What should you know about erratic periods perimenopause?

Perimenopause is the transition before menopause. Ovarian hormone production becomes less predictable, so the time between periods may shorten or lengthen, bleeding may be lighter or heavier, and a period may occasionally be missed. Some people also notice hot flushes, night sweats, sleep disruption, mood changes, or reduced sexual desire. These symptoms can occur with perimenopause, but irregular bleeding can have other causes, including pregnancy, thyroid problems, fibroids, polyps, or medicine effects.

Track the first day of each period, bleeding intensity, clots, pain, and associated symptoms. Note contraception, medicines, and the possibility of pregnancy. Arrange a routine appointment if the pattern is new, troublesome, or affecting daily life. A clinician may review your history, examine you, and choose tests based on your age, symptoms, pregnancy possibility, and bleeding pattern. Treatment can focus on bleeding, contraception, hot flushes, sleep, or mood when needed.

Seek urgent medical help for bleeding that rapidly soaks through protection, severe pelvic pain, faintness, chest symptoms, or breathlessness. Arrange prompt assessment for bleeding after sex, bleeding between periods, bleeding after menopause, or a change that persists. Pregnancy with pain or bleeding needs urgent advice because the cause cannot be assumed from perimenopause alone.

Ask whether your pattern fits perimenopause, which alternative causes should be checked, and whether you need a pregnancy test, blood tests, or pelvic assessment. Discuss options that suit your contraception needs and any history of migraine, clotting problems, or hormone-sensitive conditions.