As women enter perimenopause, the first symptom they usually notice is a change in their menstrual cycle. Periods become irregular and hard to predict. They may be short or last longer than usual. The time between periods may also get longer or shorter. The menstrual flow may be lighter or heavier than usual. Over a period of several years, menstrual periods gradually get lighter and further and further apart until they stop altogether. After 12 months without a period, you are in menopause.
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Honor Society of Nursing (STTI) answered
Julia Schlam Edelman, Obstetrics & Gynecology, answeredIrregular menstrual periods are the most frequent sign of perimenopause. Ninety percent of women experience changes in their menstrual cycle for 4 to 10 years preceding postmenopause. Menstrual cycles in perimenopause often disappear, only to reappear without warning. I have heard horror stories about the sudden, unexpected return of a menstrual period that can involve bleeding through clothes in a public setting. If this happens to you, rest assured: you are not alone!
During perimenopause, your menstrual flow may become lighter or heavier. You may bleed for longer or shorter periods of time. You may miss periods or bleed more often.
Not all changes in menstrual periods are due to perimenopause alone. Sometimes there is a medical cause for the change in menstrual periods, whether the periods become heavier and longer, or lighter and less frequent. Thyroid disease is one common cause of these changes. Growths in the uterus such as polyps or fibroids may alter bleeding patterns. Finally, pre-cancer (endometrial hyperplasia) or cancer can also cause heavy or prolonged bleeding even after skipping several menstrual periods. Discuss changes in your menstrual cycle with your clinician to identify the cause.