Irregular periods in perimenopause: what's expected and what isn't

Irregular periods are often the first sign of perimenopause. Cycles may get shorter or longer, flow may change, and periods may be skipped as ovulation becomes less regular. Some patterns — very heavy bleeding, bleeding between periods or after sex, or any bleeding after menopause — are not simply 'perimenopause' and should be checked.

Changes that are common

• Cycles that become shorter, then later longer
• Skipped periods, sometimes for months
• Flow that is lighter or heavier than before

Changes to get checked

ACOG advises that abnormal bleeding in perimenopause can have other causes, such as polyps, fibroids, thyroid problems or, less often, endometrial changes, so it should be evaluated rather than assumed.

• Periods very close together (less than about 21 days apart)
• Bleeding lasting more than 7 days, or much heavier than usual
• Spotting or bleeding between periods or after sex
• Any bleeding after 12 months with no period

Pregnancy is still possible

Ovulation can still happen during perimenopause, so pregnancy remains possible until menopause is confirmed. Talk with a clinician about contraception if you don't want to become pregnant.

When to talk with a healthcare professional

• Symptoms are affecting your sleep, work, relationships or daily life.
• You want to know whether a treatment fits your personal and family health history.
• Your bleeding pattern matches anything in the 'get checked' list.

When to get prompt care

• Any vaginal bleeding after menopause (12 months without a period) should be checked by a clinician.
• Soaking a pad or tampon every hour for several hours, or bleeding with dizziness or faintness, needs prompt care.

How Dot can help

Dot's cycle log records period dates and flow so you and your clinician can see your pattern over months. Dot can show the pattern; it does not decide whether bleeding is normal.

How Dot works · Kindr Care clinical care

Related topics

• Heavy periods
• Perimenopause
• FSH
• Progesterone
• Menopause

Sources

1. American College of Obstetricians and Gynecologists. Perimenopausal Bleeding and Bleeding After Menopause (patient FAQ).
2. American College of Obstetricians and Gynecologists. Abnormal Uterine Bleeding (patient FAQ).
3. American College of Obstetricians and Gynecologists. The Menopause Years (patient FAQ).
4. National Institute on Aging (NIH). What Is Menopause?.

This page is educational and not medical advice. Dot does not diagnose or prescribe. See our editorial policy.