Perimenopause periods: what’s normal and what’s not?

Period changes in the lead up to menopause

Changes in your monthly period is very often one of the first signs that you are starting the approach to menopause. For some women, these changes may be very slight and hardly noticeable. Their periods just stop and that's them in menopause proper. For the majority of women, however, there will be some kind of change to their monthly cycle.

So, today on A.Vogel Talks Menopause, I'm going to take a look at what is considered to be normal changes during perimenopause and what is not normal.

What causes your periods to change during perimenopause?

As you start the journey through perimenopause and towards menopause, your oestrogen, progesterone and testosterone levels start to decrease as your body produces less of these hormones.

The problem is that they don't necessarily reduce all gradually and in harmony with each other. You can get very sudden dips of one hormone, which will cause one set of symptoms. If you get a really sudden dip of one of the other hormones, that will cause completely different symptoms.

These changes can sometimes just go completely all over the place with your hormones going up and down like a yo-yo, meaning every month can be completely different.

7 normal period changes during perimenopause

So, let's take a look at some normal period changes which you can experience during perimenopause:

1. Periods can get more frequent, get further apart, or missed

If you're usually every 28 days, you might find them going down to every 26 days, even 24 days, or sometimes, even less. Alternatively, you may find your periods get further apart. It may well be that instead of the 28 days, they're coming every 38 days for a few months. You may find that you get a missed period. You may have a normal period one month and the next month, they've just completely disappeared, and then the following month, they come back at the same regular time.

2. Late periods

You might find that your periods start to get later and later. You might find that your period starts off a few days later. The next month, they're even later. Then, you might go back to normal again.
Some women find that they only get periods once every three months for a while. I knew one lady who had one period a year for three years, in exactly the same date in the same month of that year. There can be quite a huge gap between periods at this point.

3. Periods become shorter or longer

If your periods normally lasted five days, you may find they only last three days. Or you may find that they last seven or eight days now.

4. Periods can become heavier or lighter during perimenopause

Some women say that for the first couple of days, their periods tend to be a little bit heavier, and then it eases off. You may find this time that the whole period is a lot heavier. Equally, you may find it's the complete opposite and instead of being heavy for a couple of days, it might just be a completely light period, sometimes with very little bleeding. You know it's there because you can feel it.

5. Spotting between periods

You can start to get spotting in between periods, roundabout day 14 or 15.

6. Period pain and other PMS symptoms can get worse

You may find that you start to get a lot more cramping. Your periods are a lot more uncomfortable or any other PMS symptoms that you had are more exaggerated. You may find that you get really sore, tender breasts or nipples. You might get really bloated, get really severe sugar cravings, or you just find yourself really, really hungry the whole time.

7. Period cramps but no period

You get period cramps and all the normal symptoms that your period is starting but you don't experience an menstrual bleed. In this situation, all that's happening here is that your hormones have still got a cycle. Many women find that once their periods stop, they still get a monthly cycle of symptoms but just no period appearing.

What’s not normal?

Really heavy bleeding where you find that you're having to change your tampons or your pads every couple of hours should be checked with your doctor.

You may find that you're getting clots with the bleeding and it may go on and on for days. And we've had some women who have bled heavily, continuously for over three weeks. Or you might find that you're really seriously flooding and nothing is containing the blood so it's ending up in your clothes and everywhere else.

Periods lasting more than seven or eight days, even if they're quite light, should also be checked. If you find that you're getting a period and then you're only having a break of maybe a week or two before getting another one, so there's a very short gap in between each period, should also be discussed with your doctor.

If you are getting any of these symptoms in combination, you also really need to go and see your doctor because it can be an indication of other underlying conditions, not just hormonal changes. If your periods are really going all over the place, it could just be natural processes but when you get to perimenopause other health issues can be a factor, such as:

Fibroids, polyps or cysts: These are little growths in the womb. Some women can have them for years without them causing any trouble, but when the womb itself starts to change, these can be irritated and they can just bleed continuously.

Prolapse: This is where the internal organs in the pelvic area, your womb, bladder and bowel change position. They can shift slightly. Either the bowel or the bladder can start to put extra pressure on the womb or pinch it and that can cause heavy bleeding.

If you're getting any of these particular symptoms, please see your doctor. A lot of women will be offered a scan or an ultrasound to help determine the best kind of treatment.

What can help?

For the minor changes that go on with your period, there are some things that you can take that are natural:

1. Agnus castus

If your periods start to get a little bit heavier or longer, the herb Agnus castus is known to help. It can take two to three months to kick in, so you do have to persevere with this one.

2. Menopause Support

If your periods are starting to tail off, starting to miss or getting lighter, Menopause Support can help.

A.Vogel Menopause Support | For Perimenopause, Menopause & Postmenopause Symptoms | Menopause Supplement with Soy Isoflavones, Magnesium & Hibiscus

• Support for all stages of menopause: perimenopause, menopause and postmenopause
• Provides 50mg of bioavailable phytoestrogenic soy isoflavones per day, obtained using an extract of soya beans
• Magnesium contributes to the reduction of tiredness and fatigue, and helps support the nervous system
• Also contains hibiscus extract
• Can be used with HRT, but not suitable to use with hormonal contraceptives.

Read more customer reviews

Find Menopause Support tablets in a store near you

3. Iron supplement

If your periods are a little bit more frequent or heavy, an iron supplement is really important because low iron can cause fatigue, low mood, anxiety, joint pain, and poor sleep.

Why you should track your period during perimenopause

When your periods start to change, track them, because then it will give you an idea of how long you're going in between periods. I've had some women that have suddenly gone, "Oh, I've not had a period for six months," but they can't remember exactly when the last one was. You need to know when your last period is in order to know whether you're through the perimenopause stage and now considered to be menopausal.

Normally, you are considered in menopause when you've not had any periods for two years. I know some sources say one year but in our experience over the years, quite a large number of women can go a year or more without a period, and then get them back again. You can just use your calendar to track them or you can get apps now that can be really helpful at seeing what's going on.

So, I hope you found this one helpful. Perimenopause is a big subject because there are lots of changes that can go on. If any of you had any other symptoms that you're wondering whether they are connected to perimenopause, please ask and I'll be happy to help.

Until next week, take care.