Irregular periods
Also called: skipped period, shorter cycles, heavy bleeding, flooding, two periods in one month
Cycles that shortened before they lengthened, a month skipped and then two close together, and periods heavy enough to plan a day around. This is the sign that defines perimenopause — the one that makes the rest of the list make sense. It is also the one symptom where some changes are ordinary and some are worth an appointment, so it is worth knowing which is which.
What is actually happening
Ovulation becomes unpredictable. In a cycle where you do not ovulate, no progesterone is produced in the second half — so the lining keeps building under estrogen with nothing balancing it, and when it finally sheds there is more of it. That is where the heavy periods come from. Cycles usually shorten first, because the first half compresses, and only later stretch out and start skipping. The whole transition typically runs four to eight years.
How common this is
A persistent change of seven days or more in cycle length is the accepted marker that the transition has begun. From that point, the median time to a final period is around four years.
STRAW +10 staging criteria
If you try one thing
Writing down what your cycle does
Irregular is expected in this stage. Written down is what tells you which kind of irregular you have.
Not a fix — the record. Almost everything a provider can do with this starts from knowing what your cycles have actually been doing, and almost nobody arrives with that. Three months of dates turns a vague complaint into something anyone can act on. Free.
Note three things each time: the date it started, how many days it lasted, and whether the bleeding was lighter, the same, or heavier than it used to be. Cycles getting shorter, then longer, then skipping altogether is the ordinary pattern. Some things are worth a call rather than a note, though — bleeding between periods, bleeding after sex, soaking through a pad or tampon every hour for several hours, periods closer together than three weeks, or any bleeding at all once you have gone twelve months without one.
Write it the first time you notice, before you deal with anything else.
On a hard day: The date alone. Four characters in your notes.
When you might notice
Three cycles before a pattern means anything. It is slow, and it is the thing that makes an eight-minute appointment useful.
Roughly what it costs
Free
The rest for this
What to say to a doctor
Four changes are worth an appointment rather than a wait: bleeding that soaks through a pad or tampon every hour for several hours in a row, periods lasting longer than seven days, cycles closer together than 21 days, and any bleeding at all after a full year without one. None of these mean something is wrong. All of them are things a provider would want to look at rather than attribute to perimenopause without checking.
Guía is not a doctor. This is what to bring so the appointment goes somewhere.
Something else bothering you
Guía is not a doctor and none of this is medical advice. It is here so you can have a better conversation with someone who is. Who made this
Which of these is for you?
Three questions and Guía puts the ones that fit your symptoms into a plan — in the right order, with the smaller version for the days you cannot. Free, and there is nothing to buy.
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