Perimenopause is a term used to refer to the transition period to menopause. While menopause marks the end of your menstrual cycle, perimenopause is the time period that occurs before menopause. Perimenopause starts several years before actual menopause begins and this is the time during which the ovaries gradually start to produce less levels of estrogen. Usually perimenopause begins in a woman’s 40s, but in some cases it can also start during the 30s or even earlier. Perimenopause has different effects on your body and is also know to affect your periods in various ways. So how does perimenopause affect your periods? Let us take a look.
What is Perimenopause?
Perimenopause is menopause transition. While menopause marks the end of your menstrual cycle, perimenopause marks the transition period until you reach menopause. Perimenopause actually means ‘around menopause’ and this is the time period during which your body undertakes the natural processes to transition to menopause. Menopause also marks the end of your reproductive years.(1)
The age at which women start perimenopause varies from person to person, but you might start to notice some of the signs of progression towards menopause somewhere in your 40s. Menstrual irregularity is the first sign you will start to notice along with some other changes. Menopause typically happens between the ages of 40 to 55.
The symptoms of perimenopause can continue for anywhere between one to ten years and during this time, the hormones progesterone and estrogen remain in flux, fluctuating from month to month. These shifts in your hormone levels are going to be erratic and will also have a direct effect on your ovulation as well as the rest of your cycle. You may also notice that you will progress from irregular periods to developing a different bleeding pattern and then to having missed periods.
Some of the other symptoms of perimenopause you are likely to observe include:(2)
- Hot flashes
- Vaginal dryness
- Night sweats
- Memory issues
- Sleep troubles
- Changes in sexual desire
- Difficulty urinating
Read on to find out how perimenopause affects your periods and what you should be expecting from your periods once perimenopause begins.
5 Ways In Which Perimenopause Affects Your Periods?
Here are some of the things you will notice in your periods as you begin perimenopause.
Spotting Between Your Periods
It is common to notice some blood in between your periods. However, it is likely going to be so light that you will not need to use a tampon or a pad. This is known as spotting, and spotting is generally a result of the endometrium buildup and your body’s changing levels of hormones.
Many women experience spotting just before their period starts or as it is about to end. It is also common to observe mid-cycle spotting which takes place around ovulation time.
If, however, you are spotting once every two weeks, then this could be a sign that you are having a hormonal imbalance. You should not ignore this and should discuss it with your doctor.
In order to keep a track of spotting and your periods during the time of perimenopause, it will be helpful if you keep a diary. You can maintain records regarding the following information:
- When your periods start
- How long they last
- How heavy is the flow
- Is there any spotting in between
- What week/day of the cycle did you experience spotting
Nowadays, there are also many different apps that allow you to do this, for example, Eve.
If you are worried about stains or leaks from spotting, then you can consider wearing panty liners. Disposable panty liners are available easily available at most drug stores or at supermarkets as well. They are available in different types of lengths and material and if you are against using disposable panty liners, then you can even consider using reusable liners such as Lunapads. These are made out of fabric and it is possible to wash them over and over again.
Unusually Heavy Bleeding
During perimenopause, your estrogen and progesterone levels tend to fluctuate, sometimes wildly. When the levels of estrogen are higher as compared to the levels of progesterone, the uterine lining starts to build up. This causes you to experience heavier bleeding during the period as the uterine lining is shed. A skipped period is also likely to cause the lining to build up, thus giving rise to heavier bleeding.
Period bleeding is considered to be heavier than normal if it meets the following criteria:
- You need to wear double protection, such as a pad and a tampon, in order to control the flow of blood
- You soak through one pad or one tampon within an hour and this continues for several hours
- It causes you to change your tampon or pad even during the night while you are sleeping
- Flow lasts longer than seven days
When you experience heavy bleeding, it is likely to last longer and cause disruption in your day to day life. You will also find it uncomfortable to carry on with your daily tasks or to exercise. Heavy bleeding is also going to make you feel overly tired and also increase the risk of other health concerns, especially anemia.
