Perimenopausal Bleeding

“Irregular periods are common and normal during
perimenopause, but other conditions
can also cause irregular vaginal bleeding”.1

Umbrella

What may the Perimenopausal Bleeding Umbrella include?

Depending on the Source (DotS) this Umbrella may include:

  • Abnormal Uterine Bleeding (AUB)
  • Perimenopausal Bleeding

Perimenopause

What is perimenopause?

DotS the definition of perimenopause may vary. The Australasian Menopause Society’s (AMS) definition is:

“Peri-menopause refers to the time from the onset of a change in menstrual cycle pattern or onset of menopausal symptoms, through to one year after the last menstrual period. The average duration is 4-6 years with onset in the fifth decade of life (40’s)”.2

Period Changes

During perimenopause, how may periods change?

In What Is Menopause? What Is Perimenopause (The Menopausal Transition?) the AMS note:

“Hallmarks of the perimenopause are changes in a woman’s menstrual periods such as, irregular periods or changes in flow. Cycles can be shorter or longer in length”.3

Skipping Periods

During perimenopause is it normal to skip periods?

The North American Menopause Society (now the Menopause Society) explain:

“During the transition to menopause (called perimenopause), it is normal to skip periods, but very frequent or heavy bleeding episodes often requires an evaluation by your healthcare provider. Any bleeding after menopause requires an evaluation by your healthcare provider”.4

Spotting

What does spotting mean?

In Mayo Clinic Q and A: Spotting, Perimenopause and Menopause the (United States) Mayo Clinic elaborate on the answer to the question:

“DEAR MAYO CLINIC: I am 52 and recently had gone 10 months without a period, so I had assumed I was in menopause. But, over the past three months, I’ve noticed some light spotting. Does this mean I’m not in menopause? How do I know when I’m in menopause, and do I need to see a gynecologist or health care provider about this issue?

ANSWER: It’s possible that you haven’t reached menopause yet. Clinically, menopause is defined as going without a period for one year. At 10 months, you don’t quite meet that threshold, but it is possible that you are just beginning menopause. However, depending upon when you last saw your health care provider and had a pelvic exam, it might be worthwhile to make an appointment, as there are a number of conditions where breakthrough bleeding is the first indication of an issue…”.5

Menstrual Calendar

Where may I find a menstrual calendar to keep a record of perimenopausal bleeding?

In MenoNotes the NAMS include:


Menstrual Calendar

  1. Menstrual Calendar
  2. Menstrual Calendar: Calendario Menstrual [Spanish]
  3. Menstrual Calendar: Calendrier Menstruel [French]

Follow up

When may follow up be required?

In Perimenopausal and Postmenopausal Bleeding the European Menopause and Andropause Society note:

“Women who experience perimenopausal or postmenopausal bleeding but who have no clear diagnosis or who have recurrent or persistent symptoms, should be followed up, typically after 6 months”.6

Health Care Provider

What if I think I have perimenopausal bleeding?

If you think you have perimenopausal bleeding, it may be in your best interest to choose to talk your health care provider about this. In Menstrual Calendar the Menopause Society note:

“Call your health care provider if you experience:

  • Periods that are much heavier than usual
  • Spotting or bleeding between periods
  • Periods that last longer than 10 days
  • Bleeding after sex
  • Frequent periods (fewer than 21 days between periods)
  • Any bleeding after menopause”.7

Perimenopausal BleedingIn Perimenopause: Symptoms and Causes – How Do I Know If Changes In My Periods Are Normal Perimenopausal Symptoms or Something To Be Concerned About? the (United States) Cleveland Clinic elaborate on:

“Irregular periods are common and normal during perimenopause, but other conditions can also cause irregular vaginal bleeding. If any of the following apply to you, see a healthcare provider to rule out other causes:

  • Your periods become very heavy or contain large blood clots
  • You change pads or tampons every one to two hours
  • Your periods last several days longer than usual
  • You spot or bleed between periods
  • You bleed after sex
  • Your periods occur less than 21 days apart”.8

In Your Period: When To See Your Doctor the (Australian) Jean Hailes for Women’s Health explain:

“There are many reasons you might need to see your doctor about your period. For example, if:

  • Your periods pattern change
  • You have increasingly heavier periods
  • You have long periods (more than eight days)
  • Your periods come less than three weeks apart
  • Your periods come more than two to three months apart

Also see your doctor if:

  • You bleed between periods (especially after menopause)
  • You bleed after having sex
  • You have painful periods that affect your quality of life”.9

Health Topics A-Z

Where may I find Health Topics A-Z related to Perimenopausal Bleeding?

In Health Topics A-Z you may find:

Health Topics A-Z

Links

Where may I find Links related to Perimenopausal Bleeding?

