Perimenopause bleeding every two weeks: what to know

During perimenopause, ovulation may become irregular or may not happen in some cycles. Hormone changes can then cause the uterine lining to shed earlier, later, or unpredictably. Bleeding two weeks apart may be a short cycle, spotting between periods, or a period that has not fully settled. Other explanations include fibroids, polyps, thyroid problems, infection, medicines, contraception, or pregnancy-related causes. Keeping a record helps distinguish timing from volume and duration.

Track the first and last day of each bleed, whether it was spotting or a flow, how often pads or tampons were changed, and symptoms such as cramps, fatigue, dizziness, or pelvic pressure. Arrange a non-urgent appointment if the pattern continues, is different from your usual cycles, or affects daily life. Bring a list of medicines and contraception, and mention any chance of pregnancy. A clinician may recommend an examination or tests based on your history.

Seek urgent care for rapidly heavy bleeding, fainting, severe pain, breathlessness, or profound weakness. Get prompt medical advice if you feel light-headed, have symptoms of anaemia, develop fever or unusual discharge, or could be pregnant. Bleeding after menopause always warrants assessment.

Ask whether the pattern could reflect irregular ovulation, whether you need a pregnancy test or blood tests, and what treatments could reduce disruptive bleeding. Ask which changes in amount, pain, or timing should trigger urgent help.