Periods may become less predictable during perimenopause. Some people have heavier months. But heavy, prolonged or recurring abnormal bleeding needs medical review, even if you also have hot flushes or other signs of the menopause transition.
Why might the bleeding change?
Changing ovulation patterns can alter the cycle. Fibroids, polyps, adenomyosis, changes in the uterine lining, pregnancy-related causes and some medicines are other possibilities. A clinician needs the history, age and sometimes an examination or tests to distinguish them. Calling it “hormonal” without checking may miss a treatable problem.
Describe how many days bleeding lasts, whether you soak through protection, pass clots or feel tired, dizzy or breathless. Note spotting between periods or bleeding after sex. A blood count may help assess anaemia. Further testing or gynaecology referral depends on the findings and your preferences.
When to seek help urgently
Very heavy bleeding with faintness, severe pain or possible pregnancy needs prompt care. Otherwise, make an appointment if the pattern is new, repeated or affects your daily life. If you have had no period for 12 months and then bleed, it is postmenopausal bleeding and should be assessed promptly even if light.
Bring your symptom record to a consultation with Dr. Rina. The goal is to find the cause and discuss the right next step, not assume that all bleeding is expected in midlife.