根据《黄帝内经》记载：“女子二七而天癸至，任脉通，太冲脉盛，月事以时下，故能有子。”这意味着女性在14岁左右迎来初潮，标志着生殖系统的成熟。现代社会中，许多女性的月经周期出现了提前的趋势。有的女孩在11-12岁，甚至9-10岁就开始乳房发育和月经初潮。这种提前的月经初潮不仅可能带来心理压力，还可能对身体健康产生不利影响。例如，过早的性发育可能导致骨骺过早闭合，影响身高增长。

Menstruation is a barometer of women's health, and the amount of menstruation directly reflects the health of women's bodies. However, many women often feel confused and anxious when facing the problem of scanty menstruation. This article will explore the definition, causes, conditioning methods, and daily health care preventive measures of scanty menstruation from the perspective of combining traditional Chinese and Western medicine, and combine actual cases to help everyone better understand and deal with this common problem.

一、月经量少的中西医双重解读
1. 医学定义与危害

• ​正常标准：现代医学认为，每次月经量大于20ml为正常，小于20ml则是月经量少。一般可根据使用卫生巾的片数判断，普通中等体型女性，月经量20ml大概是4-5片卫生巾的量，相对正常的月经量应达到30ml左右，即5-7片卫生巾的量。每次月经量20-60ml（约4-7片卫生巾），＜20ml为异常（《妇产科学》第9版）。
• ​长期危害：子宫内膜容受性下降→不孕风险↑；气血亏虚→早衰、免疫力↓。

2. 西医核心病因

​类型	​典型表现	​检查指标	​治疗手段
Endocrine disorders	多囊卵巢综合征（PCOS）、甲减	雄激素↑、TSH↑、B超监测卵泡	达英-35、优甲乐+促排卵药
子宫器质病变	宫腔粘连（Asherman综合征）	宫腔镜检查、内膜活检	宫腔镜手术+雌激素序贯治疗
卵巢功能衰退	FSH＞40IU/L、AMH＜1.1ng/ml	性激素六项、抗缪勒管激素	激素替代疗法（HRT）

3. 中医辨证分型

• ​肾气不足型：初潮早（＜12岁）、经色淡、腰膝酸软→右归丸加减。
• ​肝郁血瘀型：经前乳房胀痛、经血紫黑有块→逍遥散合桃红四物汤。
• ​脾虚痰湿型：肥胖、白带多、舌苔厚腻→苍附导痰丸+参苓白术散。

4. 月经量少的原因

①Endocrine disorders

• Polycystic ovary syndrome (PCOS)：PCOS is one of the main causes of scanty menstruation. Its typical symptoms include reduced menstrual volume, prolonged menstrual cycles, and even amenorrhea. In addition, PCOS patients may also experience elevated androgen levels, leading to symptoms such as hirsutism and acne.
• Thyroid dysfunction: Hyperthyroidism or hypothyroidism will affect hormone secretion, which in turn affects menstrual volume.
• Hyperprolactinemia: Excessively high prolactin levels can inhibit ovulation and lead to reduced menstrual flow.

常见的如多囊卵巢综合征（多囊）、甲状腺功能异常、高泌乳素血症等，会导致激素分泌问题，影响子宫内膜生长。正常情况下，女性来月经前子宫内膜大概要达到1厘米厚度，若内膜不够厚，或内膜厚但不剥脱，都会导致月经量少或月经不顺畅。

激素分泌出现问题，会影响子宫内膜的生长，使其无法正常发育。很多人做过B超，做B超时往往会关注子宫内膜的情况。子宫内膜的厚度决定了月经量的多少以及月经是否能够正常来潮。女性在来月经前，子宫内膜厚度大概要达到一厘米。达到这个厚度，就如同海绵吸满了水，水越充足，才能挤出更多的水，这里的水就相当于月经和血量。

当月经来临，子宫内膜增厚，随着月经到来，子宫内膜剥脱并开始出血，血液慢慢排出体外，月经结束后，内膜又会逐渐变薄。之后身体自动造血补充，内膜又会逐渐变厚。这就是月经量在检查上的体现。

②Endometrial problems

• Insufficient endometrial thickness：The endometrium is the "soil" for menstruation, and its thickness directly affects the amount of menstruation. Generally speaking, the thickness of the endometrium should reach about 1 cm to ensure normal menstrual volume.
• Endometrial non-exfoliation: Even if the endometrium is thick enough, if the endometrium is not shed, menstruation cannot be discharged normally, resulting in less menstrual flow.

