In daily life, there are often female friends because of “how much menstruation problem” and tangled, many women are most worried about less menstruation will cause aging, and even often go to the beauty salon at great expense to “maintain” their ovaries, is this worry necessary? Is this worry necessary? Is ovarian care really effective? Does a low menstrual flow mean that menopause is imminent? What causes menorrhagia? I hope the following answers can relieve you of your worries and concerns. 1. Do women menstruate to eliminate toxins from their bodies? What exactly is menstruation? Currently, many women have a misconception that menstruation is for detoxification, which is an extremely absurd concept. Menstruation is the periodic shedding and bleeding of the endometrium that accompanies the ovarian cycle of ovulation, which can also be interpreted as the result of the failure of the endometrium to prepare for pregnancy each month. The first menstruation is an important sign of puberty, suggesting that the ovaries produce enough estrogen to cause the endometrium to proliferate, and after estrogen reaches a certain level with significant fluctuations, causing the endometrium to shed and menstruation to occur. So, in essence, menstruation is blood. Menstrual blood is dark red in color. 95% of menstrual blood comes from venous and arterial blood, while the rest is fluid exuded between tissues and endometrial cell fragments, inflammatory cells, cervical mucus and shed vaginal epithelial cells. 2.What is normal menstruation? Normal menstruation contains four basic elements: ① Menstrual cycle (the interval between the first day of two menstrual periods): generally 21 to 35 days, an average of 28 days; ② Period (the duration of each menstrual period): generally 2 to 8 days, an average of 4 to 6 days; ③ The volume of menstruation, that is, the total amount of blood loss of a menstrual period, the normal volume of menstruation is mostly 20 to 60 ml; ④ Cycle regularity: between the menstrual cycles of the last 1 year There are a few women who have menstruation once every 2 months since the first menstruation, i.e., the cycle is about 60 days, and the difference between cycles is less than 7 days, which has its own regularity, which is also considered normal and belongs to individual differences. When the difference between menstrual cycles is more than 7 days, it is considered abnormal and belongs to the category of menstrual disorders. 3, the reduction of menstruation will affect the elimination of toxins in the body, which will lead to chloasma, wrinkles, eye bags, and then gradually amenorrhea, premature aging and premature menopause? Menstruation is a physiological phenomenon unique to women. As soon as menstrual blood is produced, it has to be discharged, unless the discharge channel is blocked. There is no reason why any toxins in the body need to be expelled from the menstrual blood, and it has nothing to do with chloasma, wrinkles, or bags under the eyes. If there is no combined organic disease affecting menstruation or evidence of ovarian failure is detected, there will be no amenorrhea, reduced menstruation, and even if there is amenorrhea, premature aging does not necessarily occur. Usually, when there are no structural changes, the low menstrual bleeding is not a problem of other blood being “held” somewhere in the body and not being able to be discharged, so in general, if there are no combined organ problems and no fertility requirements, there should be no need to treat the low menstrual flow, and it is not because of the “toxic The “less discharge” will not affect the body; while excessive menstrual flow is excessive blood loss, serious cases can lead to severe anemia or even shock, is the need for active attention and treatment. 4. Is a low menstrual flow a sign of premature ovarian failure? Not necessarily. Under normal circumstances, the total blood loss during a menstrual period is about 20 to 60 ml. It is common for a menstrual period to be a little more or a little less than usual due to a variety of factors, unless the menstrual flow is so low that the total bleeding during the entire menstrual period cannot even wet a sanitary napkin, then it is necessary to consider consulting a doctor. The common causes include: endometritis, uterine adhesions, ovarian hypofunction, etc. Premature ovarian failure is due to some reasons (such as family history of premature ovarian failure, autoimmune thyroiditis, systemic lupus erythematosus, rheumatoid arthritis and other autoimmune diseases, history of pelvic radiotherapy, etc.) leading to depletion of follicles in the ovaries, resulting in a decrease in estrogen levels in the body, mainly manifesting as menopausal symptoms, including: hot flashes and sweating, facial flushing, low libido, etc., while in terms of menstruation, the initial phase mainly In the early stage of menstruation, the menstrual cycle is disordered and the amount of menstruation can be high or low, and in the later stage, amenorrhea (i.e. no menstruation) occurs. 