What should I expect from my menstrual cycle during perimenopause?
Hormones fluctuate during perimenopause, or the 5-8 years before you stop having menstrual cycles, so each menstrual cycle can be different. If you count from the first day of bleeding during one period to the next first day of bleeding, a “normal” cycle is 21-35 days.
During perimenopause, menstrual periods can be:
- Closer together than they used to be
- Irregular due to skipping cycles
- Heavier
- More painful
- Associated with more symptoms like breast tenderness, irritability, headaches
If your cycles change during perimenopause, it’s a good idea to evaluate for other causes of heavy or irregular bleeding including fibroids, endometriosis, and thyroid disease.
Options for treating menstrual issues during perimenopause depend on your medical history and main goals for management. If you aren’t using another form of contraception, you can still get pregnant in the perimenopausal period!
- For women with bad periods and premenstrual mood issues, an oral contraceptive pill may help.
- A Mirena IUD (intrauterine device) can help with heavy menstrual bleeding and provide contraception.
- Some women may choose an endometrial ablation procedure if they are having regular, heavy menstrual cycles. An ablation procedure involves removing the lining of the uterus that grows in response to hormones every month, so that there is little to no bleeding.
- Tranexamic acid is an oral non-hormonal medication that can be taken monthly during each menstrual cycle to decrease the amount of bleeding.
- Some women may desire treatment with hysterectomy (removing the uterus surgically) because they cannot or do not want to take hormones.
This post is for educational purposes only and not medical advice. This website is not intended to provide medical diagnosis or treatment. Please consult with your personal physician.