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How perimenopause affects your period: irregularities, heavy bleeding, and more

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Perimenopause
3
 minutes
February 28, 2025
Medically reviewed by: 

Perimenopause marks a time of significant hormonal shifts, and one of the earliest signs is often changes in your menstrual cycle. From irregular periods to heavy menses during perimenopause, understanding what’s happening to your body can make this transition more manageable. This blog dives into common menstrual cycle changes after 30 like getting a period every 3 weeks, perimenopause cramps with no period, and the presence of blood clots during period menopause to help you navigate this stage with confidence.

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Period every 3 weeks: what it means

A period every 3 weeks can be one of the first signs of hormonal imbalance during perimenopause. Shorter cycles occur as your ovaries produce less progesterone, the hormone that regulates the length of your cycle. This can lead to more frequent periods, often accompanied by spotting or irregular flow.

What to do:

  • Track your menstrual cycle using an app or calendar to identify patterns.
  • Consult your doctor if frequent periods disrupt your daily life or cause significant discomfort.
  • Explore hormone therapy options if cycles become unpredictable or bothersome.

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Menstrual cycle changes after 30

Many women notice menstrual cycle changes after 30, especially as they approach their late 30s or early 40s. These changes often signal the onset of perimenopause and can include:

  • Shorter or longer cycles
  • Heavier or lighter periods
  • Changes in flow consistency

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What to expect:

  • Fluctuating hormone levels can lead to symptoms like mood swings, fatigue, and breast tenderness.
  • Some women experience cycles that become progressively irregular.

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Heavy menses during perimenopause

Heavy menses during perimenopause are not uncommon and can occur when estrogen levels remain relatively high while progesterone levels drop. This hormonal imbalance can lead to prolonged or heavy bleeding lasting more than seven days.

What to do:

  • Use high-absorbency menstrual products to manage heavy flow.
  • Maintain a diet rich in iron to prevent anemia.
  • Seek medical advice if heavy bleeding persists, as it could indicate underlying conditions like fibroids or polyps.
  • If you have to change a pad, menstrual cup, or tampon more than every 1-2 hours, you should seek in-person care. 

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Perimenopause cramps with no period

Experiencing perimenopause cramps with no period can be confusing and frustrating. These cramps are often caused by hormonal fluctuations, which can trigger uterine contractions even when no menstruation occurs.

What to do:

  • Stay hydrated and consider over-the-counter pain relievers for relief.
  • Apply heat to the lower abdomen to reduce cramping.
  • Speak with your doctor if cramps are severe or frequent, as this could indicate other health issues.

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Blood clots during a period in menopause

Seeing blood clots during a period in menopause is another common symptom. Clots often occur during heavy bleeding episodes and are a result of slower blood flow leaving the uterus, causing it to coagulate.

What to do:

  • Monitor the size and frequency of blood clots; clots larger than a quarter may warrant medical attention.
  • Stay active to promote better circulation.
  • Discuss treatment options with your healthcare provider if clots become frequent or accompanied by other symptoms.

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When to seek medical advice

It’s common to experience changes in your menstrual cycle during perimenopause, but some signs may indicate a need for a visit to your doctor. If you notice any of the following, it's a good idea to get in touch with a healthcare professional:

  • Periods that last longer than seven days
  • Bleeding between periods
  • Very heavy bleeding (soaking through a pad, tampon, or menstrual cup every hour)
  • Severe cramps or pelvic pain

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Navigating menstrual changes with confidence

Changes like getting a period every 3 weeks, experiencing heavy menses during perimenopause, or noticing perimenopause cramps with no period are all part of this transitional phase. By understanding these shifts and seeking care when needed, you can navigate perimenopause with greater confidence and comfort. Don’t hesitate to reach out to a healthcare provider to discuss your symptoms and explore treatment options tailored to your needs.

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