5. How to measure the amount of menstruation? Under normal circumstances, the total blood loss (i.e. menstrual flow) of a menstrual period is about 20ml to 60ml. According to the guidelines of the Chinese Society of Obstetrics and Gynecology for the diagnosis and treatment of abnormal uterine bleeding, when the menstrual flow exceeds 80ml per month, it is defined as excessive menstruation; when the menstrual flow is less than 5ml per month, it is defined as scanty menstruation. The above definition is a rather abstract concept, which can be simply measured in life by the following methods: ① Excessive menstruation: use the amount of sanitary napkin or tampon to assess, about every 1 to 2 hours to wet a large sanitary napkin or tampon, it means that the amount of menstruation is excessive; or compare with your usual menstrual volume, if it increases 2 to 3 times, then combined with dizziness, weakness, tinnitus, mucous membrane of mouth and lips and nail bed Pale and other manifestations of anemia, more can indicate excessive menstruation, need to seek medical help. ②Low menstrual flow: If you take a sanitary napkin to assess, about a piece of night sanitary napkin soaked with blood when the blood volume is about 20-30ml, so if it is obvious that it does not reach this standard, but only slightly less than the usual menstrual volume, it is not pathological and need not be particularly worried. 6.What is the matter with the menstrual flow becoming less? First of all, the concept of menorrhagia needs to be clarified and judged according to the criteria as described above. It is necessary to consult a doctor only if there is indeed a low menstrual flow, otherwise there is no need to care. There are several possible causes of menorrhagia: (1) obstruction of the menstrual blood discharge channel: mainly the uterine cavity adhesions and/or cervical canal adhesions, so that the flow of menstrual blood is not smooth, which is the most common cause of reduced menstrual flow or even secondary amenorrhea, often accompanied by dysmenorrhea, mostly occurs in women with a history of multiple abortions or scraping history, need hysteroscopy to confirm the diagnosis, ultrasonography is generally not visible. (2) Endocrine disorders, mainly due to certain factors (such as hypothyroidism, polycystic ovary syndrome, use of sex hormone drugs, elevated prolactin, hyperinsulinism or hyperandrogenemia, etc.) leading to endocrine disorders in the hypothalamic-pituitary-ovarian axis of the body, the body’s estrogen secretion decreases and cannot make the endometrium proliferate to a certain thickness, thus causing low menstrual flow or even amenorrhea. A sex hormone test is needed to clarify. (3) Damaged or diseased endometrium. Since menstrual blood comes from the shedding of endometrium, any disease that may cause damage to endometrium or inhibit proliferation can cause scanty menstruation or even amenorrhea. ① Surgical damage to the endometrium: such as abortion, uterine cleaning, hysteroscopic endometrial polyp electrosurgery and other uterine operations will inevitably damage the endometrium, and when the basal layer of the endometrium is damaged in a large area or secondary to uterine adhesions, it can lead to reduced menstruation or even amenorrhea. It is worth mentioning that repeated surgical scraping of the uterus is the most common cause of endometrial damage, and some people say that medical abortion is safer and avoids cervical surgery operations. However, if the abortion is incomplete, it will prolong the bleeding time, which will not only cause anemia but also cause infection in the uterine cavity and damage to the endometrium as well when removing the uterine residues. We would like to urge you to use strict contraception when you do not want to have children, because endometrial damage can directly lead to infertility. It is difficult to treat. Especially when the basal layer of the endometrium is damaged, decreased menstruation can easily occur. ②Endometrial lesions: such as endometrial tuberculosis, endometritis, endometrial atrophy, etc. Endometrial infection with tuberculosis can damage the endometrium, leading to reduced menstruation and even amenorrhea. Some patients suffer from pelvic tuberculosis since childhood, but they are unaware of it and often present to the clinic with primary amenorrhea. In these patients, the endometrium is severely damaged, making conception difficult despite successful anti-TB treatment. (4) Ovarian hypofunction: When ovarian function declines, the estrogen level decreases, affecting the proliferation of the endometrium and reducing menstrual flow. This can be clearly diagnosed by measuring sex hormones through blood sampling. (5) Rapid decrease in body fat content due to excessive exercise or improper weight loss can also lead to decreased menstrual flow or even amenorrhea. In addition, more women have reduced menstrual flow due to mental and emotional factors, such as exam stress or emotional excitement in anticipation of something happening, and the continuous overly nervous mental state can inhibit the secretion of hormones in the pituitary gland of the hypothalamus, which subsequently leads to a decrease in ovarian estrogen secretion, thus causing reduced menstrual flow. All in all, the most crucial thing is to find the cause of low menstrual flow, and then treat the symptoms. 