, the nature of menstruation can change radically. For example, if before a woman experienced severe pain at the time of menstruation, then after childbirth, as a rule, the discomfort disappears. This is due primarily to the fact that during childbirth, the bend of the uterus is leveled and the blood freely comes out, whereas earlier all this caused great pain.
Restoration of the menstrual cycle after childbirth
To help the body in a quick time and without consequences restore the menstrual cycle, you must adhere to some rules:
- The day regimen must be properly organized.
- Always rest after doing any work.
- Meals should be timely and balanced.
- Do not be nervous about any reason, you need to avoid stressful situations.
- Make sure that there are no postpartum complications.
- Treat all diseases in time so that they do not go into the chronic stage.
The first periods can be scanty due to excessive production of prolactin, which appears for two main reasons:
- The appearance of a benign prolactinoma tumor, which is responsible for the production of milk.
- Diseases associated with endocrine disorders.
If there are no menstrual periods for a long time after delivery, other suspicious symptoms appear, for example, scanty menstruation, alternate with copious, with blood clots, severe pain, etc., consult your doctor as soon as possible, as delay can be dangerous.
Norm and pathology
In order to identify the failure of menstruation (including in the form of a hypomenorrhea), first it is worth distinguishing between a normal and a pathological menstrual cycle.
The correct menstrual cycle looks like this: menstrual painless or small pain, the duration of discharge from 3 to 5 days, the normal interval for different women varies and should be in the range of 21-35 days, the amount of discharge of each monthly from 50 to 150 milliliters.
A woman who monitors her health should know exactly the length of her cycle, her character, the approximate abundance of secretions, the course of the premenstrual period.
Violation of any of the characteristics of menstruation is an indicator of a possible failure of the menstrual cycle, which affects both the general health of the woman and the desire to become pregnant in the future.
Causes of Hypomenorrhea
Postpartum hypomenorrhea can occur for reasons directly related to pregnancy and the postpartum period itself - a change in the hormonal balance. It happens if you want to lose the excess weight that appeared after pregnancy, with excessive physical exertion. The birth of a child, especially the first birth itself is stressful.
Scanty periods are caused by various factors, but also directly or indirectly dependent on pregnancy and childbirth:
- rapid and obvious weight loss, drastic weight loss during fasting, exhaustion,
- various postpartum infections and occurring independently of the genera, intoxication associated with them,
- suffered stress or mental disorders
- hormonal imbalance and endocrine diseases,
- hormonal drugs,
- lack of breastfeeding,
- defeat of the genital organs with various infections, for example, tuberculosis,
- exposure to harmful factors (radiation, chemicals),
- tumors of the genitourinary system, pelvic disease,
- genital infections.
Although hypomenorrhea is physiological, but, as a rule, it is a pathological symptom.
Signs of hypomenorrhea
Normal menstruation is replaced by scant bloody discharge: smearing traces, drops and blood stains. The color of the discharge changes to light or dark brown, painful periods appear.
At the same time, the duration of menstruation may decrease. Changing the well-being of women. Additional symptoms may be added: bloody discharge in the middle of the cycle, headache, general weakness, nausea, back pain, chest discomfort, constipation, and lower abdominal pain.
Also one of the phenomena of hypomenorrhea are nasal bleeding. In case of violation of the secretion of estrogen hormones in a woman can decrease sexual desire.
Physiological hypomenorrhea after childbirth
With regular breastfeeding, when breastfeeding passes without delay, and lactation persists, then menstruation stops for the entire period.
However, if for some reason breastfeeding becomes irregular, the woman does not want to feed herself, or there is a forced pause, then scanty periods can appear.
This is typical during the introduction of complementary foods to the child. During this period, the mother begins to breastfeed less frequently, one of the feedings is skipped. As a result, menstruation may resume, but at first they are scarce.
As the mother's body is rebuilt, hormones return to normal, menstruation normalizes over several cycles — this condition is considered physiological.
If the cycle does not return to normal for a long time, or after normalization, his discharge became scarce again, this may indicate a serious malfunction in the woman’s body and the development of any gynecological disorders, which is a direct indication for going to the doctor.
Prolonged postpartum hypomenorrhea can be caused by endometriosis, endocrine diseases and metabolic disorders. Specialist consultation is necessary to prevent serious consequences, such as the development of future infertility.
Аборт является как серьезным стрессом для нервной системы женщины, так и «встряской» для гормональной системы организма.
Во время аборта наносится травма: выскабливается внутренней слой матки, беременность прерывается и происходит резкая гормональная перестройка. All this necessarily leads to a violation of the cycle, one of which is hypomenorrhea.
The consequences of hormonal failure lead to the fact that as the body recovers, normal periods can recover to six months. It happens that menstruation after an abortion is resumed earlier. It all depends on the type of abortion, the correct execution of the procedure, the duration of pregnancy.
Scanty menstruation is sometimes followed by an abortion and lasts up to 7 days in the form of a uterus reaction to the procedure. And they are also often observed after a medical abortion in the form of a sedative discharge lasting from 1 to 3 days and are renewed at an interval of a week.
If, along with the described period after the abortion, there was pain in the left side or on both sides, pain in the lower abdomen, the discharge had an unpleasant smell, then a gynecologist's examination is necessary.
After an unsuccessful pregnancy, hypomenorrhea is a frequent manifestation. At the same time, particles of the fetus, the membrane of the amniotic bubble, blood from the endometrial vessels of the uterus are secreted.
Also, the discharge may become scarce due to adhesions and scars, which are sometimes formed after a miscarriage.
Suddenly aborted pregnancy is manifested by a sharp hormonal disruption, which causes temporary disruption of the menstrual cycle.
