Perimenopause and a late period

During perimenopause, the ovaries may not release an egg in every cycle or may do so at a different time. The uterine lining can therefore shed later, earlier, or with a different amount of bleeding. A late period is a common presentation of perimenopause, but it does not identify the cause by itself. Pregnancy remains possible while periods continue. Stress, illness, weight change, intense exercise, thyroid problems and some medicines can also affect timing.

Write down the first day of each period, the number of days between bleeds, flow, pain and any spotting. If pregnancy is possible, take a home pregnancy test according to its instructions and repeat or seek advice if uncertainty remains. Keep contraception in place until a clinician confirms it is no longer needed. Mention hot flashes, night sweats, sleep problems or mood changes at an appointment, since the wider pattern is more informative than one late cycle. Treatment is not always needed, but bothersome symptoms can be addressed.

Arrange medical advice for repeated late or missed periods, bleeding between periods, bleeding after sex, new pelvic pain or a positive pregnancy test with pain or bleeding. Seek urgent care for severe pain, fainting, dizziness, or bleeding that is heavy enough to make you feel weak or unwell. Any bleeding after twelve months without a period should be assessed.

Ask whether your cycle pattern fits perimenopause, whether pregnancy or other tests are needed, and how to manage contraception and bleeding changes. Bring your cycle record and list of medicines.