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Scanty periods: brown in color, without pain, with fever, nausea, chest and abdominal pain
Last reviewed: 04.07.2025
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Each woman has her own menstrual cycle, but its irregularities, including scanty periods, depend on how well hormones regulate the monthly changes in the ovaries and uterus. That is, how hormones in the female body ensure the entire reproductive cycle and the transition from its premenstrual phase to menstruation, during which the mucous membrane inside the body of the uterus is cleansed by separating its swollen functional layer.
Causes scanty periods
The main causes of scanty periods or hypomenstrual syndrome are associated with disturbances in the physiological balance of hormones, the interaction of which determines the menstrual cycle of women.
The etiology of these disorders and their pathogenesis may be primary, i.e. associated with congenital developmental features, including the genitals, endocrine system and brain structures. A reduction in the volume of menstrual discharge occurs:
- in case of functional insufficiency of the anterior pituitary gland, which produces gonadotropic hormones and FSH (follicle-stimulating hormone);
- with a deficiency of ovarian estrogen (which produces it as a result of the stimulating effect of FSH);
- as a result of increased production of the hormone prolactin by the pituitary gland (against the background of pituitary neoplasms or hypothyroidism), and the excess level of which affects the synthesis of other sex hormones (estrogen and progesterone), changing their normal ratio;
- in case of malfunctions of the hypothalamus, which regulates the activity of the pituitary gland with the help of releasing factors – neurohormones folliberin, lulliberin, prolactoliberin;
- due to partial dysfunction of the adrenal cortex, which synthesizes less cortisol, aldosterone and estriol (which is associated with a deficiency of adrenocorticotropic hormone - ACTH produced by the pituitary gland);
- due to excessive production of male sex hormones and the development of secondary adrenogenital syndrome;
- with insufficient levels of progesterone synthesized by the corpus luteum of the ovaries and the adrenal cortex.
The list of secondary causes of scanty periods may include all acquired pathological changes in the reproductive system (diseases of the uterus and ovaries, injuries and surgeries on the pelvic organs); stress and environmental factors (increased radiation levels); a number of infectious and somatic diseases that affect the menstrual cycle; significant weight loss (girls with critically low weight have a significant deficiency of estrogen, deposited in adipose tissue, as well as anemia).
In gynecological practice, it is not considered a pathology when menarche in teenage girls, that is, the first menstruation is scanty, since at puberty the hormonal background is only forming, and the synthesis of sex hormones is minimal. This also applies to cases when menstruation is on time, but scanty, observed in women before the onset of menopause.
We recommend that you read the publication – Menstrual Cycle Irregularities
When can scanty periods occur?
So, scanty and short periods, as previously noted, are typical at the beginning of sexual development and for women in premenopause.
If your period is scanty and your stomach is pulling, this may be either a sign of pregnancy or a consequence of hormonal contraception. In the first case, pulling sensations above the pubic symphysis and scanty periods after a delay in the next menstruation are often noted. And, as gynecologists say, scanty periods in the first month of pregnancy are possible and are a kind of result of rapidly occurring hormonal changes.
So, scanty periods after unprotected intercourse – provided that a woman usually has a normal period – require confirmation or denial of the fact of pregnancy.
And later, scanty periods during pregnancy may mean its termination or the presence of an ectopic pregnancy. More information - Periods during pregnancy
Scanty brown menstruation is also possible for one to two weeks after the fertilization of the egg and its implantation in the uterine mucosa. And with the same degree of probability, it may be an ectopic pregnancy.
It should be borne in mind that the same menstrual discharge, as well as scanty periods with blood clots, occur in the presence of polyps and endometrial hyperplasia in the uterine cavity.
Scanty periods after the IUD (installation of an intrauterine device), as well as after removal of the IUD, also have a brown tint and clots, which is a side effect of this method of contraception.
But scanty periods with endometriosis (proliferation of the uterine endometrium beyond its limits), as well as with myoma (a nodular benign neoplasm in the muscular layer of the uterine wall) are a fairly rare phenomenon. These pathologies are characterized by intense menstrual discharge up to metrorrhagia, that is, uterine bleeding. And when the discharge is scanty, then, most likely, the pathology has affected the ovaries, which leads to ovulation disorders.
