Heavy Periods During Perimenopause Linked to Fatigue. Here's How to Cope

Irregular menstrual cycles during midlife, or changes in the amount and duration of menstrual flow, is often a telltale sign of perimenopause.

This phase before menopause, known as the menopause transition, typically affects females in their mid to late 40s and early 50s, though the age of onset may vary significantly.

Unlike menopause, which is confirmed when a person has gone 12 months without a period, perimenopause is often characterized by abnormal menstrual bleeding.

Heavy menstrual bleeding during perimenopause can significantly impact quality of life. A recent study found that heavy or prolonged menstrual bleeding may lead to fatigue, which helps explain why females are two to four times more likely to experience syndromic fatigue during midlife, which can be debilitating, researchers say.

The results, published online on March 12 in Menopause, the journal of The Menopause Society, note that 1 in 3 perimenopausal females experienced abnormal uterine bleeding.

Despite this prevalence, few studies have examined the issue nor have they explained the link between abnormal uterine bleeding during the menopause transition phase and fatigue or decreased quality of life.

Heavy bleeding may cause iron deficiency anemia (low red blood cell count), which, while treatable, is a well-known cause of fatigue.

“This study highlights the need for greater clinical awareness of abnormal uterine bleeding, particularly given the increased frequency during the menopause transition and its association with low energy or fatigue symptoms,” said Stephanie Faubion, MD, director of the Mayo Clinic Center for Women’s Health and medical director for The Menopause Society, in a news release.

“Educating women about the possibility of prolonged or heavy menstrual bleeding during the menopause transition and the potential health consequences is also needed,” she noted.