Perimenopausal Bleeding

One of the classic signs that you’re entering the early stages of menopause is irregular bleeding. However, if you’re not sure what to expect, you may not recognize the changes in your menstrual cycle that could signal early menopause. Let’s go through what to expect from perimenopausal bleeding, so you’ll be prepared when you see it.

Why is perimenopausal bleeding irregular?


As you approach menopause, you begin to run low on your supply of eggs in your ovaries. As ovarian function declines, your levels of the reproductive hormones estrogen and progesterone are out of order. As a result, their usual balance is disrupted, and your menstrual cycle can become irregular.

Perimenopausal bleeding: What is irregular bleeding?

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To talk about “irregular” periods and bleeding, let’s define what exactly we mean by “regular”. During your reproductive years, a healthy menstrual cycle can range in length from 25 to 38 days from the start of one period to the next. This varies from person to person: it all depends on what’s normal for you.

However, if your cycle continues to last more than 4 days longer or shorter than you’re used to in a few months, you can consider it an irregular period. Irregular bleeding, on the other hand, refers to any uterine bleeding that occurs outside your normal menstrual period – whether it’s simple spotting or actual blood flow.

Both irregular periods and irregular bleeding can happen from time to time thanks to blips in your hormone levels. This may be due to anything from stress to illness, and it’s not always a cause for concern. However, many women entering menopause find that a pattern of irregular periods and bleeding becomes the new normal.

Perimenopausal bleeding: When will it start?

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The average age of menopause in the United States is 51. This is defined as the point at which you haven’t had a period in a full year. However, it isn’t usually the case that your period suddenly stops without any fanfare.

For a period of time lasting anywhere from 2 to 10 years before menopause, your hormone levels change and your menstrual cycle gradually winds down to close. Many women find themselves entering perimenopause in their 40s, but depending when you are due to begin menopause, you may find it begins as early as your 30s.

Perimenopausal bleeding: What is it like?

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What perimenopause looks and feels like can vary from person to person. Some women go through this transition rather uneventfully, but others have to deal with uncomfortable irregular bleeding. Some of these may include:

  • Very heavy menstrual bleeding
  • Light spotting between periods
  • Bleeding that lasts shorter or longer than expected
  • Skipping periods or going for a long time between bleeding

Along with symptoms like hot flashes and mood swings, this unpredictable bleeding is one of the classic signs of approaching menopause.

It is perimenopausal bleeding or just abnormal periods?

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Your menstrual cycle can be disrupted for a number of reasons, so it doesn’t necessarily mean that you’re entering menopause. Let’s run through the other telltale signs to look for that can help distinguish perimenopause from other abnormal periods or bleeding.

Perimenopause signs to watch out for

  • Hot flashes
  • Night sweats
  • Feeling easily out of breath and worn out
  • Mood swings
  • Sleep disturbances
  • Vaginal dryness
  • Changes in libido and sexual satisfaction

If you’re experiencing irregular bleeding either with or without symptoms like these, see your doctor or gynecologist. Menopause isn’t a disease, but it’s important to make a diagnosis to rule out other causes of irregular bleeding – such as ovarian or uterine cancers.

Treatments for perimenopausal bleeding

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For about 20% of women, the symptoms of perimenopause can be so severe it can take a major toll on their physical and mental wellbeing. In some cases, your doctor may recommend a course of hormone therapy.

On the other hand, many women find it’s possible to relieve their perimenopausal symptoms through natural treatment such as vitamin supplements, exercise and herbal medicines.

Balanced diet

A diet with the right balance of nutrients can help you feel at your physical and mental best. In particular, women in perimenopause include soy (products like tofu and soymilk) and flaxseed supplements in their diets during this time. These foods are rich in isoflavones, which have an estrogen-like effect in the body.

Good sleep hygiene

Sometimes our busy lifestyles make it hard to get enough rest, but sleep deprivation can aggravate mental and physical stresses of perimenopause. Make an effort to get at least 6 hours of quality sleep a night to give your body the chance to recover.

Stress-less lifestyle

When you feel lots of stress, your body bumps hormone balance down the list of priorities. To fight stress in your daily life, make sure you get time to relax and do something you enjoy. Regular exercise can also be a great boost for your mental health.

You can make it through perimenopausal bleeding

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Perimenopause and menopause are natural parts of life. But when your hormones are changing, the symptoms can definitely take a toll on your body and mind alike.

Irregular bleeding is one of the classic signs of perimenopause, so if you notice a major change in your menstrual cycle, don’t ignore it. See your gynecologist as soon as possible to work out what’s going on. If it turns out you’re entering perimenopause and you suffer from severe symptoms, there are therapies to help you feel more comfortable.