Scanty periods with ovarian cysts are also less frequent than heavy and prolonged periods. Small volume of discharge is more typical for follicular cysts and is practically not observed with endometrioid cysts.
Scanty periods with mucus are possible in almost all of the above cases, including cervical erosion, vaginal and cervical infections.
As a rule, scanty periods after IVF are evidence that, despite long-term use of hormonal drugs before the in vitro fertilization procedure, the attempt to get pregnant was unsuccessful. Reproductive specialists also name the consequences of unsuccessful IVF as heavy and painful periods, periods with blood clots, spotting, etc.
Not all lactating women do not have periods; many have scanty periods while breastfeeding. And obstetricians do not see this as a deviation, since the hormonal background after childbirth is restored in each woman with different intensity.
Scanty periods as a side effect of pharmacological agents
The causes of scanty periods may be iatrogenic. Thus, taking hormonal pharmacological drugs prescribed by doctors increases the sensitivity of the mammary glands; women experience denser and sore breasts after scanty periods, and scanty brown periods are also observed.
Nausea, vomiting and scanty periods are often observed when taking birth control pills - Janine, Ovidon, Regulon (Marvilon, Novinet), Yarina, etc. For example, side effects of the contraceptive Regulon include skin rashes, redness, itching and scanty periods; the use of Janine tablets can be accompanied by pain in the abdomen and mammary glands, increased heart rate, intestinal disorders, scanty periods and nausea, weight gain, insomnia and depression.
The cycle is often disrupted and there are scanty periods after Postinor (Follistrel, Gravistal, Microlut) or Mifepristone, there are scanty periods after Escapelle - hormonal contraceptives for emergency cases (taken after coitus). Among their side effects are: a feeling of discomfort in the lower abdomen, dizziness and weakness, nausea and vomiting, scanty periods and fever.
To compensate for the lack of the hormone progesterone and prevent habitual miscarriages, to treat endometriosis, infertility and various menstrual cycle disorders, gynecologists often prescribe the drug Duphaston (Dydrogesterone) with synthetic progestin. In addition to the fact that both heavy bleeding and scanty periods are possible when taking Duphaston, progesterone analogues provoke headaches, skin allergic reactions and quite a few other side effects.
Scanty periods are possible after Utrozhestan, an analogue of Duphaston, but containing natural progesterone.
Side effects reported include nausea, diarrhea, itchy skin, and scanty periods after taking Clomiphene (Clomivid, Fertilin), a drug used to stimulate ovulation.
There are complaints of patients about nausea and scanty periods when taking Femoston - a drug for HRT during perimenopause containing synthetic analogues of estradiol and progesterone. This drug can also cause headaches; pain in the pelvis, abdomen and mammary glands; cramps in the calf muscles; intense uterine bleeding.
Scanty periods after Mastodinon also happen, although this is a herbal preparation and does not contain hormones, but it acts on the pituitary gland and helps reduce prolactin production. As for the drug Terzhinan (in the form of vaginal suppositories), prescribed for bacterial vaginosis and urogenital candidiasis, it does not contain hormones. And experts believe that possible scanty periods after a course of Terzhinan suppositories may be associated either with a history of uterine or ovarian diseases, or with the simultaneous use of hormonal agents, such as contraceptives.
For more information on whether there can be scanty periods after a medical abortion, see the publication – Medical Termination of Pregnancy
According to doctors, cases when scanty periods are observed after antibiotics or after aloe injections have nothing to do with the drugs: such actions have not been identified among their side effects. But there is such a thing as individual hypersensitivity to drugs. And if there are problems with hormone levels and the menstrual cycle, then a reduction in discharge during menstruation is also possible when using certain drugs.
Risk factors
Gynecologists and endocrinologists name quite numerous risk factors for the development of hypomenorrhea. These are uterine diseases that provoke scanty periods with clots in endometrial hyperplasia, and ovarian diseases - when women complain of scanty periods with an ovarian cyst, as well as that they have scanty periods and abdominal pain, which may be due to ovarian hyperplasia or polycystic ovary syndrome.
