How common are irregular periods in perimenopause?

A period may arrive earlier or later than expected, last for a different length of time, or include spotting. Some people also notice hot flushes, night sweats, sleep changes, mood changes, or vaginal dryness. These symptoms can overlap with other conditions, and perimenopause is not confirmed by irregular bleeding alone. Pregnancy remains possible while periods continue, so contraception and pregnancy testing may need discussion.

Track dates, flow, clots, pain, spotting, and symptoms such as hot flushes. Mention any medicines, contraception, or bleeding after sex at an appointment. A clinician can review whether examination or tests are needed and discuss options for troublesome bleeding or other symptoms. If bleeding is affecting work, sleep, or daily activities, ask for support rather than trying to tolerate it alone.

Seek urgent help for very heavy bleeding with dizziness or faintness, severe pelvic pain, or possible pregnancy with pain or bleeding. Arrange prompt assessment for bleeding after sex, repeated bleeding between periods, bleeding after a year without periods, or a new persistent change that concerns you. These patterns need review even during perimenopause.

Does my bleeding pattern fit perimenopause, or should another cause be checked? Do I need contraception or a pregnancy test? What treatments could help my bleeding or hot flushes? Which changes should prompt another appointment?