Missing periods during perimenopause

Perimenopause is the transition before menopause. Ovulation becomes less predictable, so the interval between bleeds may shorten, lengthen, or include a missed period. Flow may also become lighter or heavier. Other symptoms can include hot flushes, night sweats, sleep disruption, mood changes, or lower sexual desire.

A missed period is not proof that menopause has occurred. Pregnancy can remain possible while periods continue, so mention contraception and pregnancy possibility during an assessment. A clinician can also consider other explanations for a changed cycle.

Record bleeding dates, flow, pelvic symptoms, hot flushes, sleep, and medicines. Use products that make heavy bleeding easier to monitor, and discuss contraception if pregnancy is not desired. Treatments for troublesome symptoms depend on your health history and personal preferences.

Book a routine review if changes interfere with sleep, work, sex, or daily activities. Bring your cycle record and a list of medicines, supplements, and relevant medical conditions.

Seek prompt care for bleeding that soaks through protection repeatedly, bleeding after sex, bleeding between periods, or any bleeding after menopause has been established. Severe pelvic pain, dizziness, or fainting also warrants urgent assessment.

Could my bleeding pattern fit perimenopause? How should I manage heavy or disruptive symptoms? Do I still need contraception? Which bleeding changes should prompt an urgent call?