Is It Normal to Skip Periods in Perimenopause?

In the journey through menopause, one of the common questions is whether it is normal to skip periods in perimenopause. Here’s why missed periods are a typical occurrence during this phase of life, and what to expect as you progress towards the milestone of menopause.

Is It Normal to Skip a Period During Perimenopause?

During perimenopause, which typically starts in someone’s early 40s, the menstrual cycle begins to shift. These changes become more significant in late perimenopause and signal the approach to menopause. One of the most noticeable changes is differences in the length of menstrual cycles and periods of time without a period. So, the short answer is yes—it’s entirely normal to experience different menstrual cycle patterns, including missed periods during perimenopause.

Normal changes in your menstrual cycle during perimenopause include:

• Heavier or lighter menstrual flow
• Spotting (light bleeding) between periods
• Change in the length of your cycle by more than seven days
• Skipping periods, or going more than 60 days between periods

Why Do We Get Missed Periods During Menopause?

The menstrual cycle is regulated by hormones, primarily estrogen and progesterone. Before perimenopause begins, these hormone levels cycle in a generally regular pattern that dictates the length of your menstrual cycle. In perimenopause, age-related changes and fluctuating levels of estrogen and progesterone cause changes in the frequency and regularity of periods. 

Changes in the menstrual cycle before menopause are driven by the aging of your ovaries. Here’s a closer look at the process: 

1. Follicle depletion: Follicles are the tiny sacs within the ovaries that contain immature eggs. You are born with all of your egg cells. The menstrual cycle occurs as one or more of these egg cells matures and is released from an ovarian follicle.  As you age, the number of follicles in your ovaries decreases. This is a gradual process that starts even before perimenopause begins.
2. Hormonal changes: As the number of follicles decreases, the ovaries produce less estrogen and progesterone, the hormones that regulate the menstrual cycle.
3. Irregular ovulation: With fewer follicles and less hormone production, ovulation becomes less predictable. In some months, ovulation may not occur at all (called anovulation), leading to skipped periods.
4. Hormone fluctuations: The hormonal imbalance resulting from reduced follicles can cause variations in the menstrual cycle, leading to irregular periods.

How Long Do Missed Periods Last During Perimenopause?

Each person has to deal with irregular periods for a different length of time. Some may experience irregular cycles for a few months, while others may have sporadic periods for several years before reaching menopause. Menopause is officially declared when a woman has gone without a period for 12 consecutive months not due to another cause, so the countdown restarts when any bleeding occurs—even after months of no periods.

Perimenopause and Skipped Periods: It IS Normal

While irregular and skipped periods can be inconvenient and sometimes unpredictable, they are not a cause for alarm. However, consult with a healthcare provider if you have concerns or experience severe symptoms. 

Furthermore, while the chance of pregnancy is diminished in perimenopause, it’s still important to use reliable birth control until you are officially postmenopausal (12 consecutive months without a period).

Remember, you’re not alone in this journey, and support and information are available to help you manage the challenges of perimenopause with resilience and optimism. For more information and support around your menopause journey, including a range of options for menopause symptom relief, download Midday from the App Store or visit us at Midday.Health.