# How your cycle changes in perimenopause

> Shorter, longer, heavier, skipped

Category: Perimenopause · 4 min read · Written by the Splash team · Sources checked October 2026
URL: https://splash.care/learn/perimenopause/cycle-changes

## Quick answer

- Cycles often become irregular, heavier or lighter.
- Predictions get less precise as your cycle changes.
- Bleeding after sex, between periods, heavier than before, or at all after menopause needs checking.

One of the first signs of [perimenopause](https://splash.care/learn/glossary/perimenopause) is usually a change to your periods. As [ovulation](https://splash.care/learn/glossary/ovulation) becomes less regular, periods can get unpredictable.

- Periods coming more often or less often
- Bleeding getting heavier or lighter
- Skipped periods, then a few regular ones again
- [Spotting](https://splash.care/learn/glossary/spotting)

Because the pattern can shift so much, period [predictions](https://splash.care/learn/apps-privacy/how-accurate-are-period-apps) become less precise. That is not a fault in you or the app: your cycle is genuinely changing. Eventually your periods stop altogether.

**Myth:** Irregular periods in your 40s are always just perimenopause.

**Fact:** They often are, but other things like thyroid problems, pregnancy, fibroids, polyps or PCOS can also change your cycle, so new changes are worth checking.

## Heavy bleeding

Heavier periods are common at this stage, and it is the impact on your life that counts. The NHS describes [heavy bleeding](https://splash.care/learn/period-care/heavy-periods) as soaking through a pad or tampon every 1 to 2 hours, passing [clots](https://splash.care/learn/period-care/clots) bigger than about 2.5cm (a 10p coin), bleeding for more than 7 days or flooding. Treatments exist, such as a hormonal coil ([IUS](https://splash.care/learn/glossary/ius)) or [tranexamic acid](https://splash.care/learn/glossary/tranexamic-acid), and heavy bleeding can cause [iron](https://splash.care/learn/nutrition/iron)-deficiency [anaemia](https://splash.care/learn/glossary/anaemia).

**Quick quiz:** You have not had a period for 14 months and then have light bleeding. What should you do?

1. Ignore it as one-off spotting
2. See a GP, even if it was only once
3. Wait three more months

Answer: See a GP, even if it was only once. The NHS says any bleeding after 12 months without a period needs checking, even if it is a small amount or only happened once. It is usually not serious, but it can sometimes be a sign of cancer, and early checking helps.

If you start [HRT](https://splash.care/learn/glossary/hrt) while still having periods, some [irregular](https://splash.care/learn/cycle-basics/irregular-cycles) bleeding or spotting is common at first and usually settles within 6 months. Tell a GP if it continues beyond 6 months or gets heavier.

> **Splash says:** keep logging even when cycles go wild. A record of dates and flow is gold at a GP appointment.

### When to see a doctor

See a GP if you have bleeding after sex, bleeding between periods, periods that become much heavier than before, or any vaginal bleeding after 12 months without a period, even if it is only once or just a little. These need checking. Also see a GP if you soak through pads or tampons every 1 to 2 hours, bleed for more than 7 days, or feel exhausted, dizzy and breathless. Get urgent help (NHS 111 or 999) if you feel faint or have severe pain with heavy bleeding.

## Sources

1. [NHS: Symptoms of menopause and perimenopause](https://www.nhs.uk/conditions/menopause-and-perimenopause/symptoms/)
2. [NICE NG23: Menopause: identification and management](https://www.nice.org.uk/guidance/ng23)
3. [NHS: Side effects of HRT](https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/side-effects-of-hormone-replacement-therapy-hrt/)
4. [Jean Hailes: Menopause](https://www.jeanhailes.org.au/health-topics/menopause/)

This is general information, not medical advice. Splash can’t diagnose. If you’re worried, talk to a GP, pharmacist or sexual health clinic. In an emergency call 999 (UK) or 911 (US).