Your Country may have Links similar to:

Links

This Links List to third party websites is neither comprehensive nor exhaustive. Inclusion on this Links List does not imply endorsement or recommendation. Non-inclusion on this Links List does not imply non-endorsement or non-recommendation. Third party websites are not under the control of Meno Martha International Menopause Directory. Third party websites may contain explicit medical images and/or sexual references. Please read Meno Martha International Menopause Directory’s Links Policy before proceeding to a Link. Please contact Webmaster if you experience a problem with a Link.

New or Updated

  1. A Cell Atlas of the Human Fallopian Tube Throughout the Menstrual Cycle and Menopause
  2. Abnormal Uterine Bleeding
  3. Abnormal Uterine Bleeding
  4. Abnormal Uterine Bleeding In Perimenopausal Women: The Role of Hysteroscopy and Its Impact on Quality of Life and Sexuality
  5. Abnormal Uterine Bleeding In Perimenopause – How To Manage It? (English Version)
  6. About the Menstrual Cycle
  7. About the Menstrual Cycle [+ Video]
  8. About the Menstrual Cycle: When To See Your Doctor
  9. Bleeding After Sex: What You Should Know
  10. Bleeding Between Periods? How To Tell If It’s A Problem
  11. Bleeding Disorders In Women
  12. Bleeding Disorders In Women: Signs and Symptoms of Bleeding Disorders In Women
  13. Bleeding During Menopause | Dr Louise Newson [Video]
  14. Blood Clots During Menstruation: A Concern?
  15. Consumer Video and Podcast Series: 2022 Consumer Videos and Podcasts – Irregular Menstrual Cycles What’s Normal and What’s Abnormal?
  16. Consumer Video and Podcast Series: 2022 Consumer Videos and Podcasts – Perimenopause: Signs, Symptoms, and Solutions
  17. Consumer Video and Podcast Series: 2024 Consumer Videos and Podcasts – Preparing for Your Menopause Health Care Visit
  18. Do My Period Changes Mean Perimenopause?
  19. Endofound.org [Endometriosis Foundation of America]
  20. Endometriosis
  21. Experts Answer Your Menopause Questions In New Video
  22. FAQs: Abnormal Uterine Bleeding
  23. FAQs: Dysmenorrhea: Painful Periods
  24. FAQs: Endometriosis
  25. Perimenopausal BleedingFAQs: Heavy Menstrual Bleeding
  26. FAQs: Perimenopausal Bleeding and Bleeding After Menopause
  27. Gynecologic Cancers
  28. Gynecologic Cancers: What Are the Symptoms?
  29. Gynecological Cancers
  30. Heavy Periods
  31. Heavy Periods
  32. Heavy Periods
  33. Heavy Periods (Menorrhagia)
  34. Heavy Periods: Overview – Heavy Periods Self-Assessment
  35. How To Talk To Your Doctor About Heavy Periods
  36. Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – Signs and Symptoms of Menopause [+ Video: Talking Menopause With Your GP] [Other Languages and Formats]
  37. Let’s Talk About Perimenopause
  38. Managing Menopause Symptoms [+ Video Courtesy: Mayo Clinic News Network]
  39. Mayo Clinic Minute: Perimenopause and Menopause [+ Video]
  40. Mayo Clinic Minute: Tips From A Gynecological Surgeon on Recovery From Surgery [+ Video Courtesy: Mayo Clinic News Network]
  41. Mayo Clinic Q and A: Spotting, Perimenopause and Menopause
  42. Menopause
  43. Menopause
  44. Menopause
  45. Menopause
  46. Menopause Checklist Podcast: Episode 2: Bye Bye Periods
  47. Menopause Map: Downloadable Resources – My Personal Path Print Tools: Questions for Your Health Care Provider
  48. Menopause Map: Downloadable Resources – My Personal Path Print Tools: Symptom Tracker
    Perimenopausal Bleeding
  49. Menopause Map: Downloadable Resources – Stages of Menopause: Perimenopause
  50. Menopause Patient Information [Videos] 2. Talking To Your GP About Menopause
  51. Menopause Preparedness Toolkit Video Series: Understanding Menstrual Health and Menopause
  52. Menopause What Are the Symptoms?
  53. Menopause: Identification and Management [NICE Guideline Published: 12 November 2015 Last Updated: 07 November 2024]
  54. Menopause: Identification and Management: NICE Guideline [NG23] Published: 12 November 2015 Last Updated: 07 November 2024
  55. Menopause: Symptoms – Changes To Your Periods
  56. Menopause: Understanding the Changes and Finding Relief | Dr Susan Davis | The Proof Podcast EP 256
  57. Menorrhagia (Heavy Menstrual Bleeding)
  58. Menstrual Calendar
  59. Menstrual Calendar: Calendario Menstrual [Spanish]
  60. Menstrual Calendar: Calendrier Menstruel [French]
  61. Menstrual Cycle
  62. Menstrual Cycle: What’s Normal, What’s Not
  63. Menstrual Cycle: What’s Normal, What’s Not – How Can I Track My Menstrual Cycle?
  64. Menstrual Hygiene Day [28 May]
  65. My Periods Have Changed. Is Menopause Around the Corner?
  66. National Center for Complementary and Integrative Health: How Safe Is This Product or Practice?
  67. Navigating Menopause: Honest Answers To All Your Questions [+ Video: What To Expect in Menopause]
  68. Ovarian Cancer/Primary Peritoneal
  69. Peri-Menopause and Irregular Periods
  70. Perimenopausal and Postmenopausal Bleeding
  71. Perimenopause
  72. Perimenopause
  73. Perimenopause and Menopause Checklist: Translated Checklists
  74. Perimenopause and Menopause Symptom Checklist
  75. Perimenopause or Menopausal Transition
  76. Periods
  77. Periods
  78. Periods: Overview – Menstrual Cycle: Animation
  79. Periods: Period Problems
  80. Premenstrual Syndrome (PMS)
  81. Premenstrual Syndrome (PMS)
  82. The Eve Appeal [United Kingdom]
  83. Tips for Tracking Your Bleeding
  84. Uterine Bleeding: Abnormal Uterine Bleeding
  85. Uterine/Endometrial Cancer/GDT
  86. Vaginal Bleeding
  87. Vaginal Cancer
  88. Video: Researchers Emphasize Normalization of Menopause
  89. Videos and Podcasts: Videos – A Simple Approach To Menopause: The Menopause Quick Six (www.MQ6.ca)
  90. Videos and Podcasts: Videos – Menopause and Abnormal Bleeding
  91. Webinars: Previous – Abnormal Uterine Bleeding In Perimenopausal and Postmenopausal Women
  92. What Are Heavy Periods?
  93. What Causes Bleeding Between Periods?
  94. What Is An Endometrial Biopsy?
  95. What Is Endometriosis?
  96. What Is Menopause?
  97. What Is the Menopause?
  98. When Does Perimenopause Start and How Do You Define the Beginning [Video]
  99. Why Is Bleeding So Heavy?
  100. You Need To Know [+ Video: Bleeding After the Menopause – An Important Message You Need To Know]

