My period comes without abdominal pain, but the flow is just spotting—what could be the reason, and what should I do?
May 26, 2023
Source: Cainiu Health
Dr. Lv Aiming
Introduction
In general, menstruation should not cause abdominal pain, and if menstrual flow appears as dripping, it may be due to factors such as thin endometrial lining, intrauterine adhesions, diminished ovarian function, uterine fibroids, or polycystic ovary syndrome. Appropriate treatment should be administered based on the specific condition. If this symptom persists without improvement, it is important to seek medical attention at a hospital as early as possible for proper evaluation and treatment.
Generally, menstrual pain does not occur, and menstruation may appear as spotting due to factors such as thin endometrium, intrauterine adhesions, ovarian function decline, uterine fibroids, or polycystic ovary syndrome (PCOS). Appropriate management should be based on the specific underlying cause. Detailed analysis is as follows:
1. Thin Endometrium
Menstruation reflects the cyclical changes of the female uterus, regulated by ovarian activity and influenced by estrogen levels, which promote follicular development. If a matured egg is not fertilized, the corpus luteum regresses, leading to decreased estrogen levels and subsequent necrosis of the endometrial lining, resulting in menstruation. Women with naturally thin endometrial linings may shed only a small amount of tissue, causing painless periods with spotting—this is considered normal. During this time, it is recommended to avoid cold exposure and excessive fatigue.
2. Intrauterine Adhesions
Frequent pregnancies may damage the basal layer of the endometrium. During the healing process, adhesions can form, potentially leading to localized blockage within the uterine cavity. This obstruction prevents normal outflow of menstrual blood, resulting in spotting and reduced menstrual pain. It is recommended to visit a hospital for hysteroscopic surgery to separate the adhesions.
3. Ovarian Function Decline
In older women, aging can lead to gradual deterioration of ovarian function and reduced estrogen levels. This may result in atrophy of reproductive organs and insufficient estrogen stimulation of the endometrium, thereby causing the aforementioned symptoms. It is advisable to seek medical evaluation and appropriate treatment. Under a doctor’s guidance, patients may use medications such as compound estradiol valerate tablets or dydrogesterone tablets.
4. Uterine Fibroids
Uterine fibroids are common benign tumors that typically develop within the uterine wall. They may cause irregular or abnormal menstruation. In some cases, fibroids can reduce menstrual flow, even leading to spotting. Additionally, depending on their location, fibroids may reduce menstrual pain. Patients should seek treatment at a reputable hospital, where surgical removal of fibroids may be recommended.
5. Polycystic Ovary Syndrome (PCOS)
PCOS is a hormonal disorder characterized by metabolic imbalances and often associated with the formation of multiple ovarian cysts. It commonly causes menstrual irregularities or secondary amenorrhea. In some cases, menstruation may become very light, presenting as spotting. Because menstrual flow is incomplete, significant pain may be absent. Under medical supervision, patients may be treated with medications such as letrozole tablets or bromocriptine mesylate tablets.
If these symptoms persist without improvement, it is important to seek timely medical attention for proper diagnosis and treatment.
