Periods and menopause: what to expect

Hormone changes can make periods irregular. You may skip a cycle, bleed more or less than before, or notice that the gap between periods changes. These changes happen during perimenopause; menopause itself is confirmed after twelve months without a period.

Other symptoms can appear alongside period changes, including hot flushes, night sweats, vaginal dryness, mood changes, or reduced sex drive. Bleeding that is unusually heavy, prolonged, painful, or occurs after menopause has a different significance and should be assessed.

Track period dates, flow, clots, pain, and symptoms in a calendar or app. Note medicines, contraception, and any bleeding after sex. This record helps a clinician tell a menopause pattern from another cause.

Use suitable period products and plan for an unpredictable cycle. If symptoms disturb sleep, work, sex, or mood, book a review to discuss options. A clinician may check for anaemia or other causes when bleeding is heavy or unusual.

Seek urgent help if you feel faint, very weak, short of breath, or have severe pelvic pain with heavy bleeding. Arrange a medical review for bleeding after twelve months without periods, bleeding between periods, bleeding after sex, or a pattern that is becoming difficult to manage.

Ask whether your pattern fits perimenopause, whether another cause should be checked, and which treatments could help heavy bleeding or other symptoms. Mention contraception needs, because pregnancy can remain possible during the transition until menopause is established.