What is heavy menstruation and light menstruation? A menstrual cycle with more than 60 ml of menstrual flow is considered excessive, and less than 20 ml is considered menorrhagia. When a patient comes to the doctor with a problem with her menstrual flow, the doctor will often ask: “Has your menstrual flow decreased or increased by 1/2 compared to the original? How many sanitary napkins do you use per day? How often do you change one? Does each piece get wet?” When asking patients with low menstrual flow: “Do you have abdominal pain during your period? Can you wet a sanitary napkin at most? Is it okay to use only pads?” The patient’s answer is highly subjective and it is impossible for the doctor to accurately measure the amount of menstruation, but only to make an approximate assessment based on the patient’s account. An approximate estimate of the amount of sanitary napkins is based on the fact that a normal amount is changed on average 4-5 times a day, with no more than 2 packs (10 pads) of sanitary napkins per cycle. If more than 3 packs of sanitary napkins are not enough, and almost every sanitary napkin is wet, it is considered excessive menstruation. Therefore, the amount of menstrual flow is often ambiguous, especially in the case of hypomenorrhea, when the organic disease is not very specific and only some relevant tests can be done. Why are people more afraid of menorrhagia? They are afraid that the decrease in menstruation will affect the elimination of toxins from the body, which will cause chloasma, wrinkles, and bags under the eyes, and will lead to amenorrhea, premature aging, and premature menopause. They keep asking about the causes of low menstruation and take all kinds of herbs and health supplements to solve this problem. Causes of menorrhagia: 1. Problems with the discharge channel: After the abortion, the uterine cavity and cervical adhesions are caused, and the menstrual blood does not flow smoothly, which is manifested as low menstrual flow, accompanied by dysmenorrhea. The history of abortion can be traced. 2, endometrial damage: abortion surgery scrapes the endometrium of the basal layer of the uterus, especially painless abortion, due to intravenous anesthesia, the patient is painless, often too serious suction and scraping, serious damage to the endometrium. Some people say that medical abortion is safer and avoids uterine surgical operations. However, if the abortion is incomplete, it will prolong the bleeding time, which is not only easy to cause anemia, but also easy to cause infection in the uterine cavity and damage to the endometrium as well when removing the uterine residue. 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. 3. Infection with tuberculosis: Infection of the endometrium with tuberculosis can cause damage to the endometrium, resulting in reduced menstrual flow and even amenorrhea. Some patients suffer from pelvic tuberculosis since childhood, but they are not aware of it and often consult the doctor with primary amenorrhea. These patients have severe damage to the endothelium and have difficulty conceiving despite successful anti-TB treatment. 4.Ovarian hypofunction: When the ovaries are hypofunctional, the estrogen level decreases, which affects the proliferation of the endometrium and reduces menstrual flow. This can be clearly diagnosed by measuring FSH, LH and E2. 5. Endocrine diseases: Prolactinemia, polycystic ovary syndrome, abnormal thyroid function can cause a decrease in menstrual flow or even amenorrhea. The diagnosis can be confirmed by hormone measurement. 6. Drugs: The use of contraceptives and psychiatric drugs can reduce the volume of menstruation. Treatment of menorrhagia: 1. Cervical and uterine adhesions: Separation of adhesions by hysteroscopy, intraoperative placement of the IUD, postoperative application of estrogen for 3 months for endometrial repair, and hysteroscopy after 3 months to assess the endometrial condition. 2. Infection with tuberculosis: Diagnosis relies on endometrial biopsy and for patients with tuberculosis in the active stage, anti-tuberculosis treatment should be administered. Unfortunately, there is no way to make the endometrium grow because the basal layer of the endometrium has been destroyed and the endometrium does not respond to estrogen and the application of more estrogen cannot change the menstrual problem. 3, hypovarianism: For patients with reduced menstrual flow due to hypovarianism, it is simply impossible to increase menstrual flow by changing ovarian function, and the current promotion of ovarian maintenance is extremely unscientific. However, we can apply hormone replacement to supplement estrogen to make the endometrium proliferate and increase the menstrual flow. 4. Endocrine diseases: Treatment of related diseases is sufficient. Patients with polycystic ovary syndrome can lose weight and at the same time apply Daine-35 to lower androgen and restore regular menstruation; patients with hyperprolactin apply bromocriptine to lower prolactin, restore ovulation and resume menstruation. In conclusion, for patients with reduced menstrual flow with fertility requirements, treatment is based on the etiology, where fertility is difficult to achieve in patients with endometrial tuberculosis and ovarian hypofunction. For patients without fertility requirements, no uterine or cervical adhesions, no endocrine diseases, and normal ovarian function, reduced menstrual flow is not a big problem. Many patients think that menstrual blood can expel toxins, and reduced menstrual flow makes toxins poorly expelled, which affects health and causes facial pigmentation and poor complexion. In fact, menstruation is just a phenomenon, and it does not matter how much. Patients with endometrial tuberculosis without fertility requirements do not need to treat amenorrhea at all as long as their ovaries are functioning normally. In patients with declining ovarian function, any treatment that attempts to correct ovarian function is not helpful, that is, we know that ovarian function is going into decline, but we are powerless to stop it and have to let it progress. However, we can supplement estrogen with hormone replacement to achieve regular menstruation.