Perimenopause period changes: Closer cycles, symptoms & when to see a doctor

In this article, we’ll dive into what perimenopause period changes you can expect, why these changes and symptoms occur, and when to consult with your healthcare provider if you’re experiencing irregular vaginal bleeding.

What to expect from your period during perimenopause

The main perimenopause period changes you may experience include changes to the:

• Consistency
• Regularity
• Color of your bleed
• Intensity of your cramping symptoms

Let’s go through each of these below so that you have a better understanding of what might be happening in your body.

Your period flow may become lighter or heavier

During perimenopause, the flow and intensity of your period are likely to change. It might become heavier some months but lighter as you near menopause [2]. Dealing with an unpredictable period can feel frustrating. It can be a real shock if you're used to a certain cycle routine, and it can make everything from planning day-to-day activities to just feeling comfortable in your own skin a lot more challenging. But there are a few benchmarks to keep in mind and some ways to manage an unpredictable period.

A heavy flow is typically defined as needing to change your tampon or pad in less than two hours, bleeding for more than seven days, or bleeding that involves passing large clots. You may also find yourself needing to change period products multiple times throughout the night, or find yourself feeling more tired and weak than usual [2]. 

While this heavy bleeding is fairly common (it affects about one in five women), it’s very important to see your healthcare provider to make sure there isn’t an underlying condition besides perimenopause that may be causing the heavy bleeding [2]. Otherwise, having period products on hand that are designed for heavier flows can help you feel more comfortable throughout the day and overnight.

On the other hand, your period may also get much lighter than you’re familiar with during perimenopause. Throughout this time, there will likely be some months when you don’t ovulate (known as anovulatory cycles), so you may skip a period, or it may be very light [3]. Spotting during perimenopause is also common, which happens because of shifting hormone levels. For a lighter, unpredictable flow like this, keeping pantiliners in your home cabinet or your purse throughout the day can help you stay prepared.

Your flow timing may become irregular

Along with irregular flow consistency, the timing in between your periods may also become irregular. They may even get so close together that you’re asking yourself: Is it possible to have a period every 2-3 weeks? 

While that may seem far too frequent, especially if you’ve been on a consistent cycle for years before, it is possible to experience bleeding that often during perimenopause. Your body’s response to changing hormone levels can cause periods to come much earlier or later than you’re used to. This may be as close together as 2 to 3 weeks, or as far apart as 60 days [3]. 

This irregularity is so common during perimenopause that it’s actually one of the main markers medical professionals might choose to look at to define the perimenopausal stage with their patients. Before perimenopause, you may notice a general, gradual decrease in cycle length (for example, if you have a 28 day cycle, you might notice it shorten to 25 days). But as perimenopause starts and progresses, the length of your cycles may get more irregular and variable. For example, you might start to see cycles of 21 days followed by 29 days, or go up to 60 days without a period [4].

This change, however, might not happen for everyone. It’s important to note that you may experience little (if any) variability in cycle length during this time. About 15 to 25% of women report very little changes to their cycles leading up to menopause [4].

Your flow may change colors

Period blood colors can range from bright red to dark brown to light pink — all of this is normal, but you might notice a more dark red or brown coloring than you’re used to during perimenopause. This darker blood color just indicates blood has been sitting in the uterus for longer than usual, and its exposure to oxygen causes the color to darken over time (a process called oxidation). This is especially likely if you’re finding that your periods are coming later than usual. 

Typically, this change in period blood color during perimenopause isn’t cause for concern, but if you notice blood or discharge that is not the normal brown, pink, or red, it may be a sign of infection that needs medical attention [5,6]. If you’re uncertain of what’s happening in your body at any time, or want to explore your symptoms in depth, reach out to your healthcare provider.

You may have cramping, but no actual period

One of the more complex symptoms reported by women in perimenopause is abdominal pain, which might include cramping, without an actual period. You may experience the familiar tightening sensation in the abdomen and expect your period to come soon, but no bleeding happens. 

