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    How Long is Too Long for a Period During Perimenopause?

    Updated 14 February 2022 |
    Published 27 August 2019
    Fact Checked
    Reviewed by Dr. Anna Klepchukova, Intensive care medicine specialist, chief medical officer, Flo Health Inc., UK
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    The road to menopause comes with many changes. Night sweats, hormonal imbalances, and vaginal dryness are a few of the well-known symptoms of perimenopause. Heavy, painful periods are also a symptom that’s quite common — roughly 25 percent of women report experiencing them. Read on to learn the basics of perimenopause bleeding and how to manage extended perimenopause periods.

    How long are normal perimenopause periods?

    Ordinarily, your menstrual cycle occurs every 21 to 35 days and lasts from 2 to 7 days.  However, perimenopause periods can last much longer. Some months, the ovaries might not produce sufficient levels of estrogen and progesterone, preventing menstruation altogether. Other months, the imbalance might cause the uterine lining to become overly thick, which means it will take longer to be shed by your body to shed. 

    Excessive bleeding and long periods are fairly common during perimenopause. Many women experience an increased flow and extended perimenopause periods before entering menopause.

    If you’ve had periods that are several days longer or more frequent or heavier than usual, it’s a good idea to see your doctor.

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    Is it normal to have longer and heavier periods during perimenopause?

    Excessive bleeding and long periods are fairly common during perimenopause. Many women experience an increased flow and extended perimenopause periods before entering menopause. 

    In fact, one in four women say that their periods are heavy enough to interfere with day-to-day activities, such as going to work or attending social events. According to University of Michigan researchers, 91 percent of women aged 42–52 surveyed reported heavy menstruation for 10 or more days during their transition to menopause. This phenomenon occurred one to three times within a three-year period. 

    There are various other health factors which come into play, including body mass index (BMI), use of hormones, and the presence of uterine fibroids. 

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    What causes longer-than-normal periods during perimenopause?

    During a regular menstrual cycle, your levels of estrogen and progesterone rise and fall in a relatively consistent pattern. However, while in perimenopause, your hormones don’t follow a set pattern and your ovaries produce erratic and unpredictable perimenopause periods. 

    When you’re about to enter menopause, you’ll ovulate less frequently, creating one of two possible scenarios. In the first scenario, your ovary doesn’t release an egg, and the lining of the uterus doesn’t shed, which causes a missed period. 

    In the second scenario, the lining of your uterus has grown extra thick and requires more time to shed. The excessive buildup of tissue means longer periods and intense menstrual flow. 

    Gradually, however, your periods will become less frequent and eventually stop altogether. Experts consider the transition to menopause complete once a woman has gone without having a period for at least 12 consecutive months. 

    Several uterine conditions become more prevalent during the perimenopausal phase. Be sure to pay close attention to any abnormal symptoms such as:

    • Uterine polyps: These are generally benign growths located in the uterus and cervix. Left untreated, certain types of uterine polyps may become cancerous.
    • Uterine cancer: Warning signs include vaginal changes like abnormal bleeding, among other symptoms.
    • Endometrial atrophy: This is a thinning of your uterine tissues brought on by low estrogen levels. Similar to cancer, one telltale sign is abnormal bleeding. 
    • Endometrial hyperplasia: Inversely, this condition causes your uterine lining to become unusually thick. High levels of estrogen, in conjunction with low progesterone, are usually the cause. In rare cases, endometrial hyperplasia could lead to uterine cancer. 

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    How to cope with extended perimenopause periods

    Have you noticed your menstrual symptoms growing more pronounced and uncomfortable during perimenopause? Consider the following remedies:

    Hormone therapy

    Hormone therapy is capable of reducing bleeding, shortening periods, and alleviating PMS by hindering the buildup of your uterine lining. 

    Over-the-counter pain relievers

    Taking over-the-counter pain medications like ibuprofen while on your period eases some of the discomfort associated with monthly cramps.

    Intrauterine Device (IUD)

    Using IUDs to treat heavy, painful periods has proven effective for many. It works by thinning the lining of your uterus and lessening the adverse effects of abnormal perimenopause periods. 


    Regular physical activity is known to combat bloating and relieve menstrual cramps. Doctors recommend daily exercise to perimenopausal women to manage menopause symptoms,  such as stress, pain, and stomach-related issues. 

    Quality products

    If you’ve been dealing with increased flow and extended perimenopause periods, invest in a few high-quality feminine care items. Experts recommend extra-long pads with wings or tampons designed for heavy days, menstrual cups, and/or protective underwear for leakage. 

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    When to see a doctor

    Whenever you observe irregularities or abrupt shifts in your menstrual cycle, it’s wise to consult your doctor. Warning signs include: 

    • Very heavy menstrual bleeding (e.g., you need to change your tampon/pad hourly for several consecutive hours)
    • Bleeding after sexual intercourse
    • Several short menstrual cycles (roughly 3 weeks in length)
    • Several periods lasting much longer than usual
    • Bleeding after one year of having no periods at all

    Although perimenopause periods are an inevitable part of every woman’s life, it’s still essential to see your gynecologist for an annual checkup. They’ll be able to assess your chances of developing menopause-related conditions and advise you on how to manage your symptoms.

    History of updates

    Current version (14 February 2022)

    Reviewed by Dr. Anna Klepchukova, Intensive care medicine specialist, chief medical officer, Flo Health Inc., UK

    Published (27 August 2019)

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