③Organic changes in the uterus

• Uterine inflammation, adhesions, polyps：These organic changes will directly affect the function of the endometrium, leading to a decrease in menstrual volume. For example, women who have given birth or have undergone uterine curettage may have inflammation or adhesions in the uterus, which will affect the amount of menstruation.
• 因此，很多女性看到月经量少就认为是血虚而进行补血，大部分情况下有一定道理，但前提是要排除子宫存在炎症、粘连、息肉等器质性改变的情况。

Case Study

Ms. Li, 32 years old, came to see a doctor because of scanty menstruation. B-ultrasound examination showed that the thickness of the endometrium was insufficient, only 0.5 cm. Combined with other examination results, it was diagnosed as scanty menstruation caused by endocrine disorders. After three months of hormone treatment and Chinese medicine conditioning, Ms. Li's menstrual flow returned to normal.

---

​二、中西医联合调理方案

（整合搜索结果与临床路径）
1. 分阶段干预策略

​阶段	​西医重点	​中医协同	​疗程目标
急性调理期（1-3月）	激素调节（如PCOS用二甲双胍）	桂枝茯苓丸祛瘀生新	内膜厚度≥8mm
巩固期（4-6月）	监测排卵（基础体温法）	归脾汤补气血+艾灸关元穴	月经周期规律（±3天）
维持期（＞6月）	生活方式干预	八珍益母丸+耳穴压豆（内分泌穴）	预防复发

2. 特色外治法

• ​中药灌肠方：红藤30g+败酱草20g+三棱15g，睡前保留灌肠（湿热瘀阻型）。
• ​穴位埋线：取子宫、三阴交、足三里穴，每月1次，调节冲任二脉。

3. 月经量少在中医角度的认知

1. 中医认为月经与肾气、天癸、冲任二脉关系密切。

1）肾气（天癸）是源头：

肾气充足，天癸才能正常发挥作用。月经来的早或晚，一定程度上反映了肾气的情况，过早来月经大多是提前损耗肾气，不过也有肾气充盈且月经正常的天赋异禀者。

首先是源头，即天癸。天癸实际上就是肾气是否充足的体现，肾气充足，天癸才能正常发挥作用。

这在月经初潮的早晚上有典型表现，有的人月经来的早，有的人来的晚。根据我的观察，月经来的早的人，大多是因为提前损耗、催发了肾气，从而损伤了身体的肾气。所以，我认为过早来月经并非好事。

当然，也存在特殊情况，有些肾气极为充盈的人，即便月经提前，也不会提前绝经，且从始至终月经量都相对充足，这类人属于天赋异禀。肾气如同水龙头开关，只有肾气充足，月经才会正常来潮。

2）任脉通、太冲脉盛是通道：

任脉和太冲脉如同水管、河道，要通畅稳固。若通道出现问题，会导致月经期出血、排卵期出血，或月经提前、推迟等情况。

其次是任脉通、太冲脉盛，这如同水管、河道，河道要通畅、稳固，月经才不会出现异常。因为有的女性会出现不在月经期也出血的情况，即非经期出血，还有部分人会在排卵期出血。这是因为通道可能出现堵塞或渗漏，导致月经异常流出。除了月经异常流出，还会出现月经提前或推迟的情况，这些都与通道问题有关。

中医看待问题较为全面，分析这些问题时并非只关注单一因素，而是要综合关联来看。

3）情绪影响：

情绪对月经影响很大，心情好时月经乳房可能不痛，心情不好时不仅乳房痛、小腹痛经，月经量也可能变少、有血块或颜色变深。女性以肝为先天，要养肝养血，避免熬夜，因为熬夜伤肝，会使皮肤变差、衰老加快。

4. 中医临床常见的月经量少类型及调理方法

①Qi and blood deficiency

• symptom：The menstrual flow is small, light in color, and bloodless. The patient is usually short of breath, lazy to speak, and easily tired.
• Preparation method: Take Bazhen Pills, Shiquan Dabu Pills, or stew more Siwu Soup (you can add Astragalus to replenish Qi) to replenish Qi and blood.

②Types of liver and kidney deficiency

• symptom：It often occurs in women over 40 years old who are approaching perimenopause or menopause. Symptoms include hot flashes, sweating, soreness in the waist and knees, etc.
• Preparation method: Take Liuwei Dihuang Pills, Zuogui Pills, etc. to nourish the liver and kidneys.

