There's A Reason Your Periods Can Get Heavier In Your 40s, Expert Says

For many women, perimenopause, or the period that leads up to menopause, begins in their 40s. This happens when your body is getting ready to stop having periods for good.

Often, the process changes your menstrual cycle. It can make your periods irregular, longer, or shorter. And it can lead to heavier periods, too.

Here, HuffPost UK spoke to Dr Ghazala Aziz-Scott, a specialist in women’s health at the Marion Gluck Clinic, to work out why this happens, what’s normal, and when you should speak to a GP. 

Why do some people’s periods get heavier in their 40s? 

During this decade, Dr Aziz-Scott explained that the amount of progesterone women produce during the second half of their menstrual cycle (the luteal phase) can decline.

Meanwhile, some women actually start to produce more oestrogen in perimenopause.

Progesterone “is a hormone that stabilises the endometrial lining and oestrogen has the opposite effect of stimulating the endometrial lining,” the doctor stated. 

If your progesterone declines while your oestrogen rises, you might become what Dr Aziz-Scott calls “oestrogen dominant”.

This “imbalance leads to the endometrial lining being less stable and a greater blood loss”. Some people don’t ovulate at all for certain menstrual cycles during perimenopause (anovulation), which can also make periods heavier.

What is normal for periods in perimenopause? 

Irregular ovulation and changes to hormones in our pituitary gland, like FSH (follicle-stimulating hormone) and LH (luteinising hormone), can make periods “erratic”, the expert advised. 

The perimenopause “can go on for many years, with initially the odd anovulatory cycle to periods of amenorrhoea [having no periods at all] for several months,” she continued. 

“Perimenopausal periods tend to be closer together, and much heavier; for example, a 28-day cycle might be 22 days. Periods can be clotty, and flooding may occur”. 

But this can vary from woman to woman. Some might find that they see a sudden stop to their periods, “and it is also very common to have several months of no periods and experience spotting or very light bleeds”. 

How can I make periods in menopause easier? 

Eating well, including consuming more cruciferous vegetables (like broccoli and cabbage), milled flax seeds, and “a wide variety of colourful fruit and vegetables” might go some way towards balancing oestrogen dominance, the specialist said. 

Hormonal treatments, including those which include progesterone or the Mirena coil, are “popular” among those with very heavy periods, she added. 

“If periods are very heavy, medications such as mefenamic acid and tranexamic acid can reduce the blood flow while menstruating, as one of the common patterns of perimenopause is iron deficiency anaemia due to the heavy blood loss,” Dr Aziz-Scott told us. 

In some cases, “a small dose of synthetic progesterone directly onto the lining of the womb [can] make periods much lighter or disappear altogether, restoring quality of life and decreasing the risk of anaemia”. 

But in general, she added, you should speak to your doctor to work out what’s going on with your hormones.

When should I see a GP about heavy periods in my 40s? 

The NHS said that you should see your doctor if you notice any menopause or perimenopause symptoms for the first time and want to know what you can do about them.

And Dr Aziz-Scott shared that you should speak to your GP if your periods are affecting your quality of life – you might also want to go for “education and reassurance about what is going on in your body”. 

Sometimes, your doctor may prescribe appropriate treatments like mefenamic acid. 

“It is also helpful to discuss any symptoms you may be experiencing and how to manage these,” the expert ended.

“Iron deficiency anaemia is a very common occurrence, and many women don’t realise this until they are really feeling unwell, with low energy, weakness and even breathlessness. So if you do have very heavy periods, checking your haemoglobin and iron levels is very important.”