When to worry about heavy periods with perimenopause

During perimenopause, hormone patterns fluctuate and ovulation may become less predictable. Periods may arrive closer together or farther apart, last longer, or become heavier. These changes can fit perimenopause, but they can also overlap with problems such as fibroids, polyps, changes in the womb lining, or pregnancy. A new bleeding pattern should not be attributed to hormones without assessment.

Track dates, flow, clots, pain, spotting, and any bleeding after sex. Make an appointment if heavy bleeding affects sleep, work, exercise, or intimacy, or if you feel tired or light-headed. Mention contraception, medicines, pregnancy possibility, and the date of your last expected period. A clinician may recommend an examination, blood tests, or imaging based on your history.

Get urgent medical help for rapidly increasing bleeding with faintness, severe weakness, breathlessness, chest discomfort, or confusion. Seek prompt assessment for severe pelvic pain, fever, or bleeding after menopause. If pregnancy is possible, say so immediately because urgent pregnancy-related causes must be considered.

Ask whether your pattern is consistent with perimenopause, whether you need testing for anaemia or another cause, and which treatments suit your medical history. Discuss what to do if bleeding returns after a period without bleeding.