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Changes before the Change: Perimenopausal bleeding

Changes before the Change bookletAlthough some women may abruptly stop having periods leading up to the menopause, many will notice changes in patterns and irregular bleeding. 

Whilst this can be a natural phase in your life, it may important to see your healthcare professional to rule out other health conditions if other worrying symptoms occur.

Many women experience Abnormal Uterine Bleeding (AUB) during perimenopause. AUB  is defined as bleeding that differs in frequency, regularity, duration or amount to your regular menstrual bleeding. [1] Changes to the menstrual cycle often carry no significant consequences [2]; however, they could have a range of causes. Although it may simply be a symptom of perimenopause, it is still sensible to raise the issue with your healthcare professional. A thorough history and physical examination will indicate the cause of uterine bleeding and help discern the need for further investigation and treatment. [3] Other investigations for abnormal uterine bleeding include a PAP Smear, Endometrial or Uterine Sampling (Endometrial Biopsy), a Vaginal Ultrasound (Echography) and routine laboratory testing.

pdfChanges before the Change1.06 MB


  1. The American College  of Obstetricians and Gynecologists (March 2017). "Frequently Asked Questions FAQ095 Gynecologic Problems: Abnormal Uterine Bleeding". www.acog.org/-/media/For-Patients/faq095.pdf?dmc=1&ts=20170530T2118409798 (Cited May 2017).
  2. (2016). "Abnormal Uterine Bleeding". Journal of Midwifery & Women's Health, 61(4). 522-527.
  3. Singh S, Best C, Dunn S, Leyland N, Wolfman WL, et al (May 2013). Clinical Practice – Gynaecology Committee. "Abnormal uterine bleeding in premenopausal women". Journal of Obstetrics and Gynaecology Canada, 35(5):473–479.

Conten updated 16 October 2017

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