What do irregular periods feel like with perimenopause?

During the transition toward menopause, ovulation and reproductive hormone levels can become less predictable. A period may arrive earlier or later than expected, last for fewer or more days, or be lighter or heavier than your previous pattern. You may occasionally skip a period, then bleed again after a longer gap.

Other changes can include hot flushes, night sweats, sleep disruption, mood changes or vaginal dryness. These symptoms vary, and irregular bleeding can also result from pregnancy, fibroids, polyps, thyroid conditions, medicines or other causes.

Track dates, flow, clots, spotting, pain and other symptoms. Arrange a routine review if the pattern is new, troublesome or affecting daily life. Bring a list of medicines and contraception, and mention whether pregnancy is possible. A clinician can decide whether an examination or tests are needed and discuss options for troublesome bleeding or menopausal symptoms.

Use period products that suit the changing flow and plan for unexpected bleeding. Do not assume every change is perimenopause, particularly if you are younger than expected for the transition or symptoms began suddenly.

Seek prompt care for bleeding that soaks through protection repeatedly, dizziness, faintness, severe pelvic pain, bleeding after sex or bleeding between periods that persists. Any bleeding after twelve months without a period needs medical assessment, even if it is light.

Does my pattern fit perimenopause, or should we check another cause? What can help with heavy bleeding, pain, hot flushes or sleep problems? Which symptoms should lead me to seek urgent care?