Perimenopause and a delayed period

During perimenopause, the ovaries may not release an egg on the same schedule each cycle. This can make a period later, earlier, lighter or heavier than expected. Perimenopause can present with irregular periods and missed periods alongside hot flushes, night sweats or mood changes. A delayed period is not proof of perimenopause: pregnancy, stress, changes in weight, thyroid conditions and some medicines can also alter bleeding patterns.

Write down the first day of each bleed, its flow, pain and any symptoms between periods. If pregnancy is possible, use a home pregnancy test according to its instructions and seek clinical advice if the result is unclear or symptoms continue. Do not stop contraception solely because periods are irregular; ovulation may still happen during perimenopause. Book a review when changing cycles are worrying or disruptive.

Seek medical advice for repeated missed periods, bleeding between periods, bleeding after sex or a sudden change in flow. Get urgent help for severe one-sided pain, fainting, shoulder-tip pain or heavy bleeding with weakness, especially if pregnancy is possible. A clinician can assess the pattern and decide whether examination or testing is needed.

Ask whether your cycle pattern suggests perimenopause, how to rule out pregnancy or another cause, how long to continue contraception, and which bleeding changes should prompt an earlier review.