Can perimenopause cause heavier periods?

Yes, it can. During perimenopause, ovulation gets less predictable, so the usual balance between estrogen and progesterone can get thrown off. If you don’t ovulate, you don’t make the usual progesterone that helps stabilize the uterine lining. Estrogen may keep building that lining, which can lead to a heavier period when you finally bleed.

At Alloy, we also see that perimenopause can change periods in a lot of ways, not just heavier bleeding. They can become lighter, longer, shorter, earlier, later, or skip altogether. Our guide to perimenopause periods explains this in a simple way, and our irregular periods page has a quick overview too.

If bleeding is unusually heavy, lasts longer than expected, happens between periods, or comes with dizziness, fatigue, or shortness of breath, it’s worth getting checked. Any bleeding after menopause, meaning after 12 months with no period, should always be evaluated.

If your periods are getting disruptive, here at Alloy our low-dose birth control pill is one option that can help regulate irregular menstruation during perimenopause.

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For a quick explanation of why this happens, this chapter from independent menopause expert Dr. Corinne Menn is especially clear: How irregular ovulation affects the uterine lining.

This answer was created using the following resources:

• How to Know If You're in Perimenopause - Menstrual Changes

• Your Menopause Questions, Answered | Dr. Taylor Hahn - Recognizing Non-Period Symptoms

• Perimenopause 101 | Dr. Corinne Menn - Managing Perimenopausal Bleeding

• Are Irregular & Phantom Periods Normal during Perimenopause?

• What Causes Irregular Periods in Your 40s? Perimenopause

• What is Menopause?

• Low Estrogen Symptoms: Top Causes and Treatments

• Can Perimenopause Start in Your 30? The 'Millennial Menopause