Disclaimer: Not everyone who goes through menopause identifies as a woman and not all people who identify as women go through menopause. At Jayla, our core audience is people who identify as women, so we primarily use the word “women.” However, we’re working on specific content for people going through menopause who might not identify women. Inclusivity is a key value of ours, so bear with us!
Understanding Perimenopause
Perimenopause is a time in life when most women can expect to experience changes in their periods. Menopause occurs when a woman has gone 12 consecutive months without having a period, while the time leading up to menopause is known as perimenopause.
Because the perimenopause journey looks different for every woman, it can be difficult to know which changes are normal, and which changes are a cause for concern. In this article, we’ll review some of the normal period changes to expect during perimenopause as well as some reasons you might want to contact a healthcare provider.
Period Changes During Perimenopause
Initially, period changes during perimenopause may include shorter cycles (the time in between each period) and heavy bleeding. Many women experience increased cramping during perimenopause. This phase can last from a few months to a year or two.
After this point, your cycles will likely become more irregular and you may start to skip periods. Your periods may even vary in length, meaning that you may start to bleed for more or fewer days than normal. Some women experience spotting in between periods during this time as well. It is important to rule out pregnancy any time you have missed a period and are sexually active because it is still possible to become pregnant during perimenopause.
When to Worry About Period Changes During Perimenopause
While heavier bleeding and spotting in between periods can be normal and expected during perimenopause, they can sometimes be a sign of abnormal changes happening within the uterus. These changes include fibroids, polyps, cysts, and hyperplasia (an increase in the number of cells). An important phenomenon that can present with spotting or heavy bleeding is endometrial hyperplasia, which is an overgrowth of cells in the uterine lining that can lead to more serious conditions like uterine cancer.
If you experience significant period changes during perimenopause, including heavy bleeding, it’s crucial to talk to your healthcare provider. They will want to discuss these changes with you in detail, and possibly recommend a pelvic exam, a pelvic ultrasound, and an endometrial biopsy (a procedure that takes a small tissue sample from the uterus, or endometrium, to check for abnormal cells). This short office procedure allows your provider to obtain a very small sample of cells from inside the uterus to determine if they are normal.
Individual Experiences of Perimenopause
Every woman’s journey through perimenopause is unique, but being aware of period changes during perimenopause and potential issues like heavy bleeding during perimenopause can help you seek the care you need.
For example, some women experience heavier periods and irregular periods at the same time rather than as one phase after the other. Some women experience perimenopause for a few months, while others may experience perimenopause for multiple years before fully entering menopause. Because there are many variations of normal, it can be difficult to determine what is normal and what is not.
Though both spotting and heavy periods during perimenopause could be a result of normal hormonal changes, it is important to let your healthcare provider know about any period changes that you are experiencing to determine whether an evaluation for other conditions is warranted.
