Heavier bleeding can be an early sign of the hormonal changes of perimenopause..

The fluctuation of hormones in early perimenopause can lead to heavier periods. For many women this is one of the first signs that things are changing.
Remember that perimenopause can begin as early as your late 30s for some women or may begin for others anywhere in the 40s.

For some women, periods will become lighter and less frequent, for others they may become heavier and more frequent in the years leading up to menopause.

If you've noticed that your periods have become heavier here are a few possible contributing factors to consider:

-Low progesterone levels
Progesterone begins to become lower in perimenopause, whilst oestrogen tends to swing wildly, initially becoming higher and then usually lower the closer you get to actual menopause, the ceasing of your period (defined by having reached 12 months since your last period). When the ratio of oestrogen to progesterone is out of balance, heavier bleeding is common. How to know if your progesterone level are low? Certain symptoms will give us some clues (to be discussed next week) and salivary hormone testing can be helpful.

-Iron deficiency
Heavy or frequent bleeding can both lead to an iron deficiency, but heavy bleeding can also result from being deficient in iron. This is why regular iron testing is important. It becomes especially important if you experience heavy bleeding or have digestive issues which make it hard to digest and absorb iron (including Coeliacs disease, Crohn's disease, IBS or leaky gut) or you don't eat a lot of red meat or iron rich foods. A recent Covid or other infection (viral, bacterial or parasitic) can often deplete your iron stores leaving you low in iron.

-Thyroid Issues
Thyroid issues are very common during perimenopause and post-menopause due to changing hormone levels. Heavy periods are more common if you have an underactive thyroid, so it can be helpful to have a full thyroid hormone test done (TSH, T3, T4, thyroid antibodies and reverse T3- GPs will often only look at TSH so a referral from a naturopath or integrative GP may be needed to get the full picture via a comprehensive thyroid function and hormone profile).

-Dairy consumption
For some women dairy products cause an increase in a type of immune cell called mast cells which can lead to production of prostaglandins (another naturally produced chemical) which can increase both heavy bleeding and period pain. Some women at this stage of life who previously tolerated dairy begin to notice that it doesn't agree with them anymore and not only notice that cows milk makes their periods heavier or more painful but that it causes them to feel bloated or experience constipation or diarrhoea.

-Fibroids
Fibroids can develop or become larger during perimenopause due to the increases in oestrogen and can contribute to heavy bleeding. Most of the time fibroids are largely benign and will shrink once your oestrogen levels lower post menopause.

Concerned about heavy periods? If you've noticed a change in your periods or an increase in PMS and other symptoms throughout your cycle and would like to find out what is happening with your hormones including any relevant referrals for iron/thyroid or hormone testing appointments can be booked here:

Current/returning clients: https://blossomwellbeing.as.me/?appointmentType=2667879