Q: Hello Doc, please I need some clarification on this. I used to menstruate five days initially when I was very young. Then, I got married it changed to three days. Recently for the past three months it has been just two days. I’m just 43 years now. Could there be a problem? Do I need to see a doctor or is it a sign of menopause? Thanks
A: What is normal in terms of menstrual cycles varies from person to person with menstrual flow lasting between 2 to 8 days and the cycle lasting anything from 21 to 35 days. A reduction in flow (scanty period) is called hypomenrrhea (pronounced hai-po-men-oria) and a reduction in the number of days of flow to less than 3 days is called oligomenorrhea (oli-go-men-oria). Women with oligomenorrhea may go up to 35 days without a period.
Now at the onset of puberty, the flow and cycle can vary from one cycle to the other; the same goes for the other extreme of life (old age) when women head towards menopause. So, can it be menopause? First, a definition….menopause is a period defined by at least 12 months of cessation of menstrual period. It occurs as a natural process of aging which can start as early as late 30s as the ovaries start making less amounts of hormones with an average age of about 51 years. Menopause can also be induced by chemotherapy or radiotherapy (treatment for cancers), surgical removal of the ovaries etc. This is called premature menopause. This is also likely to run in families. So, it could be menopause…but your doctor is in the best position to confirm that.
What else could have caused your flow to reduce? They include pregnancy (the supposed periods may be an implantation bleed), crash dieting (when you want to lose all the weight you added in 5 years in one week :D), intense physical activity, Polycystic Ovary Disease (PCOD), imbalance of hormones, Diabetes or thyroid problems and use of contraceptives. Previous instrumentation like Dilatation and Curettage (D and C) can result in a condition called Asherman’s syndrome which manifests as reduction in menstrual flow. In the same way that stress can delay a menstrual period, it can also cause a reduction in flow.
Oligomenorrhea is not necessarily a serious problem, but it could be indicative of an underlying disease. You must work with your gynaecologist in order to manage this. If the cause is PCOD, focus will be on the treatment; if due to intense exercise, reducing intensity will be helpful; if due to crash dieting, focus on eating a proper balanced diet will help etc. Your gynaecologist will carry out a detailed examination and investigation to arrive at the cause and advice on treatment.
For posts on related topics, please click on this link: https://chatwithdrketch.com/2016/08/15/daily-health-tips-ovarian-cysts-and-fertility/
Have a great evening, great people 😀