As a rule, the cycle should return to normal for about 2 months. If this does not happen, then prolonged scanty menstrual periods after a miscarriage can be symptoms of a hormonal pathology or infection, which requires the advice of a doctor.
The normal menstrual cycle sometimes changes for physiological reasons. Hypomenorrhea is one of the frequent such manifestations and can occur normally after childbirth. However, accurate identification of the cause is only possible for a qualified specialist. Therefore, hypomenorrhea is always an indication for consultation with a gynecologist.
Symptoms and diagnosis
In the first 3-4 days after childbirth, blood and placental tissue clots are separated in a larger volume. The color is bright scarlet, the lining is enough for 2-2.5 hours. On the 5th day, the discharge becomes brown, dark maroon, as they contain less blood. The remaining small fragments of placental tissue, mucous membranes are released.
After 7 days, the secret fades, changes shade to yellow-white. By the end of the second week, scanty discharge after childbirth is considered to be a positive dynamic of uterus recovery, in the coming days the lochia will stop. If a woman does not breastfeed, menstruation will begin after 4 weeks.
The nature of the bleeding indicates the state of the body after childbirth. During normal menstruation, 120-150 ml of blood goes away. A larger volume (from 200 ml) means a sign of bleeding. If within 3-4 hours on the strip a stain of no more than 2.5 cm in diameter appears - these are very scanty periods after birth, this complication is called hypomenorrhea.
- smearing traces
- small blood spots in 2-4 hours,
- color brown (from light to dark),
- lower abdominal tenderness
- menstruation lasts 1-2 days,
- selections appear in the middle of the loop,
- lower back pain
Often, hypomenorrhea compensates for scanty vaginal discharge with nosebleeds. If the nature of the pathological condition is associated with impaired hormonal levels, there is often a lack of sexual desire.
When referring to a gynecologist, the patient's history, the course of pregnancy and previous births are studied. After making a preliminary diagnosis, an additional examination is performed - UAC, hormone analysis, clotting. Gynecologist takes a smear on the tank sowing, ultrasound is appointed. It is recommended to undergo biopsy of the uterus tissue, MRI.
Very scanty first periods after childbirth are considered the norm, amid changes in hormonal levels, lack of estrogen. After 2-3 months, the cycle and volume of discharge should be restored. If this does not happen, it is recommended to pass tests to identify the cause of the deviation. When during weak periods after birth there is nausea, abdominal pain, urgent examination is required.
Hypomenorrhea is diagnosed in every 7th woman after childbirth, since during this period there are many provoking factors. Stress, lack of sleep, increased physical activity. Against the background of estrogen deficiency, 70% of patients have scanty periods after childbirth during breastfeeding. If there is no influence of other reasons, the cycle is restored within 2 months at the end of lactation.
- breast milk deficiency
- changed hormones,
- mental disorders (stress, depression),
- complications of postpartum infections
- endocrine diseases
- infections of the genital, urinary system, small pelvis (including tuberculosis, HIV stage 4).
With sufficient milk production, menstruation stops for the entire period of breastfeeding. But, if the mother puts the baby to the breast not regularly, with large time intervals, often gives the nipple, soon there will be scanty monthly brown color after childbirth. The same is observed with the introduction of complementary foods, reducing the number of applications per day.
Since all the processes of the reproductive system regulates the central nervous system, a violation of the mental state will affect the production of hormones. With a lack of estrogen, the symptom disappears with the end of lactation. But mental disorders require treatment.
Depression, as the cause of scanty menstrual periods after childbirth, is observed in a third of the diagnosed patients. In the complex therapy, the help of a psychologist is needed.
If after childbirth monthly periods have become scarce, in 10% of cases an infection of the fungal, bacterial and viral type is diagnosed. Hypomenorrhea, with infection of the body, is accompanied by associated symptoms: fever, weakness, loss of appetite.
HIV infection (up to 5-10 years) and tuberculosis (up to 1 year) does not have external manifestations, so you shouldn’t delay the examination during poor menstruation after childbirth. During the prescribed therapy, neutralize the pathology and restore the cycle.
It is not necessary to treat the physiological hypomenorrhea, when hormonal recovery, when estrogen is produced in abundance, menstruation will resume. Irregular, scanty discharge from a woman, without lactation, requires examination and medical treatment of the cause.
- tomography of the brain and pelvic organs.
It is recommended to exclude a possible ectopic pregnancy, with meager bleeding, accompanied by abdominal pain. About 2% of pregnancies occur in the first six months after birth, with the risk of miscarriage.
Treatment of hypomenorrhea is selected depending on the nature of the provoking disease. If the cause is an infection with inflammation, broad-spectrum antibiotics Abactal, Monural, Cefixime (urinary diseases), Ceftriaxone, Apmicillin, Azithromycin (universal) are used. When HIV infection, tuberculosis, endocrine diseases are prescribed drugs of narrow action.
But more than 70% of patients with hypomenorrhea are women with impaired hormonal levels after childbirth. In addition to scanty periods, they are characterized by irritability, frequent mood swings, disturbing sleep. Hormone therapy restores the normal two-phase regular cycle.
Treatment is not prescribed for the physiological form of the disorder, if the cause is stress, climate change. When a woman is on a diet, a menu rich in protein, fiber, carbohydrates is recommended.
Treatment is not required if hormonal imbalance is triggered by the use of contraceptives. With the right dosage and schedule, there will be no harm to the body, the period will gradually normalize.
During the period of breastfeeding, scanty and spotty first menstruation after childbirth, the normal manifestation of altered hormonal levels. The phenomenon of physiological, safe, if there are no symptoms of nausea, dizziness, weight loss. Menstruation will recover in 1-2 months after the end of lactation.