Your doctor is right — this pattern is entirely expected in perimenopause. Irregular periods are, in fact, the hallmark of the perimenopausal transition.

As ovarian function becomes less consistent, the hormonal signals that regulate the menstrual cycle — FSH from the brain, and oestrogen and progesterone from the ovaries — become erratic. Some months ovulation occurs normally; some months it doesn’t happen at all; some months the timing is shifted. The result is exactly what you describe: long gaps followed by periods coming close together, cycles that are shorter or longer than usual, flow that varies from barely there to unexpectedly heavy.

This can continue for several years. The average duration of perimenopause is four to eight years, and menstrual irregularity is present throughout much of that time.

However, certain changes within this irregular pattern do warrant investigation and should not be dismissed as “just perimenopause”:

• Very heavy bleeding (soaking through protection in under two hours, or passing large clots)
• Bleeding that lasts longer than 10 days continuously
• Bleeding after sex
• Any bleeding more than 12 months after what you believe to have been your last period

Keep a simple record of your period dates, duration, and flow, and bring it to your gynaecologist. It helps them distinguish expected perimenopausal irregularity from patterns that need investigation.