Perimenopause Periods: Spotting, Heavy Bleeds, and More

When your estrogen levels are high in comparison to your progesterone levels, your uterine lining builds. This results in heavier bleeding during your period as ... HealthlineHealthConditionsDiscoverPlanConnectShopSubscribeMentalWell-BeingLifeYouthinFocusMind&BodySelf-CareConditionsTherapyMaternalWellnessParentingCrisisSupportHowPerimenopauseCanAffectYourPeriodsandWhatYouCanDoMedicallyreviewedbyMeredithGoodwin,MD,FAAFP—WrittenbyAshleyMarcin—UpdatedonJuly23,2020SpottingHeavybleedingDarkbloodShortcyclesLongcyclesMissedcyclesIrregularityWhentoseeyourdoctorUnderstandingperimenopauseMenopausereferstotheendofyourmenstrualcycle.Onceyou’vegone12monthswithoutaperiod,you’vereachedmenopause.Theaveragewomangoesthroughmenopauseat51yearsold.Thetimeperiodbeforemenopauseiscalledperimenopause.Perimenopausesymptomsoccurfor4years,onaverage.However,perimenopausecanlastanywherefromafewmonthsto10years.Duringthistime,thehormonesestrogenandprogesteroneareinflux.Yourlevelswillfluctuatefrommonthtomonth.Theseshiftscanbeerratic,affectingovulationandtherestofyourcycle.Youmaynoticeanythingfromirregularormissedperiodstodifferentbleedingpatterns.Othersymptomsofperimenopauseinclude:hotflashesnightsweatssleeptroublesmemoryissuesdifficultyurinatingvaginaldrynesschangesinsexualdesireorsatisfactionHere’swhatyoucanexpectfromperimenopauseandwhatyoucando.1.SpottingbetweenperiodsIfyounoticesomebloodonyourunderwearbetweenperiodsthatdoesn’trequiretheuseofapadortampon,it’slikelyspotting.Spottingisusuallytheresultofyourbody’schanginghormonesandthebuildupofyourendometrium,oruterinelining.Manywomenspotbeforetheirperiodstartsorasitends.Mid-cyclespottingaroundovulationisalsocommon.Ifyou’reregularlyspottingevery2weeks,itmaybeasignofahormonalimbalance.Youmaywanttospeakwithyourhealthcareprovider.WhatyoucandoConsiderkeepingajournaltotrackyourperiods.Includeinformationsuchas:whentheystarthowlongtheylasthowheavytheyarewhetheryouhaveanyin-betweenspottingYoucanalsologthisinformationinanapp,likeEve.Worriedaboutleaksandstains?Considerwearingpantyliners.Disposablepantylinersareavailableatmostdrugstores.Theycomeinavarietyoflengthsandmaterials.Youcanevenbuyreusablelinersthataremadeoffabricandcanbewashedoverandoveragain.ProductstotryIfyoudealwithspottingbetweenperiods,usingcertainproductscanhelpyoutrackyoursymptomsandavoidleaksandstains.Shopforthemonline:periodjournalpantylinersreusablepantyliners2.AbnormallyheavybleedingWhenyourestrogenlevelsarehighincomparisontoyourprogesteronelevels,youruterineliningbuilds.Thisresultsinheavierbleedingduringyourperiodasyourliningsheds.Askippedperiodcanalsocausetheliningtobuildup,leadingtoheavybleeding.Bleedingisconsideredheavyifit:soaksthroughonetamponorpadanhourforseveralhoursrequiresdoubleprotection—suchasatamponandpad—tocontrolmenstrualflowcausesyoutointerruptyoursleeptochangeyourpadortamponlastslongerthan7daysWhenbleedingisheavy,itmaylastlonger,disruptingyoureverydaylife.Youmayfindituncomfortabletoexerciseorcarryonwithyournormaltasks.Heavybleedingcanalsocausefatigueandincreaseyourriskforotherhealthconcerns,suchasanemia.WhatyoucandoAsyoumayknow,takingibuprofen(Advil,Midol,Motrin)duringyourperiodcanhelpwithmenstrualcramps.Ifyoutakeitwhenyou’rebleedingheavily,itmayalsoreduceyourflow.Trytaking200milligrams(mg)every4to6hoursduringtheday.Ifcrampsandpaincontinue,talktoyourhealthcareproviderabouthormonalapproachestotreatment.Somewomenhaveamedicalorfamilyhistorythatdiscouragestheuseofhormonesintheperimenopausalperiod.3.BrownordarkbloodThecolorsyouseeinyourmenstrualflowcanrangefrombrightredtodarkbrown,especiallytowardtheendofyourperiod.Brownordarkbloodisasignofoldbloodexitingthebody.Womeninperimenopausemayalsoseebrownspottingordischargeatothertimesthroughoutthemonth.Youmayalsonoticechangesindischargetexture.Yourdischargemaybethinandwatery,oritmaybeclumpyandthick.WhatyoucandoIfyou’reconcernedaboutyourmenstrualflow,youmaywanttoscheduleanappointmenttoseeyourdoctor.Thevariationincolorisusuallyduetotheamountoftimeittakesforthebloodandtissuetocycleoutofthebody,butitcansometimesbeasignofanotherunderlyingcondition.Ifthere’safoulodortothevaginaldischarge,itmaybeasignofinfection.Seeyourhealthcareprovider.4.ShortercyclesWhenyourestrogenlevelsarelow,youruterineliningisthinner.Bleeding,asaresult,maybelighterandlastfewerdays.Shortcyclesaremorecommonintheearlierstagesofperimenopause.Forexample,youmayhaveaperiodthat’s2or3daysshorterthannormal.Yourwholecyclemayalsolast2or3weeksinsteadof4.Itisn’tuncommontofeellikeyourperiodjustendedwhenthenextonecomes.WhatyoucandoIfyou’reworriedaboutshort,unpredictablecycles,considerleakageprotectionsuchasliners,pads,orperiodunderwearlikeThinx.Passontamponsandmenstrualcupsunlessyouhaveamenstrualflow.Insertioncanbedifficultoruncomfortablewithoutthislubrication.You’realsomorelikelytoforgettochangeyourtamponorcup,increasingyourriskforcomplications.ProductstotryIfyourperiodsareunpredictable,youcanprotectyourselffromstainswithleakageprotectionproducts.Shopforthemonline:pantylinerspadsperiodunderwear5.LongercyclesInthelaterstagesofperimenopause,yourcyclesmaybecomemuchlongerandfartherapart.Longercyclesaredefinedasthoselongerthan38days.They’rerelatedtoanovulatorycycles,orcyclesinwhichyoudon’tovulate.A2008studysuggeststhatwomenwhoexperienceanovulatorycyclesmayhavelighterbleedingthanwomenwhoexperienceovulatorycycles.WhatyoucandoIfyou’redealingwithlongercycles,itmaybetimetoinvestinagoodmenstrualcuporacyclesetofblood-wickingunderwear.Youcanalsousepadsortamponstohelpyouavoidleakage.ProductstotryIfyouhavealongcycle,avarietyofproductsareavailabletohelpyouavoidleakage.Shopforthemonline:menstrualcupsacyclesetofblood-wickingunderwear,likethesefromThinxandAwwapadstampons6.MissedcyclesYourfluctuatinghormonesmayalsobetoblameforamissedcycle.Infact,yourcyclesmaybecomesofarapartthatyoucan’trecallthelasttimeyoubled.Afteryou’vemissed12consecutivecycles,you’vereachedmenopause.Ifyourcyclesarestillmakinganappearance—howeverdelayed—ovulationisstilloccurring.Thismeansyoucanstillhaveaperiod,andyoucanstillgetpregnant.Anovulatorycyclescanalsocreatedelayedormissedperiods.WhatyoucandoMissedcycleseverysooftenusuallyaren’tcauseforconcern.Ifyou’vemissedafewconsecutivecycles,youmaywanttotakeapregnancytesttodeterminewhetheryoursymptomsaretiedtoperimenopause.Otherearlysymptomsofpregnancyinclude:nauseabreasttendernessfrequenturinationsensitivitytosmellsheartburnYoucanalsomakeanappointmentwithyourdoctorinsteadoftakingahometest.Yourdoctorcanrunteststodeterminewhetheryou’reexperiencingsymptomsofperimenopause,menopause,orpregnancy.Ifyouaren’tpregnantanddon’twanttoconceive,usebirthcontroleverytimeyouhavesex.Fertilitydoesn’tenduntilyou’vecompletelyreachedmenopause.Usecondomsandotherbarriermethodstopreventsexuallytransmittedinfections(STIs).ProductstotryAmissedperiodmayactuallybeasignofpregnancy,whichcanbeconfirmedwithanat-hometest