Perimenopause Spotting & Menstrual Changes – Explained

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Perimenopause is the period after menstruation and right before menopause. There are many hormonal changes during this time which can lead to a variety of different perimenopausal symptoms—most of which are downright miserable and annoying. 

The primary indication that your menstruation and fertility are coming to an end is irregular periods. It can be super heavy for days, to be followed by perimenopause spotting all month, or perhaps perimenopause spotting instead of a period, or sometimes—no blood at all!

This phase can be confusing to say the least. That is why we are here to help you figure out what’s normal and what’s not when it comes to menstrual changes during this transition. 

Let’s start with the basics. 

What is Perimenopause?

What is Perimenopause?

Perimenopause is the transitional period leading up to menopause that can last for many months, a few years, or even a decade-long. It can be the most erratic and unpredictable season for hormones that you’ll experience in life. And it can come with many physical, mental, and emotional symptoms.

If you want to learn about other Perimenopause symptoms besides spotting and menstrual changes, check out this blog!  

Stages of Perimenopause

There are 2 stages of perimenopause: the early and late phase. 

Early Stage

  • Perimenopause happens during your 30s or 40s
  • Frequent irregular periods
  • Hot flashes, mood changes, and other symptoms

Late Stage

  • Perimenopause happens during your 40s or 50s
  • Lesser or lighter periods 
  • Symptoms may go on for years post-menopause

What To Expect In Perimenopause?

Scientifically speaking, perimenopause occurs around  age 45 and typically lasts for 4 years

There are many clues that you may get when perimenopause has arrived or is right around the corner. Here are some examples. 

Signs & Symptoms To Expect During Perimenopause

There is a total of  34 symptoms that occur throughout menopause

However, during  perimenopause, these are the most common signs to look out for: 

Physical Symptoms

  • Irregular periods
  • Sore breasts
  • Night sweats
  • Hot flushes
  • Urine leakage
  • Sleeping problems
  • Bloating, diarrhea, or constipation
  • Unintentional weight loss
  • Hair thinning
  • Dry mouth or mouth ulcers
  • Skin problems
  • Muscles and joint pains
  • Headaches and Brain Fog 

Sexual Symptoms

Here are the sexual symptoms of perimenopause
  • Vaginal dryness
  • Painful sex 
  • Low sex drive

Psychological Symptoms

  • Anxiety 
  • Depression 
  • Panic attacks
  • Mood disorders
  • Irritability



How to prepare for the unexpected?

How to prepare for the unexpected?

Remember that your journey will be unique. Don’t assume you’re perimenopausal just because you have a few symptoms or because your friend at the same age already is. In the same way, it’s alright to seek out a second opinion if your doctor had been dismissive of the possibility that you’re having early or premature menopause. 

The best way to prepare for this transition is to live a healthy lifestyle and keep yourself well–informed, regardless of your age. It’s never too early to prepare for perimenopause!

If you need a little motivation to get into the best physical, mental, and emotional health possible, this blog about Weird Perimenopausal Symptoms can help!  

How Can Perimenopause Affect Your Periods?

Your hormones directly influence your period. To be precise, your progesterone and estrogen levels are responsible for regulating your menstruation every month. But this smooth-sailing cycle changes as you draw closer to menopause. 

During perimenopause, your hormones will start fluctuating sporadically. This hormonal imbalance will cause irregular bleedings that vary in timing, frequency, heaviness, and length. 

Is Spotting Normal During Perimenopause?

Perimenopause spotting during perimenopause is normal.

You can have spotting and still have normal perimenopause. However, this symptom can also signify an underlying health issue.

To clarify, spotting is having small amounts of blood instead of a regular menstrual flow.

But the real question is,
how do you sort out what’s normal and what’s not?   

So here’s what to look for:  


  • Brief spotting before or after a regular flow
  • Some spotting after intense exercise or sexual intercourse
  • Spotting during the first few months of using birth control pills

Not Normal

  • Perimenopause spotting all month
  • Spotting in between periods 
  • Consistent spotting along with extreme cramps
  • Spotting after 12 consecutive months of no period 

If you see your doctor, he or she will usually look for signs of uterine fibroids, polyps, endometriosis, infection or sexually transmitted disease (STD), and cancer. 

This will be assessed through physical examination and other tests like: 

  • Endometrial biopsy
  • Dilation and Curettage
  • Sonohysterography
  • Hysteroscopy
  • Transvaginal ultrasound 

What About Heavy Bleeding and Period Color?

Many women experience heavy bleeding and the color of their period changing during perimenopause.

Many women’s perimenopausal journeys are not a walk in the park. More often than not, women deal with heavy (sometimes prolonged) bleeding, and sometimes a change in the color of their period. 

Let’s discuss both of these possibilities. 

Heavy Bleeding

There are 2 main reasons for heavy bleeding during perimenopause:

  • Hormonal imbalance – your uterine lining thickens when your estrogen level is too high while your progesterone is too low
  • Missed period – your uterine lining continues to build up every time you skip a period 

In both cases, a thick uterine lining will take more time and intensity to shed when you finally get your period. 

Period Color 

It’s normal to have a bright red, dark brown, or dark colored blood during perimenopause. In fact, it can also appear thin and watery or clumpy and thick. You should only be concerned if your blood is orange or gray, as this can be a sign of infection. 

How To Deal With Perimenopause Symptoms and Prepare for Menopause

The first thing you can do is find a support circle that not only sees and hears you, but is also knowledgeable about women’s health. In Women Cycles, we work with some amazing practitioners who teach women how to heal from pelvic floor dysfunction, after having overcome it themselves.

Another way to thrive during perimenopause is to prepare your body and mind for it. Know and believe that you can do this! One of the first ways to achieve this is by learning how to de-stress while doing things like eating healthy, staying hydrated, exercising, socializing, and visiting your OB-GYN once a year. 

Also, don’t forget to take good care of your pelvic floor!

A healthy pelvic floor can improve your overall reproductive health. If it’s well-taken care of, it prevents and reduces the onset of severe menopausal symptoms and other health issues. But just so you know, Kegels, pessaries, and even surgeries won’t do the job. You don’t need “band-aid” solutions like these, and here’s why

Be Menopause-Ready with Women Cycles!

Asking for help is a strength, not a weakness.

For all you know, there’s a whole community of women that can speak about how beautiful the aging process can be!

Women Cycles is one such community that help women who wants to:

  • Lift their kids and grandkids without fear
  • Jump, run, dance, play
  • Find pleasure in sex
  • Feel like themselves again
  • Lose that constant feeling of anxiety
  • Connect to their pelvic floor and their entire body
  • Disconnect from the symptoms they face 
Be Menopause-Ready with Women Cycles!

To achieve this, we built the No Kegels System (NKS) — a science-based natural healing solution to help women get their pelvic floor health back in 12-weeks, starting with just 10 minutes a day!

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