Perimenopause period changes: What you need to know

Sarah Hyland

Certified Menopause Coach

27 June 2024

Period changes during perimenopause

Everyone has a different period experience. Normal flow before perimenopause can be heavy, light, or medium, and your cycle can be short or long. There's usually a pattern or routine that's kind of your ‘normal’.

For those of us not on hormonal medication or birth control, period changes in perimenopause can be a really good indicator of which stage of perimenopause we’re in.

In early perimenopause, somewhere in the late 40s for most women, periods can become heavier, and the cycle can get a bit short. PMS can also get worse. This is because as we get closer to the menopause years, we may not release an egg or ovulate as regularly as we did in the peak fertility years, and the body, because it's determined to squeeze out the last few eggs, will release extra follicle-stimulating hormone to jolly up (increase) ovulation.

That results in a peak in oestrogen or oestrogen dominance, where progesterone levels can't keep up with the oestrogen spike, and this can give us PMS with bells on. So, increased breast tenderness, tiredness, mood swings, and irritability.

In mid-perimenopause, periods can become quite erratic, sometimes with no discernible pattern or flow. For many women, this can kind of be the most difficult stage because oestrogen levels are high one minute and low the next, and the instability can be really tiring.

If there are any sleep or stress issues, it can feel a bit overwhelming, and it can really fuel anxiety. In this stage giving your nervous system plenty of rest and relaxation, and support can really pay off.

Now, as you get closer to the end of perimenopause, oestrogen levels will get progressively lower. You might get a little bit of flushing at this stage. Periods will get light and farther apart. Eventually, they are going to stop coming. But you won't be out of perimenopause, through menopause and (officially) considered to be post-menopausal until you haven't had a period for one whole year.

More tips and advice

For more information and advice head over to Menopause coach Eileen's blog: 'Perimenopause periods: what's normal and what's not', where she goes into more details about the different types of changes and things to look out for.

You may also find these articles helpful:

Why are perimenopause periods so heavy?

Why are perimenopause period so painful?

Signs you're in the late stages of perimenopause

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