Perimenopause may cause your periods to become more erratic due to hormonal changes.

Perimenopause can make your once-regular periods suddenly irregular.

Before perimenopause, your estrogen and progesterone levels rise and fall in a consistent pattern during your menstrual cycle. When you’re in perimenopause, hormone changes become more erratic. This can lead to unpredictable bleeding patterns.

During perimenopause, your periods may be:

  • Irregular. Rather than having a period once every 28 days, you might get them less or more often.
  • Closer together or further apart. The length of time between periods can vary from month to month. Some months you might get periods back to back. In other months, you might go more than four weeks without getting a period.
  • Absent. Some months you might not get a period at all. You might think you’re in menopause, but it’s not official until you’ve been period-free for 12 months.
  • Heavy. You may bleed a lot, soaking through your pads.
  • Light. Your bleeding might be so light that you barely need to use a panty liner. Sometimes the spotting is so faint that it doesn’t even look like a period.
  • Short or long. The duration of your periods can change, too. You might bleed for just a day or two or for more than a week at a time.

In the years leading up to menopause, your ovaries stop ovulating regularly. As ovulation becomes infrequent, the hormones produced by the ovaries — estrogen and progesterone — also begin to fluctuate and decline. These hormones are typically responsible for regulating the menstrual cycle.

As these hormonal changes take place, it can have an effect on more than just your period. You may also experience:

  • breast tenderness
  • weight gain
  • headaches
  • difficulty concentrating
  • forgetfulness
  • muscle aches
  • urinary tract infections
  • changes in mood
  • decreased sex drive

While it’s difficult to estimate how long these symptoms will last, they can be expected to continue well into menopause.

When you’re in perimenopause, it’s normal for your periods to be irregular and to come closer together. But sometimes these abnormal bleeding patterns can signal an underlying problem.

See your doctor if:

  • bleeding is unusually heavy for you or you soak through one or more pads or tampons in an hour
  • you get your period more often than every three weeks
  • your periods last longer than usual
  • you bleed during sex or between periods

As you progress through the perimenopausal stage and into menopause, your periods should occur less and less frequently. Once menopause has begun, there shouldn’t be any bleeding at all.

If you’re experiencing any unexpected bleeding or other menstrual changes, talk with your doctor. They can determine whether these changes are tied to perimenopause or if they’re a sign of another underlying condition.

Also keep your doctor informed about any other perimenopause symptoms you may be experiencing. The more they know, the more beneficial your care plan will be.