During perimenopause, menstrual cycles can become unpredictable, with some women experiencing unusually heavy periods. These changes are due to fluctuating estrogen and progesterone levels, which affect the uterine lining’s thickness. When estrogen dominates without sufficient progesterone to balance it, the lining may build up excessively, leading to heavier, prolonged, or irregular bleeding.

Heavy periods can cause fatigue, iron deficiency, and social discomfort. Some women may also experience clotting or severe cramps. While changes in menstrual flow are expected during perimenopause, extremely heavy bleeding or bleeding between periods should be discussed with a healthcare provider to rule out other conditions like fibroids or polyps.

Managing heavy periods may involve lifestyle changes, iron supplements to prevent anemia, or medical treatments such as hormonal therapy or non-hormonal medications to regulate bleeding. If symptoms become disruptive, a healthcare provider can suggest personalized treatment options.