Why bleeding changes in perimenopause
As you approach menopause, ovulation becomes irregular and hormone levels swing around. This makes your cycle unpredictable: periods may come closer together or further apart, be lighter or much heavier, and you may notice spotting between periods or when you wipe.
Some of this is a normal part of the transition. Cycles becoming irregular is expected, and light spotting mid-cycle can happen as hormones fluctuate.
What's worth getting checked
Some bleeding patterns should still be assessed, even in perimenopause. See a GP if you have very heavy bleeding (flooding, large clots, needing to change protection hourly), bleeding that lasts longer than seven days, bleeding after sex, or periods that come closer than three weeks apart consistently.
These can be caused by benign issues like fibroids or polyps, hormonal changes, or occasionally something that needs closer investigation. Heavy bleeding can also lead to iron deficiency, which is worth checking and treating.
How it's managed
Your GP can arrange blood tests (including iron studies) and, where needed, a pelvic ultrasound. Treatments for troublesome perimenopausal bleeding include hormonal options such as the pill or a hormonal IUD, which can regulate or lighten periods.
And a reminder for later: once you're fully postmenopausal (12 months with no periods), any bleeding at all should be checked promptly.
Related condition
Menopause & perimenopause →References & sources
- 1.Menopause — Jean Hailes for Women's Health
- 2.Menopause — Better Health Channel
- 3.Hormone replacement therapy — healthdirect
- 4.Post-menopause — healthdirect
- 5.Menopause health info — Australasian Menopause Society
This content is general information and not a substitute for individual medical advice. Please consult a GP for your personal situation.
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