Various genital tract infections may be involved in this condition, in which scanty periods are sometimes observed after thrush, chlamydia or trichomoniasis.
Increased cortisol in the blood due to frequent or prolonged stressful conditions explains scanty periods after stress; read more - How are stress and hormone levels in the female body related?
Reduced immunity and weakening of the body with common diseases affect the menstrual cycle, and there may be scanty periods with a cold, flu, diseases of the upper respiratory tract and ENT organs. So scanty periods and temperature can coexist independently of each other if a woman has, for example, bronchitis or purulent tonsillitis.
Scanty periods without pain, in principle, do not particularly bother women and many are satisfied, especially since no one has canceled either the hereditary features of the reproductive cycle of women, or the predisposition to certain gynecological pathologies caused by genes. However, experts do not advise relaxing, even when such a cycle disorder occurs after significant weight loss. As is known, scanty periods after a diet with a reduction in the intake of nutrients necessary for the body very often lead to a serious hormonal imbalance, which negatively affects fertility.
Risk factors also include surgical interventions on the pelvic organs, which cause scanty periods after hysteroscopy of the uterus or scanty periods after laparoscopy of the ovary, temporarily weakening their functions.
Along with bleeding during termination of pregnancy, scanty periods are also possible after scraping (curettage) of the uterine cavity during an abortion, stopping uterine bleeding or removing a fibroid. In addition to reducing menstrual flow, these operations are fraught with the development of secondary amenorrhea (absence of menstruation) and Asherman's syndrome (formation of adhesions in the uterus).
Symptoms scanty periods
The characteristic signs of scanty periods are a decrease in the amount of discharge (with the volume of blood for all days of menstruation 4-5 times less than normal), and a slight reduction in the duration of menstruation and a disruption in their periodicity are also possible.
Hypomenorrhea, like other forms of abnormal menstruation, may be accompanied by general malaise, headaches and dizziness, a feeling of engorgement and soreness of the mammary glands.
Many women with scanty periods may experience bilateral aching and cramping abdominal pain, nausea and vomiting.
What's bothering you?
Complications and consequences
Most often, the consequences and complications of menstrual irregularities in the form of scanty periods are manifested due to its main cause. Thus, due to insufficient levels of estrogens in the body of women of childbearing age, there are difficulties with the onset of pregnancy, as well as problems with dry skin, thinning hair, decreased bone strength and susceptibility to genitourinary infections.
Deficiency of FSH also leads to a decrease in the ability to become pregnant and give birth to a child, since without this hormone, maturation of the egg is impossible. When the level of progesterone is reduced, the body's thermoregulation may be disrupted; a depressive state with headaches, bouts of irritability and aggression may develop; extensive acne rashes may appear on the skin and excess hair may grow.
And infertility, obesity, memory loss, depression and galactorrhea are the most likely pathological consequences of excess prolactin.
Diagnostics scanty periods
The main methods for diagnosing scanty periods include a standard gynecological examination, collecting the patient's medical history and complaints, as well as tests:
- general blood test;
- blood test to detect STDs;
- biochemical blood test for hormone levels (all sex hormones, thyroxine and ACTH);
- vaginal smear for cytology and microflora.
Instrumental diagnostics consists of ultrasonography (ultrasound) of the pelvic organs and, if necessary, computed tomography.
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Differential diagnosis
To identify the underlying cause of this disorder, differential diagnostics are performed, which uses: hysteroscopy of the uterus (endoscopic examination of the endometrium), laparoscopic examination of the ovaries, ultrasound of the thyroid gland and adrenal glands, CT of the brain (pituitary gland).
Who to contact?
Treatment scanty periods
The treatment of scanty periods prescribed by the doctor should take into account the causes of this pathology. And if the cause is in diseases of the uterus or ovaries (mentioned earlier), then they should be treated, including possible surgical treatment, for example, with ovarian cysts, polyps in the uterus and other pathologies, the treatment of which can be carried out surgically.
