Irregular Periods
Heavier, lighter, earlier, later, or missing — changing periods are usually the first sign of perimenopause.
What it feels like
Periods arriving earlier or later than expected. Cycles that become unpredictably shorter or longer. Bleeding that is heavier than before, with large clots, or lighter and briefer. Months where your period simply does not arrive. For many Indian women, this irregularity — particularly the heavier periods — is the first unmistakable sign that something has changed.
Why it happens
Regular periods depend on a precisely timed sequence: the brain releases FSH, which stimulates a follicle in the ovary, which produces oestrogen, which triggers ovulation, which produces progesterone, which eventually falls and triggers menstruation. During perimenopause, the ovaries respond less reliably to FSH. Ovulation becomes irregular or absent. Without consistent ovulation, the hormonal sequence breaks down — producing cycles that are shorter, longer, heavier (when oestrogen dominates without progesterone to balance it), or absent.
Our free 3-minute symptom check is designed for Indian women.
What helps
- Track your cycles in an app (Clue, Flo) or a simple calendar — patterns help your doctor assess where you are
- Heavy bleeding (soaking a pad in under an hour, for several hours) warrants a doctor's visit
- Any bleeding after 12 months without a period must always be investigated promptly
- You can still become pregnant during perimenopause — contraception may still be needed until confirmed menopause
- Ask your gynaecologist about tranexamic acid or the Mirena IUD if heavy bleeding is affecting your life
Frequently asked questions
What counts as irregular periods during perimenopause?
Any significant change from your usual pattern: cycles shorter than 21 days or longer than 35, variation of 7+ days between cycles, periods that are significantly heavier or lighter than before, or skipping one or more periods. In perimenopause, gaps of 60 days or more between periods are a sign you are in late perimenopause.
Why are my periods heavier during perimenopause?
Heavier periods during early perimenopause are caused by oestrogen dominance — oestrogen rises without sufficient progesterone to counterbalance it (because ovulation is being skipped). This causes the uterine lining to thicken more than usual, resulting in heavier bleeding when it does shed. Fibroids and adenomyosis — both more common in women in their 40s — can compound this bleeding significantly and are worth investigating if periods are very heavy.
Can I still get pregnant with irregular periods in perimenopause?
Yes. Irregular periods do not mean you cannot ovulate — occasional ovulation still occurs during perimenopause. Pregnancy is possible until 12 consecutive months without a period. If you do not want to become pregnant, speak to your doctor about contraception that is appropriate for this life stage.
When should I see a doctor about irregular periods?
See a doctor if: bleeding soaks through a pad every hour for several hours; you have bleeding between periods or after sex; you have not had a period for 3+ months and are not pregnant; or you have any bleeding after 12 months without a period (post-menopausal bleeding always requires investigation).