Hypomenorrhea: Understanding Light Periods

Everyone’s period is different. Our menstrual cycles vary from person to person — and even from month to month. But should you be worried if your periods seem much lighter than usual?

Women’s health specialist Dana Leslie, CNP, weighs in on what could be causing your light menses.

What is hypomenorrhea?

Simply put, “hypomenorrhea” is the clinical term for periods that are lighter than is typical for you.

“Hypomenorrhea is described as a decrease in menstrual flow, with bleeding that lasts for a shorter duration than your typical cycle,” Leslie explains. “The bleeding typically lasts two days or less, and the pattern persists for several months.”

The occasional scanty flow doesn’t always signify a problem. It’s not uncommon to experience changes in your flow throughout your life, in terms of:

• How many days your period lasts
• How heavy your flow is
• What other symptoms you experience (like PMS and cramps)

But sometimes, hypomenorrhea can signal a change in hormone levels or other health concerns. And if you experience three periods’ worth of lighter-than-usual bleeding, it’s time to see a healthcare provider to figure out what’s going on.

Causes of light menses

Sometimes, light periods are just your body’s version of business as usual.

“If your cycle has been light since you started menstruating, there’s likely no need to be concerned,” Leslie clarifies. “It may be normal for your body. But if you’re experiencing changes in your cycle, there’s likely an underlying cause.”

Let’s take a look at some of the possible causes of hypomenorrhea, including other symptoms that can accompany each of them.

Stress

Stress can wreak havoc on your body — including making your periods lighter or causing them to disappear altogether.

Here’s how it works: When your body is under stress, it releases the steroid hormone cortisol (sometimes referred to as the “stress hormone”). Too much cortisol messes with your body’s ability to release gonadotropin-releasing hormone (GnRH).

“When GnRH release is disturbed, your body’s production of estrogen and progesterone is altered,” Leslie explains. “This causes irregularities in your menstrual cycles.”

Chronic stress can even lead to amenorrhea, which is when you don’t get your period at all.

What to do about it: If you suspect that stress is behind your hypomenorrhea, speak with a healthcare provider. They can help you find ways to manage stress and get your body — and your mental and emotional health — back on track. This may include medication, therapy and lifestyle changes, like meditation, mindfulness and other strategies for managing stress.

Weight loss

Did you know that losing weight can change your menstrual flow? Your body needs a certain amount of fat and calories to produce estrogen and maintain ovulation. But if it’s not getting what it needs, it can suppress your reproductive hormones.

Essentially, your body sees weight loss — especially rapid weight loss due to a restrictive diet or over-exercise — as a form of stress. This triggers the whole cortisol/GnRH process.

“Weight loss changes your hormone levels, specifically by reducing estrogen production,” Leslie explains. “This can lead to changing bleeding patterns and even cause you not to ovulate.”

What to do about it: Decreasing your exercise levels and increasing your caloric intake can help bring back your regular periods — but this can be especially difficult if you’re dealing with body dysmorphia or living with an eating disorder. A healthcare provider can help you figure out the safest and healthiest way to reach a healthy weight that supports your menstrual cycle.

Overactive thyroid

Your thyroid, which helps regulate your metabolism, plays an important role in your overall hormonal balance. When you have an overactive thyroid, though, excess thyroid hormone can interfere with your menstrual cycle.

“Hyperthyroidism disrupts your hormonal balance, which affects communication from your brain to your thyroid and ovaries,” Leslie says. “This can make your cycle both lighter and shorter.”

An overactive thyroid usually brings other symptoms, too. Look for signs like:

• Anxiety
• Fatigue
• Increased heart rate
• Sweating more than usual
• Trouble sleeping

What to do about it: If you’re experiencing symptoms of an overactive thyroid, see a healthcare provider for diagnosis and treatment. Options range from medications to surgery.

Polycystic ovary syndrome (PCOS)

When you have PCOS, your ovaries produce unusually high levels of hormones called androgens.

“Elevated androgens disrupt hormonal production, which may prevent your ovaries from releasing eggs,” Leslie explains. “This leads to changes in the menstrual cycle.”

PCOS often brings other symptoms, too, like:

• Acne and/or oily skin
• Dark patches of skin
• Excess hair growth on your face, arms, chest or abdomen
• Hair thinning or hair loss
• Weight gain

What to do about it: If you think you might be living with PCOS, it’s important to speak with a healthcare provider who can make a diagnosis and help determine a course of treatment. Options include hormonal birth control, insulin-sensitizing medicine and medications to block androgens, along with various lifestyle changes that can help.

Perimenopause

Perimenopause marks your body’s transition toward menopause, and it’s a natural part of the aging process. But before your periods stop coming altogether, you may first experience changes in your cycle that can last for several years.

“In perimenopause, you experience an overall decrease in estrogen production from your ovaries,” Leslie says. “This causes irregular cycles, usually along with other symptoms.”

Perimenopause can start as early as age 35, bringing a wide variety of symptoms that can include:

• Brain fog
• Hot flashes and/or night sweats
• Mood changes
• Vaginal dryness

What to do about it: Once you’ve entered perimenopause, nothing can restore your periods to the regularity you might’ve experienced before. But if other symptoms of perimenopause are interfering with your quality of life, it’s important to talk to a healthcare provider so they can help. There is a variety of treatment options that can help you find relief.

Cervical stenosis

Cervical stenosis is a condition where your cervix is narrower than usual.

“Sometimes, a narrowing of the cervical opening doesn’t allow blood to flow out of the uterus, which can cause you to experience lighter periods,” Leslie explains.

Cervical stenosis is usually the result of:

• An infection, like an STI or bacterial vaginosis
• Congenital abnormalities
• Prior surgery
• Radiation therapy
• Trauma to your cervix or uterus

This condition often brings pelvic pain and discomfort, too, which can make it uncomfortable or painful to have sex and use tampons.

What to do about it: If cervical stenosis is causing irregular periods, but not pain or discomfort, a healthcare provider may recommend monitoring the condition rather than treating it. If it’s causing you problems, though, they’ll discuss treatment options with you.

How is hypomenorrhea treated?

Hypomenorrhea is a symptom of other conditions and issues, so it requires treating whatever is causing it.

“Even if you’ve recently lost weight or been under a lot of stress, don’t assume they’re the cause of your lighter-than-usual periods,” Leslie urges.

Your healthcare provider will likely want to run tests to figure out what’s at the root of your light periods. This may include:

• A physical exam
• An evaluation of your medical history evaluation
• Bloodwork
• Imaging, like a magnetic resonance imaging (MRI), transvaginal ultrasound and/or a sonohysterogram

When to see a doctor

A light period here and there is typically nothing to worry about. But if your menstrual cycle has significantly changed — and that change has stuck around for three months or more — it’s time to schedule a chat with a healthcare provider to see what’s up.

“Any consistent change in your bleeding pattern is a reason for investigation,” Leslie emphasizes.