Long periods in perimenopause

During the menopause transition, ovulation may become less predictable. The womb lining can therefore build and shed differently, causing periods to last longer, arrive closer together, become heavier or be followed by spotting. Perimenopause also commonly brings other changes such as Irregular Periods, Hot Flushes, Night Sweats, mood changes or lower sex drive.

Bleeding is not automatically due to perimenopause. Polyps, fibroids, medication effects, pregnancy-related causes and other conditions can produce similar changes, so the overall pattern and your personal history matter.

Track the start and end of each bleed, flow, clots, pain and any bleeding after sex. Note hot flushes, night sweats, missed periods and medicines. Arrange a routine review for a new pattern, repeated long periods or symptoms affecting daily activities.

At an appointment, discuss contraception if pregnancy is possible, because ovulation can still occur during perimenopause. Assessment may include an examination, pregnancy testing, blood tests or imaging when indicated.

Seek urgent help if bleeding is suddenly heavy, you feel faint or very weak, or you have severe pelvic pain or fever. Prompt medical review is needed for bleeding after sex or any bleeding after menopause.

Ask whether your symptoms fit perimenopause, whether another cause should be excluded, and how to monitor the bleeding. Ask about contraception, treatment choices and the warning signs that should lead to urgent care.