“Irregular periods are common and normal during
perimenopause, but other conditions
can cause abnormalities in menstrual 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 (NAMS) 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:

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 NAMS 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

In Perimenopause: 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 cause abnormalities in menstrual bleeding. If any of the following situations apply to you, see a healthcare provider to rule out other causes.

  • Your periods are changing to become very heavy, or accompanied by blood clots
  • Your periods last several days longer than usual
  • You spot or bleed after your period
  • You experience spotting after sex
  • Your periods occur closer together”.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:

Links

Where may I find Links related to Perimenopausal Bleeding?

Your Country may have Links similar to:

Sources

Where may I find the Sources quoted?

You may find the Sources quoted at:

Sources

  1. Perimenopause: How Do I Know If Changes In My Periods Are Normal Perimenopausal Symptoms or Something To Be Concerned About? Last Reviewed: 05 October 2021. Cleveland Clinic https://my.clevelandclinic.org/health/diseases/21608-perimenopause Accessed: 22 May 2024
  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: 22 May 2024
  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: 22 May 2024
  4. Menstrual Calendar. 2015. North American Menopause Society https://www.menopause.org/docs/default-source/2015/menonote-menstrual-calendar-english.pdf Accessed: 22 May 2024
  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: 22 May 2024
  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: 22 May 2024
  7. Menstrual Calendar. 2015. North American Menopause Society https://www.menopause.org/docs/default-source/2015/menonote-menstrual-calendar-english.pdf Accessed: 22 May 2024
  8. Perimenopause: How Do I Know If Changes In My Periods Are Normal Perimenopausal Symptoms or Something To Be Concerned About? Last Reviewed: 05 October 2021. Cleveland Clinic https://my.clevelandclinic.org/health/diseases/21608-perimenopause Accessed: 22 May 2024
  9. Your Period: When To See Your Doctor. Last Updated: 21 May 2024 | Last Reviewed: 25 March 2024. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/periods/your-period Accessed: 22 May 2024
Topic Last Updated: 22 May 2024 – Topic Last Reviewed: 22 May 2024

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