Perimenopause Periods Closer Together: Why It Happens and What to Do About It

Is having periods closer together normal during perimenopause?

In a word: Yes. But that doesn’t mean that all women experience shorter cycles during perimenopause.

Perimenopause and menopause can vary greatly from person to person. Perimenopause, also called the menopausal transition, begins when your ovaries start producing fewer hormones, and it lasts until you enter menopause.

This stage typically occurs in your mid-to-late 40s, although in some cases, it may appear in your late 30s or early 50s. Perimenopause lasts approximately 4 years; but for some, it may last just a few months or continue for 10 years! 

The average age for a woman to enter menopause is 51. You are considered menopausal once you have gone at least 12 months without any periods or bleeding. Sometimes, sudden hormonal fluctuations will lead to random or unexpected menopause symptoms.

The bottom line is that it’s perfectly normal to have your periods closer together during perimenopause. Aside from increased frequency, other common perimenopause symptoms are:

• Weight gain
• Hot flashes
• Headaches
• Insomnia
• Forgetfulness
• Hair loss
• Changes in skin texture
• Muscle aches
• Mood changes
• Painful sex
• Low libido
• Vaginal changes

What causes two periods in one month?

While in perimenopause, hormonal fluctuations can shorten your cycles and cause ovulation irregularities. Periods could occur roughly every 3 weeks, or more than once per calendar month.

If your shortened cycles still last 21 days or more, or are accompanied by additional symptoms, they’re likely the result of perimenopause.

Other explanations for changes in your menstrual cycle after 40, such as frequent bleeding, include:

• Thyroid problems
• Uterine polyps
• Endometriosis
• Significant weight changes
• Birth control side effects
• Uterine fibroids
• Endometrial atrophy
• Endometrial hyperplasia
• Stress
• Uterine cancer

What other changes should you expect?

Your period evolves in a number of ways once you’ve entered perimenopause. While some women have perimenopausal periods closer together, others might notice them occurring further apart. Further changes in your menstrual cycle after 40 often include:

• Heavier periods: Your flow may become more intense over time. If bleeding is unusually heavy, however, be sure to consult your doctor.
• Lighter periods: Inversely, a lot of women experience decreased flow (resembling spotting) for up to a year before their periods stop completely.
• Skipped periods: Anovulatory cycles are another possibility during perimenopause. Keep in mind, though, that you’re still fertile at this stage. So if you’ve recently had sex and missed your period, consider taking a pregnancy test.
• Longer or shorter periods: Perhaps your period has always lasted for 4 days, but now it’s 2 or 6 days. You might even experience a random combination of both shorter and longer cycles while in perimenopause. This, too, is a fairly common occurrence.

Treatment options

Perimenopause and menopause are natural processes that every woman undergoes at some point in her life. However, there are specific lifestyle changes and medical treatments available to address any unwanted symptoms. 

• Estrogen: It can be taken orally, or applied as a patch or vaginal cream. In addition, estrogen-rich foods are a great alternative to increase your levels organically.
• Progesterone: This must be combined with estrogen to avoid hormonal imbalances unless you’ve undergone a hysterectomy and no longer have a uterus. 
• Medications: Drugs used to treat hot flashes, such as antidepressants, gabapentin, and clonidine, also offer symptom relief.
• Exercise: Physical activity is known to reduce stress, alleviate cramps, and promote weight loss.
• Meditation: Even a few minutes of meditation each day can make a positive impact on mood swings, depression, and similar issues.
• A nutritious diet: The risk of developing heart disease and other serious conditions increases after menopause. That’s why adopting a well-balanced lifestyle is key. 
• Calcium and vitamin D: Prevent bone loss and osteoporosis with calcium-rich foods like dairy, beans, lentils, seeds, yogurt, and some types of fish. Alternatively, begin taking a doctor-approved daily supplement.

When to seek medical advice

Although perimenopause is 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.

However, should you notice any of the following warning signs, please seek medical attention right away.

• Postmenopausal bleeding
• Heavy or painful bleeding
• Side effects of hormone treatment
• Periods less than 21 days apart
• Bleeding between periods
• Abdominal pain
• Shortness of breath, heart palpitations, or weakness
• Bleeding or pain after sex
• Feelings of anxiety, sadness, or depression

As mentioned above, symptoms like having perimenopausal periods closer together are among many potential changes in your menstrual cycle after the age of 40. 

Leading a healthier lifestyle and discussing treatment options with your doctor will go a long way towards easing the transition. By taking the proper steps, you can maintain your overall quality of life long after menopause.