Does perimenopause cause heavy periods?

During perimenopause, ovulation may become less predictable. Hormone fluctuations can allow the uterine lining to build up before it sheds, so a period may be heavier, longer, or arrive after a gap. Bleeding patterns can vary from one cycle to the next.

Heavy bleeding is not specific to perimenopause. Fibroids, polyps, thyroid problems, pregnancy-related conditions, medicines, and bleeding disorders can also contribute. A clinician may ask about your cycle, medications, pregnancy possibility, pain, and symptoms of anaemia.

Record when bleeding starts and stops, how often you change period products, clots, pain, and any dizziness or breathlessness. Book a medical review if heavy bleeding is new, persistent, disruptive, or occurring after sex. Assessment may include a pregnancy test, blood tests, or pelvic examination depending on your situation.

Get urgent help if bleeding is soaking through products repeatedly, you feel faint or unusually weak, or you have severe pelvic pain. Seek prompt assessment for bleeding during pregnancy or after menopause. Heavy bleeding can lower iron levels, so ongoing tiredness, breathlessness, or palpitations also deserve attention.

Ask what may be driving the bleeding, whether you need blood tests or imaging, and which treatments suit your health and contraception needs. Discuss how to protect iron levels and what change should trigger urgent review.