Why does perimenopause cause heavy periods?

During perimenopause, the ovaries may not release an egg in every cycle. When ovulation is delayed or does not occur, progesterone may be lower or arrive later than usual. Oestrogen can continue stimulating the uterine lining, so the lining may become thicker and then shed with heavier or longer bleeding. The next period may also arrive earlier or later, and flow can vary from one cycle to another. Heavy Periods is a common presentation of Perimenopause.

Perimenopause is one possible explanation, not the only one. Fibroids, polyps, thyroid conditions, some medicines, pregnancy-related causes, and other conditions can also change bleeding. A clinician may ask about your cycle pattern, medicines, pregnancy possibility, pain, and symptoms such as tiredness or breathlessness.

Keep a simple record of when bleeding starts and stops, how often you need to change menstrual products, whether clots or pain are present, and whether bleeding happens between periods or after sex. Bring the record and a list of medicines or supplements to an appointment. Use the menstrual products that manage your flow comfortably, rest when needed, and seek advice before taking medicines intended to reduce bleeding or pain because some options are unsuitable for certain health conditions.

Arrange medical review if heavy bleeding is new, keeps returning, disrupts daily activities, occurs between periods or after sex, or comes with increasing pelvic pain. Ask about assessment if you feel unusually tired, weak, dizzy, or short of breath, since repeated heavy bleeding can contribute to anaemia. Seek urgent help if bleeding is so heavy that you cannot keep up with changing protection, or if you feel faint, confused, severely unwell, or have intense pain.

You could ask: Could my bleeding pattern fit perimenopause, or should other causes be checked? What examinations or tests are appropriate for me? How can we check for anaemia? Which treatment options might reduce the bleeding, and what risks or interactions should I know about?