Bleeding patterns change because of changing hormones. A good way to think about this is to picture the lining of the uterus as the lawn with estrogen being the fertilizer and progesterone being the weed killer. When cycles become irregular in perimenopause, usually what is happening is the estrogen levels are too high and the progesterone levels are too low, and the lawn gets too thick resulting in heavy bleeding. Conditions such as fibroid tumors or obesity can make the bleeding heavier. Treatment options exist including maintaining a healthy weight, but also medication and surgery options.
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