Menopause Period Changes

Irregular Periods in Perimenopause: What Is Normal and What Is Not

In perimenopause, periods often become irregular. They may come closer together or further apart, and be heavier or lighter than before, until they stop for good. These changes happen because the ovaries release eggs less often. Most changes are normal. But very heavy bleeding, bleeding between periods and any bleeding after menopause need a doctor's check.

Please note: This page shares general health information in simple words. It is not medical advice. Every body is different, so talk to a doctor or gynaecologist before you try any treatment.

Key Facts About Period Changes in Perimenopause

Irregular periods are often the first sign of perimenopause.
Periods can come more or less often.
Bleeding can become heavier or lighter.
You can still get pregnant while you have periods.
Very heavy periods, bleeding between periods and bleeding after sex need a doctor's check.
Any bleeding 12 months or more after your last period must be checked.

How Do Periods Change in Perimenopause?

Your periods may change in many ways:

Coming closer together, like every 2 to 3 weeks
Coming further apart, or skipping months
Becoming heavier, with more clots
Becoming lighter or shorter
Lasting more days than before
Light spotting between periods

These changes can go back and forth for a few years before your periods stop.

Why Do Periods Become Irregular Before Menopause?

In perimenopause, the ovaries release eggs less often. In months with no egg, the body makes less progesterone. At the same time, estrogen can go up and down a lot. This makes the lining of the womb build up and shed at different times, so periods become less regular.

Hormonal birth control can hide these changes. It can make periods irregular or stop them, which makes it harder to tell when perimenopause starts.

Heavy Periods in Perimenopause

Periods can become heavier in perimenopause. Signs that your periods are heavy include:

Changing your pad or tampon every 1 to 2 hours, or emptying a menstrual cup more often than usual
Needing to use two period products at once
Periods that last more than 7 days
Passing clots larger than about 2.5 cm across
Bleeding through to your clothes or bedding
Feeling very tired or short of breath

Heavy periods can lead to low iron, which can make you very tired. Heavy periods can also have other causes, like fibroids or polyps. Rarely, they can be a sign of a more serious problem. This is why it is important to see a doctor.

Sirona Period Panties for Heavy Days

Period panties can give extra protection on heavy days and nights. The Sirona Eco-friendly Reusable Period Panty holds up to 60 ml of flow. It can be washed and reused up to 60 times. Sirona Disposable Period Panties are made for heavy flow and overnight use. You can also browse all Sirona period panties. These products help you manage bleeding. They do not treat heavy periods, so still see a doctor if your periods are very heavy.

Spotting in Perimenopause

Spotting is light bleeding between periods. In perimenopause, it can happen because hormone levels go up and down. But spotting can also have other causes, like polyps, infections or, rarely, cancer.

See a doctor if you:

Spot between periods often
Bleed after sex
Have spotting with pain or unusual discharge

Can You Get Pregnant in Perimenopause?

Yes. Even with irregular periods, you can still get pregnant. You may still release an egg some months. Doctors usually advise using birth control for a while after your last period. That is 2 years if you are under 50, or 1 year if you are over 50. Ask your doctor what is right for you.

Is Bleeding After Menopause Normal?

No. Any bleeding or spotting 12 months or more after your last period must be checked by a doctor. This is true even if it happens only once. It is usually not serious. But it can be a sign of cancer, so get it checked early. Read our full guide on bleeding after menopause.

When Should You See a Doctor?

See a doctor or gynaecologist if:

Your periods are much heavier than before.
Heavy periods affect your daily life.
Your periods last more than 7 days.
Your periods come less than 3 weeks apart.
You bleed between periods or after sex.
You feel very tired or short of breath.
Your periods stop before age 45. Read more about early menopause.
You have any bleeding after menopause.
You are on HRT and have bleeding that has not settled after 6 months.

Related Terms

Shop period care: Sirona Period Care Collection

Sources

NHS. Symptoms of menopause and perimenopause. https://www.nhs.uk/conditions/menopause/symptoms/
NHS. Heavy periods. https://www.nhs.uk/conditions/heavy-periods/
NICE. Menopause: identification and management (NG23). https://www.nice.org.uk/guidance/ng23
Ahuja M. Age of menopause and determinants of menopause age: A PAN India survey by IMS. Journal of Mid-Life Health, 2016. https://pmc.ncbi.nlm.nih.gov/articles/PMC5051232/
Sirona Eco-friendly Reusable Period Panty product page. https://thesirona.com/products/eco-friendly-reusable-period-panty
Sirona Disposable Period Panties product page. https://thesirona.com/products/disposable-period-panties

Disclaimer: This page is for general information only. It is not a substitute for advice, diagnosis or treatment from a qualified doctor. It was written by the Sirona Content Team using the trusted medical sources listed above. Always talk to your doctor or gynaecologist about your symptoms and before starting any medicine, supplement or product. If you have heavy bleeding, chest pain, trouble breathing or severe pain, get medical help right away.