Navigating the Flood: Tips to Support Heavy Periods in Perimenopause
Heavy periods in perimenopause are really common.
But because we don’t talk enough about heavy periods in the menopause transition, many women have no idea that this is a common thing until they are flooding the bathroom floor.
Even when women are prepared, sometimes the bleeding just seems to come out of nowhere. It is often unpredictable, prolonged, and exhausting. If you've found yourself suddenly needing to carry an extra change of clothes or planning your calendar around your cycle, you're not alone.
Not considering the absolute hassle of heavy periods, heavy periods can also lead to anemia and iron deficiency. It is important that perimenopausal women get the right diagnosis and treatment given many of the symptoms of iron deficiency, such as brain fog, depression, fatigue, and hair loss, overlap with symptoms of perimenopause/menopause.
What is a Heavy Period Anyway?
Heavy bleeding is a flow that is too heavy (think a super soaker) or one that lasts longer than your typical menstrual bleed, or both that interferes with daily life.
While every woman’s “normal” is different, a period is generally considered clinically heavy if:
Bleeding for longer than seven days and/or
Clots bigger than the size of a 20 cent coin
Soaking through menstrual products onto clothes or sheets
A sensation of gushing with standing
Needing to double up on menstrual products
Causing symptoms of anemia (fatigue, dizziness, shortness of breath)
How common is heavy bleeding in perimenopause/menopause really?
The Study of Women’s Health Across the Nation (SWAN) looked at bleeding patterns during the menopause transition. A whooping 91.0% of women reported at least one period that was 10 days or longer, and 77.7% reported at least 3 super long periods. Just over one-third of women (34.5%) had 3 or more periods where they bled heavily for 3+ days. It is important to note that both prolonged periods and heavy periods were more common in the later menopause transition (within 3 years of the final period) compared to the early menopause transition.
Let’s break down some practical, holistic tips to support your body and sanity through it.
What can you do to support yourself?
1. Track Your Cycle (Even If It’s a Wild Ride)
Use a period tracking app or journal to monitor symptoms, flow intensity, and cycle length. This helps you anticipate heavy days and gives your doctor a clearer picture if intervention is needed.
Bonus tip: Jot down mood swings, food cravings, and sleep patterns—you might spot a helpful pattern.
2. Replenish Your Iron Stores
Heavy bleeding can lead to iron-deficiency anemia, which can make fatigue, brain fog, and dizziness worse. Load up on iron-rich foods like:
Leafy greens (spinach, kale)
Red meat (in moderation)
Legumes and lentils
Pumpkin seeds
Bonus Tip: Pair with vitamin C (like citrus or bell peppers) to boost absorption. Or drizzle some lemon juice over your meal.
3. Balance your Blood Sugar levels
You don’t need to avoid carbs, or track your blood sugar levels (unless you are a diabetic). But perimenopause can reduce your body’s insulin sensitivity which can disrupt hormone regulation. Try these tips when building your meals:
Eating protein and fibre with every meal
Avoiding skipping meals
Limiting refined carbs (white bread, pastries, etc.)
4. Take NSAIDs (like ibuprofen or naproxen)
Take these at the start of your period as they can reduce bleeding by 20–40% and relieve cramps. They work by inhibiting prostaglandins, which trigger uterine contractions.
5. Contraception
Look at other options, which could be short term during this transition. Hormonal IUD (like Mirena) — often significantly reduces or even stops periods.
6. Mind-Body Practices
This can be a stressful time, which also doesn’t help your crazy hormones. Try adding in yoga, meditation, journaling, walks in nature
