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Today, we're going to tackle understanding the underlying causes of heavy periods during perimenopause, discover effective solutions for managing them and find out when to seek medical advice.
I’ll show you how to manage heavy periods effectively during perimenopause without overwhelming you with complex medical jargon so you can follow through all the way.
Once you’re done with this guide, you will be able to take control of your menstrual health during perimenopause, so you can start living more comfortably and confidently. If you have any questions as you’re going through it, you can reach me here and I’ll do my best to answer them.
Before we dig in, I created this FREE Menopause Health Guide to give you a head start with your menopause health.
Perimenopause and Menopause Explained
What are the perimenopause and menopause anyway?
The medical definition of the menopause is when you haven’t had a period for 12 months. It literally means when your periods stop, ‘Meno’ meaning your menstrual cycle and ‘Pause’ refers to your cycle stopping.
The menopause occurs when your ovaries no longer produce eggs and this causes your hormones - oestrogen, progesterone and testosterone - to fall.
The perimenopause means the time before the menopause when you are still having periods but your reducing and fluctuating hormone levels are triggering all kinds of symptoms. (see my blog ‘what exactly is the perimenopause?’)
The typical age for the menopause in the UK is 51 but the perimenopause can start in your thirties! During this phase, a woman's body undergoes huge hormonal changes and various physical and emotional symptoms, including changes to your menstrual cycle.
And what are ‘heavy’ periods in menopause?
Heavy periods are known by your doctor as menorrhagia.
According to the NHS, they are when you typically:
need to change your pad or tampon every 1 to 2 hours or empty your menstrual cup more often than is recommended
need to use 2 types of sanitary product together, such as a pad and a tampon
have periods lasting more than 7 days
pass blood clots larger than about 2.5cm (the size of a 10p coin)
bleed through to your clothes or bedding
avoid daily activities, like exercise, or take time off work because of your periods
feel tired or short of breath a lot
Why am I experiencing heavy periods during my perimenopause?
Heavy periods are often one of the first signs that you might be entering perimenopause.
Those reducing and fluctuating hormones that I mentioned earlier? They can cause your cycle to become erratic and irregular, often leading to heavy periods but sometimes lighter periods, sometimes less frequent and sometimes more frequent.
Also, as mentioned before, when your ovaries are not releasing an egg, progesterone is not being produced and this is what controls your womb lining.
What to do about Perimenopause and Heavy Periods
Now we know WHY it’s happening, it's time to find out what you can do if you are struggling with heavy periods during perimenopause.
Step 1. Track Your Cycle
An essential first step in managing heavy periods is to track your menstrual cycle meticulously. Knowing your cycle patterns can help you anticipate and prepare for heavy periods and is also vital information for your doctor or healthcare professionals in order to be able to help you.
Some key things that will help you with tracking your cycle:
Use a dedicated menstrual cycle tracking app.
Note down any symptoms you experience along with the dates.
Track the flow intensity and any changes in your cycle.
I highly recommend Dr Louise Newson’s Balance app for tracking your cycle.
Balance is a free app that has an in-built period tracker and it also allows you to log perimenopausal and menopausal symptoms.
Your period information is invaluable for your GP or healthcare provider, especially when you only have a 10 minute appointment.
Why not also read my blog 'Using Technology for Women's Health'?
Step 2. See Your Doctor
Make sure you book in with your doctor to discuss your symptoms.
Seeing your doctor is crucial because they can:
Rule out other underlying health conditions such as womb cancer.
Provide personalised advice based on your medical history.
Suggest medical treatments or interventions specific to your situation.
Your doctor might suggest blood tests to check for anaemia or other conditions related to heavy bleeding. They can also discuss various treatment options, such as medication or minimally invasive procedures, to manage heavy periods.
Other causes of heavy menstrual bleeding could be:
Fibroids or polyps
Endometriosis
A sexually transmitted disease
Polycystic ovarian syndrome (PCOS)
Diabetes and thyroid disorders can cause heavy periods
The National Institute for Health and Care Excellence (NICE) publishes guidance for doctors to follow regarding the assessment and management of heavy menstrual bleeding. You can access the guidance notes here.
Step 3. Consider the treatment options available
Your doctor may suggest a mirena coil which releases a synthetic progesterone that can make periods lighter (or stop altogether).
The contraceptive pill is another option, as are inflammatory painkillers such as naproxen.
Heavy bleeding can also make your iron levels low which can result in iron deficiency anemia. Your doctor may suggest iron supplements but make sure these are a gentle formula. Floradix is an excellent herbal liquid which is gentle on your stomach.
HRT can help by stabilising your hormones and so regulating your cycle and making your periods lighter. It also has many other benefits for different symptoms.
Here, Dr Louise Newson, the GP and Menopause Specialist, gives a comprehensive explanation of bleeding during perimenopause, the causes and the different treatment options.
Key takeaways
I hope this guide to perimenopause and heavy periods will allow you to skip trawling the internet for hours to get all the critical information you need.
You now have all the info in one place and can get back to it quickly.
Many women think that heavy periods are just a normal part of life and something they have to endure. The truth is that while heavy periods can be a common symptom during perimenopause, there are effective treatments and lifestyle changes that can help manage and alleviate these symptoms.
Need some extra support?
How can Jane Mackay Menopause Coaching help you overcome your menopause challenges?
My own experience of debilitating perimenopause symptoms led me to re-train as a Menopause Health Practitioner and Coach after turning my life around using some of the tips you can find in this guide.
I pride myself on offering personalised, compassionate support tailored to your unique needs.
That means you don't have to navigate the perimenopause or menopause alone. That's what I’m here for.
Take a look HERE at my range of perimenopause and menopause coaching services.
I'd be honoured to help you.
And did you see my post on ‘Menopause Bloating’? It can often go hand-in-hand with changes to our menstrual cycles so I hope this post will help you. I'd love to hear what you think.
DISCLAIMER: This page does not provide medical advice; it is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Always seek professional medical advice on any of the topics or products covered on this page.
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