Changes to Periods
For many women, changes to your menstrual period are the first and most noticeable sign that perimenopause has begun.
While this may not be exactly the same of all women, there are some common changes to menstrual periods that happen during perimenopause.
Early perimenopause
Your period will become more frequent during early perimenopause. So, you may begin to have your period more often because your menstrual cycle has shorten.
Late perimenopause
During late perimenopause – which typically happens 1-3 years before your final menstrual period – you may start to have your period less frequently. You may start to skip your period, where for two, three or more months you may not have a period. Skipping a month or more, and then having two cycles close together is also common.
Heavier bleeding during early perimenopause
During early perimenopause, you may bleed heavier (for more information on hormonal changes during perimenopause). Many women experience a heavier flow. You may experience flooding, large clots, and bleeding that soaks through your pad, tampon and/or menstrual cup more quickly than usual.
Lighter bleeding during late perimenopause
As your perimenopause progresses, and you move towards your final menstrual period, you may find that your period becomes lighter.
Learn more about your hormones oestrogen and progesterone.
Spotting
In between periods, or once they have stopped, you may experience spotting or a brown discharge.
When to seek medical advice
While you may experience heavier periods during perimenopause, please consult your doctors or healthcare provider if your periods are unusually long and/or heavy periods.
Various medical conditions (including but not limited to endometriosis, uterine fibroids, as well as endometrial or cervical cancers) may lead to unusually long and heavy periods and requires urgent medical attention.
After menopause
At menopause, you will stop having a period altogether. After menopause, if you experience bleeding, please consult your doctor or healthcare provider.
My Menopause SA
Evidence-based menopause information for South African women.
Page last reviewed: 1 March 2026
Next review due: 1 March 2027