You are here

Heavier Flow in Perimenopause


I am 49 and have had a regular light period all my life. I have 3 children and do not use oral contraception. Recently I have been experiencing large clots and heavier flow. It is the clots that concern me because I have never seen this before. Should I seek the help of a gynecologist?


Thank you for your question. It is quite common for women in perimenopause, which you probably are, to have heavier flow and with that go clots. Often menstrual cramps also increase.

The only worrisome problem about clots and heavier flow is if it means that you are at risk for a low blood count (anemia) because of loss of iron. An indicator of that is use of 16 or more soaked normal-sized pads or tampons in one full period. Often the reason for heavy flow in perimenopause is that estrogen levels are high and progesterone levels are low or the time of progesterone in the cycle (luteal phase) is too short. These hormonal changes also cause the increased cramps.

I'd look at “Very Heavy Menstrual Flow” for some suggestions. If it persists you should tell your doctor, get a blood count and probably start cyclic progesterone therapy.

The good news is that periods and all of the changes of perimenopause will eventually go away and you will graduate into menopause.

Hope this is helpful to you.

Life Phase: 
Updated Date: 
Wednesday, November 20, 2013 - 14:15

Estrogen’s Storm Season: Stories of Perimenopause

Estrogen's Storm Season

by Dr. Jerilynn C Prior

New second edition available

Estrogen’s Storm Season is now available in BOTH print and eBook (Mobi and ePUB) versions!

All royalties are recieved in our Endowment fund (overseen by UBC) and support CeMCOR's research and future.

It is full of lively, realistic stories with which women can relate and evidence-based, empowering perimenopause information. It was a finalist in 2006 for the Independent Publisher Book Award in Health.

Purchase your ebook copy via our Amazon Kindle or
Google Play storefronts!

Paperback copies (with updated insert) still available here.

Join a Study:

Get Involved

Volunteer research participants are the heart of all CeMCOR research. Participants are invited to provide feedback on study processes, to learn their own results and at the end of a study, be the first to hear what the whole study found. Please become a CeMCOR research participant—you can contribute to improving the scientific information available for daughters, friends and the wider world of women+.