Understanding menstrual changes

Perimenopause often brings menstrual changes, including longer cycles and episodes of heavier bleeding. These are most often due to hormone fluctuations that occur during this time. But there are changes that are not typical, such as very heavy bleeding that lasts for seven days or more, and breakthrough bleeding or spotting midcycle. If these occur, a woman should let her doctor know. They may be caused by treatable problems, such as fibroids (a type of uterine growth) or uterine polyps.