Taking ibuprofen (Advil) during your period will help you deal with the menstrual cramps and if you take the medication when you are experiencing heavy bleeding, it is also likely to reduce your flow by nearly 30 percent.(3) The ideal dosage should be 200 milligrams for every four to six hours each day.
However, if you find that your cramps and heavy bleeding are persisting, then it is a good idea to discuss with your doctor about any hormonal approach to treatment. Some women have a medical or family history that prohibits or discourages the use of hormones during the perimenopausal stage.
Experiencing Brown or Dark Blood
The color of your period blood keeps on changing. It can range from being bright red to becoming dark brown or even black sometimes. The color often becomes darker towards the end of your period. Brown blood or dark red blood is simply an indication of old blood that is exiting your body.
If you are going through perimenopause, then you may also notice brown colored spotting or discharge at various times during the months.
You are also likely to notice certain changes in the texture of the discharge. It might be thin and watery or it might become clumpy and thick.
If you are concerned about any sudden changes in your flow, then you should consult your doctor. A variation in the color of period blood is mostly due to the amount of time the blood and tissue have been sitting inside the body, but sometimes it can also be an indication of another underlying medical condition. If there is a foul odor as well to your vaginal discharge, then this could very well be a sign of infection and should not be ignored.
Having Shorter Cycles
During perimenopause, your estrogen levels might start decreasing. When you have low estrogen levels, your uterine lining will be thinner. Due to this, bleeding will also be lighter and only last for a couple of days. Shorter cycles are usually more common during the early stages of perimenopause.
For example, you are likely to experience a period that is two or three days shorter than your normal cycle. Your entire cycle also will start becoming shorter, lasting for only two or three weeks, instead of the standard four weeks. You may also keep feeling like your period just ended and the next one has already started.
If you are worried about having shorter and unpredictable cycles, then you can consider using leakage protection such as period underwear, pads, or panty liners.
Having Longer Cycles
During the later stages of perimenopause, you will notice that your cycles will start becoming much longer and also further apart. Longer cycles are cycles that last longer than 36 days(4). They are related to cycles in which you do not experience ovulation or anovulatory cycles.
A study carried out by the University of Iowa College of Medicine found that women who experienced anovulatory cycles tend to have lighter bleeding than women who experience cycles with ovulation.
Conclusion: When Should You See A Doctor?
Perimenopause is marked by longer cycles, shorter cycles, or even irregular cycles. While having irregular periods during the phase of perimenopause is quite normal, sometimes irregular bleeding can also be an indication of another more serious medical condition. You should consider seeing your doctor if you are experiencing any of the following:
- You are bleeding, not spotting, more frequently than once in every three weeks
- You are experiencing bleeding that is lasting for longer than seven days
- You are having extremely heavy bleeding that is requiring you to change your tampon or pad every hour
Have the details of your monthly menstrual cycle handy with you when you go to visit the doctor as they will ask you about your complete medical history and about all the symptoms you are having. They are also likely to give you a pelvic examination and may also prescribe blood tests, an ultrasound, or even a biopsy in order to rule out any serious health issues.
- Santoro, N., 2016. Perimenopause: from research to practice. Journal of women’s health, 25(4), pp.332-339.
- Santoro, N., Epperson, C.N. and Mathews, S.B., 2015. Menopausal symptoms and their management. Endocrinology and Metabolism Clinics, 44(3), pp.497-515.
- The Centre for Menstrual Cycle and Ovulation Research. (2019). Very Heavy Menstrual Flow. [online] Available at: http://www.cemcor.ubc.ca/resources/very-heavy-menstrual-flow [Accessed 11 Jun. 2019].
- Van Voorhis, B.J., Santoro, N., Harlow, S., Crawford, S.L. and Randolph, J., 2008. The relationship of bleeding patterns to daily reproductive hormones in women approaching menopause. Obstetrics and gynecology, 112(1), p.101.
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