The causes and the treatment of scanty menstruation are those which have already been considered under Amenorrhea.
Vicarious Menstruation.—Vicarious menstruation is the discharge of blood, at the menstrual periods, from some part of the body other than the uterus. In some cases, instead of a discharge of blood, a secretion of another character takes place.
The vicarious discharge may be the only phenomenon present, or it may occur supplementary to the normal uterine bleeding.
The vicarious bleeding may take place from almost any part of the mucous or cutaneous structures. It occurs from the nose, the throat, the lungs, the stomach, the bladder, and the anus. It may occur from an ulcer or other lesion of the external surface. Sometimes the cutaneous hemorrhages appear in the form of ecchymoses.
Various secretions may take the place of the bleeding. A monthly flow of milk from the breasts has been observed, and a periodical diarrhea or leucorrhea has taken place.
Vicarious menstruation is a rare condition. It may occur in defective development of the uterus and ovaries. It is usually found in debilitated nervous women, and accompanies a deficient menstrual discharge from the uterus.
Treatment.—Direct local treatment should be applied to the vicarious bleeding only when it becomes excessive. The general health of the woman should receive attention. Treatment should be applied to any local lesion of the genital apparatus that may be discovered. The directions given for amenorrhea are also applicable here.