The average duration of perimenopause is about 4 years, but it is different for each person. Once you go 12 consecutive months without a period, you officially reach menopause and the perimenopause period ends.
During perimenopause, your levels of the hormones estrogen – one of the main female hormones – and progesterone increase and decrease. This affects your menstrual cycle.
premenstrual symptoms
Dr Jayne Forrester-Patton, a GP at Your Menopause Doctor and British Menopause Society-accredited menopause specialist, says it’s very normal for your periods to gradually change as you enter perimenopause.
“One of the early signs of perimenopause can be a gradual worsening of premenstrual symptoms (PMS), these can be physical as well as psychological,” she says. “For example, you may experience headaches, bloating, breast tenderness, and mood swings in the days before menstruation. For some women, the PMS period becomes longer and they have fewer ‘good’ days each month.”
Forrester-Patton says some women may notice night sweats or hot flushes in the days right before their period.
She adds, “Menstruation can become regular even at this stage.”
irregular periods
As you move through perimenopause, your periods may become more irregular than usual.
“A classic pattern is that your periods gradually move closer together before getting further and further apart, until they eventually stop altogether,” explains Forrester-Patton.
heavy or light periods
It is also common for periods to become heavier as the interval between them increases. You may also experience spotting between periods.
“Some people may experience flooding or clotting at first,” says the menopause expert. “However, like everything related to menopause and perimenopause, the experience varies widely from person to person. Some will experience periods stopping suddenly with little warning, or others will experience lighter and easier to manage periods.”
anovulatory cycle
An anovulatory cycle is a menstrual cycle in which ovulation – the release of an egg from the ovary – does not occur. Anovulation is often caused by hormonal imbalance and can occur during perimenopause.
Symptoms of anovulatory cycles vary, but may include:
However, sometimes there are no obvious signs.
blood color changes
Your menstrual blood may also look different and sometimes, it may appear dark or brown. Menstrual blood appears red when it is fresh and quickly flushed from the body, but it may appear darker if it is old, oxidized blood that has been in the uterus for a long time. This can happen during perimenopause because hormonal imbalance means the uterine lining breaks down differently.
change in discharge
You may notice changes in the consistency of your discharge, which may become thinner or thicker.
It may help to track your periods on a calendar, so you can see how your menstrual cycle is changing. Make note of any other symptoms, such as unusual bleeding or pain – so you can see your doctor if needed.
If you’re not sure when your period will arrive, or how heavy it will be, it might be a good idea to have a stash of tampons, sanitary towels and a change of underwear in your bag. It is also helpful to have over-the-counter pain relievers such as paracetamol or ibuprofen on hand. You can also buy period-proof underwear, which will absorb unexpected leaks or spotting.
talk to your doctor
“It’s important not to ignore changes in your bleeding pattern or flow and to discuss them with your doctor so any related causes can be ruled out,” says Forrester-Patton.
Irregular bleeding may be a sign of other underlying conditions.
You should talk to your doctor if you have:
If you’re concerned about your menstrual cycle or any other symptoms, it’s best to talk to your doctor to be safe.
If you have missed your period and it is possible that you may be pregnant, you should take a pregnancy test. Even if you’re in perimenopause, you can still ovulate and get pregnant. If you are under 50, you can get pregnant even up to 2 years after your last menstruation and if you are over 50, you can get pregnant even up to 1 year after your last menstruation.