Many women try to restore their menstrual cycle using drugs with synthetic hormones, which have many side effects (for side effects of some of them, see the section Scanty periods as a side effect of pharmacological agents).
Usually, gynecologists prescribe hormonal contraceptives to “correct” the level of estrogen and progesterone. For example, with a lack of progesterone, Duphaston can be used - twice a day, 10 mg (for two weeks, from the 11th to the 25th day of the menstrual cycle). The drug is contraindicated in liver failure, enzymopathic jaundice, hereditary pigment hepatosis, acute heart failure and lactation. And its side effects are nausea and intestinal disorders, a feeling of discomfort in the mammary glands and uterine bleeding.
The drug Bromocriptine (Parlodel, Bomergon and other trade names) acts on dopamine receptors and slows the release of the hormone prolactin by the pituitary gland. It is prescribed one tablet (2.5 mg) per day. The drug is not used for low blood pressure, cardiac arrhythmia, atherosclerosis, gastric and intestinal diseases and mental disorders. Side effects include decreased blood pressure, headache, nausea, vomiting, constipation.
Tincture Tazalok (containing extracts of meadowsweet root, parsley, celery, etc.) is taken 30 drops three times a day (half an hour before meals). The product is not used in the presence of malignant tumors of any localization, during pregnancy and breastfeeding. The components of the drug can cause an allergic reaction.
Endocrinologists recommend that women with menstrual irregularities take B vitamins and vitamin E.
And homeopathy offers a remedy based on the extract of the plant Agnus castus Cyclodinone (in the form of tablets and drops), which also affects the production of gonadotropic hormones; one tablet (or 40 drops) is prescribed - once a day; treatment lasts three months. The use of this homeopathic remedy can cause allergic reactions and increased nervous excitement.
The tablet product Dysmenorm, in addition to chasteberry, contains bee venom (Apis mellifica) and an extract of the herb common pasqueflower (Pulsatilla); it is recommended for the treatment of ovarian cysts, normalization of the level of sex hormones and reduction of menstrual pain. The tablets are absorbed under the tongue - one tablet three times a day. Desmenorm can provoke vomiting, diarrhea, convulsions and a drop in blood pressure.
Folk remedies for scanty periods
An acceptable folk treatment for this condition is herbal treatment.
If the orthilia secunda (in the form of a tincture) is recommended by herbalists for the treatment of ovarian and uterine pathologies, then calendula infusion (in the form of tea) is recommended for all types of menstrual disorders.
It is better to use oregano (motherwort) infusion in the form of an alcohol tincture - 25-30 drops two or three times a day. And wormwood is usually used to prepare a decoction (a tablespoon per glass of boiling water) and taken three times a day, one tablespoon. This folk remedy is contraindicated during lactation due to the potential toxicity of wormwood essential oil, with increased stomach acidity and inflammation of the duodenum, as well as with allergies to plants of the Asteraceae family (for example, ragweed).
A decoction of lovage leaves (it is prepared similarly to a decoction of wormwood) activates blood flow in the pelvic area; the decoction should be taken one tablespoon no more than three times a day. Furocoumarins contained in the plant cause increased photosensitivity of the skin, and the plant also has diuretic properties.
Verbena officinalis (a decoction of the herb is used) contains β-sitosterol and increases contraction of the uterine muscles, and iridoid glycosides have hormone-like activity. Herbalists advise drinking 200 ml of this plant's decoction throughout the day (several sips), but warn: this remedy increases appetite and has a hypnotic effect.
Prevention
Since the causes and risk factors for scanty periods are numerous and varied, prevention of hypomenstrual syndrome includes, first of all, protection from sexually transmitted infections, normal nutrition (without strict diets that are harmful to women's health). It is useful to move more, avoid stress, strengthen the immune system and visit a gynecologist in time, without starting problems with the reproductive system. And hormonal contraceptives, like all medications containing hormones, should be prescribed by a doctor - after determining the hormone levels of each patient.
Forecast
It is difficult to predict the condition when women have scanty periods, because the biochemical interaction of hormones in the body has not been fully studied, and it changes depending on age and general health.