How Perimenopause Affects Your Period

Perimenopause can bring noticeable changes to your menstrual cycle, like longer and irregular periods, due to fluctuating estrogen and progesterone levels. Understanding these changes can help you manage symptoms more effectively and know when to reach out to a healthcare provider.

Longer Periods in Perimenopause

Perimenopause is the phase when your menstrual cycle begins to change. Menopause is the point when you’ve gone a full year without a period.

During perimenopause, the levels of estrogen and progesterone can fluctuate each month. Higher estrogen levels can lead to a thicker uterine lining, resulting in longer periods because your body needs more time to shed this lining.

If your periods are longer, it’s helpful to keep tampons, pads, or other supplies available, even if you think your period has ended. You can use a journal or apps to track your period, understand its usual length, and note any changes. 

Other Period Changes During Perimenopause

Hormone fluctuations during perimenopause can make each month vary greatly. Your cycle may deviate significantly from the usual pattern. 

Spotting Between Periods

Spotting is bleeding between periods and can occur for various reasons, including changes in birth control. During perimenopause, your periods might become unpredictable, and spotting can occur. 

While spotting is usually not concerning, you should report any excessive bleeding to your healthcare provider. Lighter periods are commonly associated with perimenopause.

Sometimes, spotting may indicate underlying issues. It’s important to discuss any concerns with your healthcare provider and keep up with regular gynecological visits and pelvic exams.

Shorter Cycles

Everyone experiences their period differently, including its length. Shortening cycles can be the first sign of perimenopause for some. 

Hormone changes during perimenopause shorten the follicular phase, leading to quicker ovulation. This often results in shorter, earlier periods, which can arrive two to three days sooner than expected.

Shorter cycles might lead to two periods in one month, with another period potentially occurring three weeks after the last.

Missed Periods

A woman’s period can change from month to month during the perimenopause phase and can even be skipped altogether. Some women will experience a skipped period followed by an especially heavy period.

Periodic changes are common during perimenopause and can result in skipped periods or particularly heavy ones following a missed cycle. 

Expectations are uncertain, though. About one in 10 individuals stop menstruating quickly, with no persistent irregularity.

Heavier Periods

Heavy bleeding during your period, called menorrhagia, involves losing 80 mL or more of blood. If you bleed through tampons or pads quickly, you may be experiencing heavy periods.

Higher estrogen levels compared to progesterone can cause the uterine lining to grow thicker, leading to heavier bleeding.

Brown or Dark Blood

Old blood may appear dark or brown as it leaves the body, while quickly exiting blood looks bright red, typical of normal periods. Blood that remains in the uterus can oxidize and change color. 

This discoloration can occur during perimenopause, ovulation, or early pregnancy. In perimenopause, hormonal imbalances commonly cause the uterine lining to break down differently, extending the time blood remains in the uterus. 

Can You Get Pregnant in Perimenopause?

The chance of getting pregnant during perimenopause is lower but still exists.

The National Center for Health Statistics reported 840 births to individuals aged 50 and over in 2017. The birth rate for those 45 and older was 0.9 per 1,000 individuals.

This means that if you’re in perimenopause and have vaginal sex, pregnancy can still occur. To prevent pregnancy, continue using birth control.

Tips for Managing Periods in Perimenopause

Period changes and symptoms can disrupt daily life during perimenopause. Fortunately, there are ways to manage these changes and improve comfort. 

Given the unpredictability of perimenopause symptoms, it’s wise to plan ahead. Prepare for hot flashes by wearing light clothing, carrying extra tampons or pads, and drinking in moderation. 

Additional treatments and lifestyle adjustments include: 

• Exercise regularly to boost mood and overall health. 
• Quit smoking to improve cardiovascular and general health.
• Maintain a healthy weight to manage symptoms. 
• Use a lubricant or vaginal moisturizer for added comfort. 
• Consider hormone replacement therapy for specific symptom relief. 
• Explore non-hormonal medications to help manage symptoms.

When to See a Healthcare Provider

Consult your healthcare provider if you experience: 

• Unusually long periods
• Excessively heavy periods 
• Spotting between periods
• Bleeding during intercourse 

While these symptoms are common in perimenopause and typically not worrisome, it’s important to update your provider on any changes. Whenever you’re uncertain or concerned, reach out to them.