Your period will change during perimenopause, from shorter to longer cycles, missed periods, and more. Here are all the changes to expect—and how to cope.
Perimenopause is the transition stage before menopause, where your reproductive organs gradually stop producing eggs. Perimenopause can last anywhere from a couple of months to multiple years (the average duration is two to four years), during which the levels of estrogen and progesterone —the two sex hormones crucial to reproductive and sexual health—fluctuate. The imbalance of these hormones leads to mood changes and hot flashes and can also impact your menstrual cycle, including your periods.
What should you expect from your perimenopause periods? During perimenopause, your period can change a lot. Here’s what to look out for and how to cope.
What happens to your period during perimenopause? During perimenopause, your levels of estrogen and progesterone fluctuate and start to decline. These changes lead to changes in your cycle, and often, your period. Eventually, at the end of perimenopause, your period will stop.
As hormones start fluctuating during perimenopause, it can affect the length of periods and menstrual flow. Your period can encounter many changes during perimenopause, from longer or shorter cycles to heavier or lighter flows and missed periods.
When do perimenopause periods start? Perimenopause can begin as early as your mid-30s but most often occurs in your 40s. Some women may start to experience symptoms of perimenopause earlier, while others might not notice any changes or symptoms until much later. The duration of perimenopause can vary as well, lasting anywhere from a few years to over a decade before reaching menopause.
Irregular periods are a good indication that perimenopause has begun. They are likely the first symptom you’ll experience, potentially along with hot flashes, vaginal dryness, or mood changes.
>>MORE: What Are The First Signs of Perimenopause?
6 types of perimenopause periods So, what changes to your perimenopause periods can you expect? Here are six different types of perimenopause periods.
Shorter cycles When estrogen levels are low, your uterine lining is thinner. This can result in a lighter and shorter period cycle.
Shorter cycles are more likely to occur in the earlier stages of perimenopause. You may also experience two periods in one month because of these shorter cycles, and the next period can happen as quickly as three weeks after your previous cycle.
Longer cycles Longer cycles (more than 38 days) are more common in the later stages of perimenopause. Higher levels of estrogen than progesterone can cause your cycle to get longer and further apart. Estrogen builds up the uterine lining and your body may take more time to shed it during menstruation.
Missed periods With your estrogen and progesterone levels thrown off, these imbalances can also lead to missed periods. Menopause begins after 12 consecutive months without a menstrual period. Even if your cycle occurs after an extended time, ovulation is still taking place and you can still get pregnant.
>>MORE: Perimenopause vs. Menopause: What's the Difference?
Brown or dark blood Bright red blood is blood that quickly leaves the body. Brown or dark blood is a sign of old blood leaving the body. This blood has a brown and dark color because it stays in the uterus longer and becomes oxidized. It’s common during perimenopause to have brown or dark blood as a result of fluctuating hormones.
Spotting You may notice spotting between periods. Spotting is light vaginal bleeding that doesn't require a pad or tampon. The varying hormone levels and the buildup of the endometrium or uterine lining can cause unpredictable period spotting before or after your period usually occurs.
Tracking your bleeding patterns can help to anticipate spotting, or you can wear panty liners to avoid leaks and stains.
Heavy bleeding You may experience heavier bleeding during perimenopause. Estrogen and progesterone levels are in flux, and when estrogen levels are higher than progesterone levels, it builds up your uterine lining. This can result in heavier bleeding when your body sheds its uterine lining during menstruation. A missed period can also cause the uterine lining to thicken and lead to heavier bleeding.
Signs of heavy bleeding are when your period blood soaks through a tampon or pad quickly or when it requires multiple menstrual products (both a tampon and pad) to manage the flow. It may disrupt your sleep because you need to change your pad or tampon. It can also last longer than seven days.
While a common symptom of perimenopause, too much heavy bleeding can be a sign of other health concerns like anemia or endometrial cancer. It's important to talk to your doctor if you have heavy bleeding.
How to cope with perimenopause periods You'll experience irregularity in your periods during perimenopause that can interfere with daily life, along with its many other symptoms . Perimenopause periods can vary from month to month, so it's helpful to track your period and prepare yourself with supplies to manage these changes.
Utilizing panty liners, carrying extra tampons and pads, using menstrual cups, and more are a few ways to plan for perimenopause periods' unpredictable symptoms. If you notice abnormal heavy bleeding, abnormal length of period, or are concerned with any changes you're experiencing, it's important to speak to your doctor.
Experiencing these changes in perimenopause periods is normal. And while unpredictable, it’s helpful to identify these symptoms and prepare for what comes next during perimenopause.