③Types of Qi stagnation and blood stasis

• symptom: The menstrual volume is small, dark in color, purple-black and contains blood clots. If it is not smooth, it will be painful, and there will be bloating or tingling.
• Preparation method：The key to TCM pain treatment is to change the pressure imbalance in the painful area. It is recommended to seek treatment from a professional physician.

Case Study

Ms. Wang, 45 years old, was approaching menopause. Her menstrual volume gradually decreased, accompanied by symptoms such as soreness of waist and knees, hot sweats, etc. She was diagnosed with liver and kidney deficiency type of scanty menstruation. She was given Liuwei Dihuang Pills and Zuogui Pills for conditioning. After three months, her menstrual volume increased and other symptoms were relieved.

---

​三、现代女性必知的月经养护法则

（结合搜索结果与生活方式医学）
1. 饮食禁忌清单

• ❌ 忌生冷：冰淇淋、冰镇饮料→寒凝血瘀。
• ❌ 忌甜腻：蛋糕、奶茶→助长痰湿。
• ✅ 宜温补：当归生姜羊肉汤（每周1次）、黑芝麻核桃糊（补肾填精）。

2. 运动处方

• ​八段锦“调理脾胃须单举”​：每日晨练10分钟，升发脾阳。
• ​凯格尔运动：增强盆底肌群，改善盆腔血液循环（适合产后女性）。
• 时不时敲一敲肘窝、腋窝、腘窝、腹股沟等部位。

3. 情志管理技巧

• ​疏肝解郁茶：玫瑰花5g+陈皮3g+绿萼梅3g，沸水冲泡代茶饮。
• ​正念冥想：每天15分钟，降低皮质醇水平（研究显示可改善经期头痛）。

---

​四、典型案例解析

案例1：PCOS继发闭经

• ​患者：28岁，闭经6个月，BMI 28.5，多毛。
• ​西医：达英-35×3月，睾酮降至正常。
• ​中医：二甲双胍+苍附导痰丸×3月，配合针灸三阴交、丰隆穴。
• ​结果：月经恢复规律，成功自然妊娠。

案例2：产后宫腔粘连

• ​患者：32岁，人流术后经量减少80%，周期性腹痛。
• ​西医：宫腔镜分离粘连+球囊支架。
• ​中医：雌激素序贯治疗+八珍汤口服，艾灸子宫穴。
• ​结果：内膜厚度从4mm增至9mm，经量恢复至正常80%。

IV. Daily health care and prevention of scanty menstruation

1. Maintain a healthy lifestyle

• Work and rest routine: Try to maintain a regular schedule and avoid staying up late.
• Eat a balanced diet: Eat more foods rich in protein, vitamins and minerals, such as fresh vegetables and fruits, high-quality protein, etc.

2. Pay attention to emotional regulation

• Emotional Management: Keeping emotions in your heart is harmful and useless, you should vent your emotions appropriately. You can try to relieve stress through exercise, meditation, etc.
• Positive attitude：Maintaining a positive and optimistic attitude is conducive to physical health.

3. Drug health care

• Liver Qi Stagnation: You can take Xiaoyao Pills or Jiawei Xiaoyao Pills.
• People with weak blood: You can take Shiquan Dabu Pills, Bazhen Pills, Bazhen Yimu Pills, etc.
• Liver and kidney deficiency: You can take Liuwei Dihuang Pills, Zuogui Pills, etc.

4. Sports and health care

• Moderate exercise: Women can perform Tai Chi, yoga and other exercises appropriately, and can also tap the elbows, armpits, popliteal fossa, groin and other parts from time to time to promote blood circulation.

​5.食疗对比表：

​类型	推荐药膳	禁忌食物
Qi and blood deficiency	当归生姜羊肉汤	冰淇淋、冷饮
肝郁血瘀型	玫瑰花陈皮茶	奶茶、甜点

V、Summarize

Low menstrual volume is a common health problem for women. Through the combination of Chinese and Western medicine, we can have a more comprehensive understanding of its causes and take corresponding conditioning measures. Whether it is organic changes or functional changes, the problem can be solved through scientific examinations and personalized treatment plans. I hope this article can provide a useful reference for the majority of female friends and help them better deal with the problem of low menstrual volume.