While menstrual cramps usually decrease after your final period, other types of abdominal pain may continue or even increase during perimenopause and into postmenopause. Factors beyond your cycle, such as hormonal fluctuations and stress, can contribute to pain during this time [7].

The good news here is that your usual period cramp remedies should still work to ease the pain. Over-the-counter pain medications such as ibuprofen or acetaminophen can help, along with heating pads to relax the muscles [8].

Other perimenopause symptoms to look for

Aside from the specific perimenopause period changes you may be experiencing, there are a few other common symptoms of perimenopause that can signal the start of this phase:

• Pain during sex
• Fatigue
• Hair loss or excessive hair shedding
• Hot flashes
• Night sweats
• Joint or muscle discomfort
• Moodiness
• Difficulty concentrating [9]

Why these perimenopause changes occur

You may be wondering why on earth these perimenopause period changes and other symptoms happen. It’s important to remember that these shifts are a natural part of this life phase, and although they can be frustrating and unpredictable, there are often ways to manage them with the right support and care. 

Basically, during the reproductive years when you have a monthly period, your body experiences changes in the concentrations of the female sex hormones estrogen and progesterone in regular intervals over the course of the cycle. These rising and falling hormone levels trigger cyclical events like ovulation and your period [1]. 

During perimenopause, levels of these two hormones start to fluctuate irregularly and eventually decline. When you hit menopause, the levels of both are low, but until that time, they can be erratic and inconsistent. These fluctuations account for the host of perimenopause symptoms you may experience during this transition [10]. We know these changes can be frustrating, but your body is doing exactly what it’s meant to do. While the journey may feel long, there are ways to ease symptoms and navigate this phase comfortably and with confidence.

Is it normal for periods to be closer together during perimenopause?

Perimenopause affects each person differently, so although no two people will have the exact same symptoms and cycle characteristics, it is possible (and normal) for your periods to happen more frequently and closer together than you’re used to. It’s also worth noting that menstrual cycles can become shorter as early as your late 20s or early 30s. For example, you might notice that you used to have your period every 30 days on average, but now it comes every 28-29 days on average. Know that this is normal and not necessarily a sign of perimenopause [11].

However, for perimenopause specifically, the irregularity you may experience can cause your periods to happen as often as every two to three weeks. It’s also common for them to spread out as we mentioned earlier.

Other causes of irregular periods

While the changing hormone levels in your body can account for most of the perimenopause period changes we’ve mentioned, it never hurts to consult with your healthcare provider about your symptoms. Irregular periods can have other underlying causes including:

• A side effect of certain medications
• An infection of the uterus or cervix
• Hormone therapy
• Polyps (growths in the uterine lining)
• Endometrial atrophy (thinning of the uterine lining)
• Endometrial hyperplasia (thickening of the uterine lining)
• Early pregnancy (implantation bleeding)
• Sexually transmitted infections
• Certain types of cancer [1]

Again, there is usually no cause for alarm if your periods become irregular during perimenopause, but it’s a good idea to consult with a healthcare professional about your specific symptoms and history to rule out any underlying conditions that may require attention.

When to see a doctor

Furthermore, if any of the common perimenopause period changes listed above are extreme enough to cause disruptions to your daily life, it’s best to talk to your healthcare provider about the symptoms. While perimenopause is a natural and important stage of life that all women with periods will experience, this doesn’t mean that you need to suffer through it. Your doctor can help you chart the best path forward in terms of management and treatment as your body navigates these hormonal changes. 

Get to know your body with Natural Cycles

Your body may be shifting, but you are still you. While perimenopause brings challenges, it also marks a new chapter — one where you can embrace changes with the knowledge, support, and care you deserve. Keeping track of your perimenopause symptoms, cycle length, and more over time can help you see patterns and be prepared to have informed conversations with your healthcare professional about your needs. 

Natural Cycles is more than just a period tracker — it uses the science of body temperature to detect ovulation or flag cycles that are anovulatory, giving you deeper insights into your cycle. Log your symptoms, compare your unique patterns, and download cycle reports to share with your doctor right from the app. Find out if NC°can support you during your perimenopause journey and beyond.