Sources

Where may I find the Sources quoted?

You may find the Sources quoted at:

Sources

  1. Perimenopause: Symptoms and Causes – How Can I Reduce My Risk of Perimenopause Complications? Last Reviewed: 08 August 2024. Cleveland Clinic https://my.clevelandclinic.org/health/diseases/21608-perimenopause Accessed: 10 April 2025
  2. What Is Menopause? What Is Perimenopause (The Menopausal Transition?). Content Created May 2022. Australasian Menopause Society https://www.menopause.org.au/hp/information-sheets/what-is-menopause Accessed: 10 April 2025
  3. What Is Menopause? What Is Perimenopause (The Menopausal Transition?). Content Created May 2022. Australasian Menopause Society https://www.menopause.org.au/hp/information-sheets/what-is-menopause Accessed: 10 April 2025
  4. Menstrual Calendar. 2015. North American Menopause Society https://menopause.org/wp-content/uploads/default-document-library/menonote-menstrual-calendar-english.pdf Accessed: 10 April 2025
  5. Mayo Clinic Q and A: Spotting, Perimenopause and Menopause. 21 December 2020. Mayo Clinic https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-spotting-perimenopause-and-menopause/ Accessed: 10 April 2025
  6. Perimenopausal and Postmenopausal Bleeding. 2022. European Menopause and Andropause Society https://emas-online.org/wp-content/uploads/2022/05/Perimenopausal-and-postmenopausal-bleeding.pdf Accessed: 10 April 2025
  7. Menstrual Calendar. 2015. North American Menopause Society https://menopause.org/wp-content/uploads/default-document-library/menonote-menstrual-calendar-english.pdf Accessed: 10 April 2025
  8. Perimenopause: Symptoms and Causes – How Can I Reduce My Risk of Perimenopause Complications? Last Reviewed: 08 August 2024. Cleveland Clinic https://my.clevelandclinic.org/health/diseases/21608-perimenopause Accessed: 10 April 2025
  9. Your Period: When To See Your Doctor. Last Updated: 12 July 2024 | Last Reviewed: 25 March 2024. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/periods/your-period Accessed: 10 April 2025
Topic Last Updated: 10 April 2025 – Topic Last Reviewed: 10 April 2025

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