.Shopfortestsandcondomsonline:pregnancytestcondoms7.OverallirregularityBetweenlongcycles,shortcycles,spotting,andheavybleeding,yourcyclesduringperimenopausemaybegenerallyirregular.Theymaynotsettleintoanydiscerniblepattern,especiallyasyougetclosertomenopause.Thiscanbeunsettlingandfrustrating.WhatyoucandoTryyourbesttorememberthatthechangesyou’reexperiencingarepartofabiggertransition.Justasitbegan,theprocesswilleventuallyendwhenyoustopovulatingandreachmenopause.Inthemeantime:Considerwearingblackunderwearorinvestinginperiodunderweartoreduceyourriskofstainedclothing.Considerwearingdisposableorreusablepantylinerstoprotectfromirregularleaks,spotting,andotherwiseunexpectedbleeding.Trackyourperiodsasbestyoucanviaacalendaroranapp.Takenotesaboutabnormalbleeding,pain,discomfort,orothersymptomsyou’reexperiencing.ProductstotryIfyou’rehavingirregularperiods,certainproductscanhelpyouavoidleaksandstainsandkeeptrackofyoursymptoms.Shopforthemonline:periodunderwearpantylinersreusablepantylinersperiodjournalWhentoseeyourdoctorInsomecases,irregularbleedingmaybeasignofanotherunderlyingcondition.Seeyourdoctorifyou’realsoexperiencingthesesymptoms:extremelyheavybleedingthatrequiresyoutochangeyourpadortamponeveryhourortwobleedingthatlastslongerthan7daysbleeding—notspotting—thathappensmorefrequentlythanevery3weeksAtyourappointment,yourdoctorwillaskaboutyourmedicalhistoryandaboutanysymptomsyou’vehad.Fromthere,theymaygiveyouapelvicexamandordertests(suchasabloodtest,abiopsy,oranultrasound)toruleoutmoreseriousissues.LastmedicallyreviewedonJuly23,2020MedicallyreviewedbyMeredithGoodwin,MD,FAAFP—WrittenbyAshleyMarcin—UpdatedonJuly23,2020ReadthisnextCanPerimenopauseCauseYourPeriodstoBeCloserTogether?MedicallyreviewedbyCynthiaCobb,DNP,APRN,WHNP-BC,FAANPPerimenopausecancausealotofmenstrualchangesbeforeyourperiodultimatelystops.Butcanitcauseyourperiodstobeclosertogether?READMOREPerimenopauseandDischarge:WhattoExpectMedicallyreviewedbyDebraSullivan,Ph.D.,MSN,R.N.,CNE,COIPerimenopauseisthetransitionalperiodleadingtomenopause.Duringthisstage,fluctuatingestrogenlevelscanaffectyourcyclefromonemonthto…READMORENaturalRemediesforPerimenopauseMedicallyreviewedbySuzanneFalck,MDDiscovervitamins,supplements,andothernaturalremediesforperimenopause.READMOREThePerimenopauseDiet:Must-KnowsMedicallyreviewedbyDebraSullivan,Ph.D.,MSN,R.N.,CNE,COIYoucan’tpreventmenopausefromhappening,butyoucandecidehowyoutakecareofyourbodyduringthistime.Learnaboutmindfullivingduring…READMOREMenopause:11ThingsEveryWomanShouldKnowMedicallyreviewedbyDebraRoseWilson,Ph.D.,MSN,R.N.,IBCLC,AHN-BC,CHTTohelpyougetahandleonmenopause,hereare11thingsyoushouldknowaboutthistransitionalstageoflife.READMOREWhatCausesExtremeHungerDuringMenopause?Hormonelevelsfluctuateduringmenopause.Learnhowthiscanstimulateyourappetite,increasecravings,andleaveyouhuntingthroughyourfridge.READMORECanADHDGetWorseDuringMenopause?MedicallyreviewedbyNicoleWashington,DO,MPHADHDsymptomscangetworsewhenestrogenlevelsdrop.LearnmoreabouthowandwhymenopauseaffectsADHDandwhatyoucandotofindrelief.READMOREHowDoesMenopauseAffectCholesterolLevels?Aftermenopause,somepeopleexperienceanincreasedriskofheartdisease,dueinparttomenopause'seffectsoncholesterollevels.Thisarticle…READMOREOur2022KindraReview:DoesItWorkandIsItWorthIt?MedicallyreviewedbyDeborahWeatherspoon,Ph.D.,MSNKindraisabrandthatspecializesinproductsthatmayhelpmanagemenopausals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