Can blood thinners lead to heavy periods in the perimenopause?

Perimenopause is the time directly before the menopause, when you still have periods, but they change in how heavy they are and how often you have them. This happens because of changes in your hormone levels and how often your ovaries release eggs.

Following a heart attack you may be prescribed blood thinning medications like low-dose aspirin or antiplatelets, which can slow down clotting when you bleed. If your medication is making your perimenopausal bleeding worse, see your healthcare professional to discuss your options. Don’t stop taking any prescribed medication in the meantime.

You can also ask for a referral to a menopause specialist to discuss your perimenopause. You may find that cyclical hormone replacement therapy (HRT), which involves taking the hormone oestrogen every day, and adding in the hormone progesterone some of the time, helps regulate your cycle and reduces heavy menstrual bleeding.

Less commonly (usually only if you’ve had your womb removed), oestrogen-only HRT is recommended. HRT could also ease other perimenopause symptoms you may be experiencing.

Patches, sprays, gels, and the coil, which is put in your womb, are usually safe ways to take these hormones for women who have had a heart attack in the past. Unlike tablets, they have no risk of blood clots or strokes. Some women with heart conditions are advised to have the coil fitted within a hospital environment so they can be closely monitored.

Keeping a period diary may help you and your healthcare professional understand the pattern of your menstrual period and decide which test or treatment may be helpful.

• Find out more about the different types of HRT
• Download the free balance app for symptom tracking and expert content on the perimenopause and menopause.

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