7.Does the low menstrual flow affect pregnancy? If the menstrual flow is only a little less than usual occasionally, it usually will not affect pregnancy, but when the menstrual flow is extremely low and reaches the above-mentioned criteria for diagnosis of menstrual flow, most of them have endometrial abnormalities, which can lead to infertility, so there is no need to be too anxious about the low menstrual flow in the first place, and when there is infertility (infertility is diagnosed only when there is no pregnancy after more than 1 year of normal sexual life) performance, then go to the clinic. 8.Is it better to have more than less menstruation? The amount of menstruation is mainly related to the thickness of the endometrium and is affected by many factors. The amount of blood loss per month is normally about 20-60ml. Any excessive or scanty menstruation beyond the normal range needs to be treated by a doctor. 9. Do I need treatment for low menstrual flow? According to the aforementioned criteria, if it is determined that menstrual flow is low, especially if it is combined with infertility or recurrent miscarriages, or if amenorrhea is present, it is necessary to seek medical treatment. Depending on the cause, the following treatments are usually available: (1) Cervical canal adhesions and cavity adhesions: Cervical canal adhesions are usually resolved by cervical dilatation, which can be performed on an outpatient basis and does not require hospitalization. The treatment of cervical adhesions is a bit more complicated, first of all, hysteroscopy should be done to clarify the diagnosis and assess the severity of cervical adhesions, and the adhesions should be separated by hysteroscopy. (2) Endometrial tuberculosis: Diagnosis relies on endometrial biopsy, and for patients with active tuberculosis, anti-tuberculosis treatment is indicated. Unfortunately, there is no way to make the endometrium grow because the endometrial basal layer has been destroyed and the endometrium is unresponsive to estrogen and no amount of estrogen applied can change the menstrual problem. (3) Ovarian hypofunction: For patients with reduced menstrual flow due to ovarian hypofunction, there is no way to increase menstrual flow by changing the function of the ovaries, and the currently promoted “ovarian maintenance” is extremely unscientific. However, we can apply hormone replacement to supplement estrogen, so that the endometrium can proliferate and the menstrual flow can increase. (4) Endocrine diseases: Treatment of related diseases is sufficient. Patients with polycystic ovary syndrome who lose weight can apply Daine-35 to lower androgen and restore regular menstruation at the same time; patients with hyperprolactin apply bromocriptine to lower prolactin, restore ovulation and resume menstruation. In conclusion, for patients with reduced menstrual flow: ① if they have fertility requirements, the cause needs to be identified and then targeted treatment, among which patients with endometrial tuberculosis and ovarian hypofunction, there is no effective treatment to improve fertility and fertility is difficult to achieve; ② if there are no fertility requirements, no cervical canal or uterine cavity adhesions, no endocrine disease and normal ovarian function, reduced menstrual flow is not a big problem. The problem is not a big one. Many women believe that menstrual blood can expel toxins, the reduction of menstrual flow makes the toxins not smoothly expelled, affecting health, so that facial blemishes, poor complexion, these concepts are wrong, no scientific basis. In fact, menstruation is just a phenomenon and it does not matter how much. For patients with endometrial tuberculosis who do not require fertility, as long as the ovarian function is normal, there is no need to treat amenorrhea; for patients with declining ovarian function, any treatment that tries to correct ovarian function is ineffective, and there is no “ovarian maintenance”, do not be fooled, that is, when we know that ovarian function In other words, when we know that ovarian function is declining, there is nothing we can do to stop it, we can only let it develop, but we can supplement estrogen and progesterone through hormone replacement to achieve regular menstruation.