What should you know about hormone changes perimenopause?

Hormone production does not change in a perfectly even pattern. Ovulation may become less predictable, so bleeding can arrive earlier, later, become heavier or be missed. Lower or fluctuating oestrogen can affect temperature regulation, vaginal comfort, sleep and sexual desire. Some people notice irritability, anxiety or low mood; others notice little change. These experiences can vary from month to month. Perimenopause is different from menopause, which is reached after twelve months without a period when no other cause explains the change.

Track bleeding, hot flushes, sleep, mood and medicines so patterns are easier to discuss. Regular movement, breathable layers, a cooler bedroom and limiting personal triggers may help with heat symptoms. Protect sleep with a steady routine and seek support if mood or intimacy is affected. A clinician can review contraception, thyroid or other causes of bleeding changes and discuss treatment choices. Ask for help if heavy periods interfere with daily activities.

Arrange medical advice for bleeding after sex, bleeding between periods, bleeding that is unusually heavy or prolonged, or any bleeding after menopause. Seek urgent care for soaking bleeding with dizziness, severe pelvic pain, fainting, chest pain or trouble breathing. New low mood with thoughts of self-harm needs immediate support through local emergency services.

Could my symptoms be perimenopause or another condition? What can explain my bleeding pattern? Which options could help sleep, flushes, mood, vaginal symptoms or contraception, and what follow-up would I need?