For many women the first sign of perimenopause isn't a hot flush, it's their periods going rogue. Closer together one month, skipping the next, suddenly much heavier, or lighter and briefer. If your cycle has become unpredictable in your 40s, this is one of the most common and expected changes, though some kinds of bleeding always deserve a check.
Why perimenopause changes your periods
In perimenopause, ovulation becomes irregular and oestrogen and progesterone rise and fall unevenly. Because those hormones control the timing and the build-up of your womb lining, your cycle length and your flow both become less predictable. This is a normal part of the transition and can carry on for a few years before periods stop altogether.
What's common in perimenopause
- •Cycles getting shorter or longer, and becoming less regular
- •Skipping periods for a month or two, then having one again
- •Heavier or lighter bleeding than you're used to
- •Periods gradually spacing out before they stop
How you know you've reached menopause
Menopause is confirmed once you've had 12 months with no period at all. Until then, even with long gaps, you're still perimenopausal, and note you can still get pregnant during perimenopause, so contraception is still worth thinking about until you're through it.
Some bleeding always needs checking. See your GP if you have: very heavy bleeding (flooding, or clots, soaking through protection), bleeding or spotting between periods, bleeding after sex, or any bleeding at all after you've gone 12 months without a period (postmenopausal bleeding). These are usually not serious, but they need looking into to rule out other causes.
Not sure if it's perimenopause?
Map your symptoms in under 10 minutes and get free, personalised advice, then talk to a nurse prescriber if you want to.
Frequently asked questions
Are irregular periods a sign of perimenopause?
Yes, often the first sign. As ovulation becomes irregular and hormones rise and fall unevenly, your cycle length and flow become less predictable, closer together, further apart, heavier or lighter.
Is it normal to skip periods in perimenopause?
Yes. Skipping a month or two and then having a period again is common as you move through perimenopause. Periods usually space out gradually before stopping altogether.
When am I officially in menopause?
When you've had 12 consecutive months with no period at all. Until then you're still perimenopausal, and can still get pregnant, so contraception is worth considering until you're through it.
When should I see a GP about my periods?
See your GP for very heavy bleeding (flooding or large clots), bleeding between periods, bleeding after sex, or any bleeding after 12 months without a period. These are usually not serious but should always be checked.
Can I still get pregnant during perimenopause?
Yes. Ovulation is unpredictable rather than absent in perimenopause, so pregnancy is still possible until you've reached menopause. Keep using contraception until then if you don't want to conceive.
