What do heavy periods feel like with perimenopause?

During perimenopause, ovulation may become less predictable. The lining of the womb can then build for longer before bleeding starts, which may produce a heavier flow or clots. You might also have skipped periods followed by a more substantial bleed, or notice cramps, breast tenderness, sleep disruption, hot flushes, or mood changes alongside cycle changes.

Perimenopause is one possible explanation, not a conclusion based on bleeding alone. Fibroids, medication effects, pregnancy-related causes, thyroid problems, and changes in the womb lining can also cause abnormal bleeding. A clinician can decide whether an examination or tests are needed, particularly if the pattern is new.

Keep a simple cycle diary: record bleeding dates, heaviness, clots, pain, and symptoms such as hot flushes or dizziness. Use products that suit your flow and plan access to replacements. Book a review if bleeding is disrupting work, sleep, sex, or exercise. Discuss options for controlling bleeding and managing other perimenopause symptoms, based on your medical history and contraception needs.

Seek prompt medical advice for bleeding between periods, after sex, or after menopause, or for a new persistent change in your usual pattern. Get urgent help if you are soaking protection rapidly, faint, severely dizzy, short of breath, or have severe pelvic pain.

Could this pattern fit perimenopause, or should other causes be checked? Do I need blood tests or an examination? Which treatments could reduce bleeding? What contraception remains suitable while my periods are changing?