Excessive bleeding during perimenopause

When ovulation is less predictable, the womb lining may build and shed differently, producing bleeding that is heavier, longer or less regular. Perimenopause can present with heavy periods, but fibroids, polyps, pregnancy-related problems, thyroid conditions, bleeding disorders and medicines can also contribute. Bleeding after sex or between periods has its own significance and should be mentioned during assessment.

Record when bleeding starts and stops, how often protection needs changing, clots, pain, dizziness and medicines such as anticoagulants. Arrange an appointment if the pattern is new, troublesome or affecting your activities. Ask about treatment choices and whether you need an examination, blood tests or imaging. Do not self-treat prolonged bleeding without advice, particularly if pregnancy is possible.

Seek urgent care if bleeding is rapidly soaking protection, continues with faintness or severe weakness, or occurs with severe pelvic pain. Get prompt advice for bleeding after sex, bleeding between periods, or any bleeding after menopause. Emergency help is needed for collapse, chest pain or trouble breathing. These warning signs reflect the symptom’s severity, not a prediction about its cause.

Ask what may explain the bleeding, whether anaemia needs checking, which treatments fit your health history, and what amount or pattern should trigger urgent review.