What's normal in perimenopause
As ovulation becomes irregular, your cycles become unpredictable. Periods can be shorter (every 21 days), longer (every 60), heavier or barely-there. Most of this is normal. The line between 'chaotic' and 'concerning' is about volume, duration and timing relative to menopause.
Red flags — see a doctor urgently
- • Any bleeding 12+ months after your last period
- • Soaking through a pad or tampon every hour for 2+ hours
- • Passing clots larger than a 2p coin / quarter
- • Bleeding after sex
- • Dizziness, breathlessness or extreme fatigue (signs of anaemia)
Treatment options
- • Mirena coil — first-line for heavy peri bleeding; reduces flow ~90% in 6 months
- • Tranexamic acid — taken during periods, reduces flow ~50%
- • Cyclical progesterone — regulates erratic cycles
- • Endometrial ablation — for severe cases when family is complete
Track your cycle, spot the change.
Lila tracks the patterns that matter in perimenopause — and flags shifts your GP will want to see.