Irregular Periods in Perimenopause: What Is Normal in Your 40s

You used to be able to plan your month around it. Now your period turns up barely three weeks after the last one, then disappears for two months, then arrives heavy in the middle of a work trip with nothing in your bag. You stand in an office loo improvising with tissue and wondering what on earth is going on.

What many of our mothers simply called महीना, "the month", has stopped keeping time. Here is what is normal, and what is not.

In short: Irregular periods in perimenopause are common. As hormones shift in your 40s, cycles can become shorter or longer, flow can get heavier or lighter, and you may skip months. But some bleeding is not normal: very heavy bleeding, bleeding between periods or after sex, and any bleeding after menopause should always be checked by a doctor.

Why do periods become irregular in your 40s?

In perimenopause, your hormones, especially oestrogen and progesterone, stop following their old predictable rhythm. They rise and fall unevenly, and you may not release an egg every month. Your cycle is built on that rhythm, so when it wobbles, your periods wobble too.

Perimenopause lasts about 4 years on average, but it can be a few months or up to 10 years. It ends at menopause, the point when you have gone 12 months in a row without a period. Here is the honest answer to how long perimenopause lasts.

Changing periods are often one of the very first signs. You may notice them alongside other changes, like broken sleep or new anxiety. See 12 early perimenopause signs at 40.

What is normal in perimenopause?

These changes are common as you move through your 40s:

• cycles getting shorter, so periods come closer together
• cycles getting longer, or skipping a month or two
• flow that is heavier or lighter than you are used to
• periods lasting more or fewer days than before
• stronger premenstrual feelings, like tender breasts, irritability or headaches

Maybe you have started choosing dark trousers "just in case", or checking where the nearest loo is before every meeting. That quiet, constant planning is tiring, and it is very common.

Common does not mean you have to put up with it. Heavy or painful periods can often be helped, and it is okay to ask about them even if they seem like "just part of getting older".

When is irregular bleeding a red flag?

See a doctor if you notice any of these:

• very heavy bleeding, such as flooding, needing to change protection very often, or passing large clots
• bleeding between periods
• bleeding after sex
• any bleeding after menopause, even light spotting
• a period that lasts much longer than usual, or a sudden big change from your normal pattern

If heavy bleeding leaves you feeling faint, dizzy or very unwell, get urgent care.

None of these automatically means something serious. They do mean you deserve a proper check, not "that's just your age".

Could it be something other than perimenopause?

Yes, and this is worth knowing. You can still get pregnant during perimenopause, even with irregular periods. If a period is late and pregnancy is possible, take a test. If you don't want to get pregnant, talk to your doctor about contraception.

Other things can also change your periods, such as thyroid problems or fibroids. A doctor can help work out what is going on. If your periods stop altogether before 45, read about early menopause before 45.

How can you track your periods without it taking over your life?

You don't need a spreadsheet. You need a few honest notes. In your phone's notes or calendar, jot down:

• the day each period starts
• how heavy it feels: light, medium or heavy
• how many days it lasts
• anything else you notice, like hot flushes, poor sleep or low mood

It is okay if you forget some days. A few months of rough notes still gives your doctor a much clearer picture. Here is why tracking your symptoms changes the doctor conversation. The MySakhi app also has daily symptom and mood check-ins if you would rather tap than type.

And a small practical kindness: keep a spare pad or two in your car, your handbag and your desk drawer. Future you will be grateful.

Try this now: a 5-minute warm-hand breath

When your body feels unpredictable, it helps to give it something steady. You can do this in bed, on the sofa, or sitting back in your office chair.

1. Lie down or sit back, and rest one warm palm on your lower belly.
2. Breathe in slowly through your nose and feel your belly rise under your hand.
3. Breathe out through your mouth, a little longer than the in-breath.
4. With each out-breath, let your belly, hips and pelvis soften.
5. Keep going for 5 minutes. If your mind runs to the calendar, come back to the warmth under your hand.

You can't do this wrong. Not controlling your body. Keeping it company.

Meditation

You Are Still You

9 min

When your body changes the rules, it is easy to feel like a stranger to yourself. This guided practice, You Are Still You, is a gentle reminder that you are not.

When should you see a doctor about irregular periods?

Book an appointment for any of the red flags above, or whenever your periods are affecting your work, sleep or mood. It is okay to bring it up even if it feels small. If you would like help preparing, here is how to talk to your doctor about perimenopause. For everything else that can change in these years, see the full list of menopause symptoms.

What if tonight you let the worry rest for a moment? Tell Sakhi how you feel and she will suggest a short practice, a sleep story or calming music. She is free and speaks English and Hindi. She is not a doctor, but she is good company on an unsettled night.

5 minutes. No mat. No mantra. Just you.