My periods in my mid-forties have become

Call your local emergency number now and go to the emergency department if, right now, you are faint or near-faint, your face or lips look white or grey, you are cold and sweaty, your heart is racing, you are passing almost no urine, or the bleeding soaks a pad in about an hour — and if none of that is happening today, you still need a clinician appointment this week rather than waiting through another heavy period.

*(I left the actual emergency digits out deliberately — I could not verify a local number this turn, so please use the emergency number for where you live. Tell me your country and city and I will pin down the exact official entry next time.)*

The short answer about perimenopause

Longer, heavier periods in your mid-forties can happen in the years around menopause — NHS lists this as one of the times heavy bleeding shows up. But it is only one of several possible reasons, and the others need looking at too: conditions affecting the womb or ovaries, fibroids, bleeding or clotting disorders, thyroid and iron problems, and some medicines or treatments. I cannot diagnose which one is yours from a message, and neither can anyone without examining you and checking blood tests. The point of this guide is not the label — it is that the label does not change what you do tonight.

Why "wait and see" no longer fits

You have already been through flooding and dizziness with this. That means the question is no longer "is this normal?" — it is "what is causing it, and am I anaemic or low on iron?" The NHS advises a GP review for heavy periods that are disrupting daily life, and blood tests (full blood count, ferritin/iron, pregnancy ruled in or out) are the usual first step. Same-week appointment, and say "heavy periods with flooding and dizziness" when you book so you are triaged as urgent rather than routine.

Tonight / today: three tiers

Tier 1 — Emergency now (any one is enough)

• Fainting, near-fainting, or you feel you are about to pass out
• Face or lips white or grey; cold sweat
• Heart racing or palpitations
• Passing almost no urine
• Bleeding suddenly much heavier, clots bigger than a coin, or the bed soaked
• Any chance of pregnancy with bleeding, or severe new lower abdominal pain, or fever with the bleeding

→ Emergency number now. Do not drive yourself. Take this page, your medicine boxes and your pad log with you. Have someone stay with you if you can.

Tier 2 — Same-day / this-week clinician assessment (this is your tier)

• You are currently steady, but periods are lasting longer, soaking products every 1–2 hours, passing clots, bleeding through to clothing or bedding, and you are tired or short of breath
• Any recent episode of flooding or dizziness, even if it settled
• Book now for the earliest slot. If they cannot see you and the bleeding is worsening, say so on the phone and ask for urgent/cancellation list.

Tier 3 — Home support while you wait (only if you are otherwise well)

• Record the bleeding (below), eat and drink normally, rest when you can, and use the practical steps further down.

Home care is for someone who is otherwise well. It is not a substitute for the appointment in Tier 2.

What to record (this is what makes the appointment 10 minutes shorter)

Also note, for each day of the period: how many days it lasted, whether it woke you, whether you needed two products at once, and whether you had to cancel normal activities. NHS markers of "heavy" include changing a pad or tampon every 1–2 hours for hours, periods lasting more than 7 days, clots larger than about 2.5 cm (roughly a 10p coin — my comparison, treat as approximate), bleeding through clothing or bedding, and feeling tired or short of breath.

What people usually try, and what tends to work better

Avoid list: starting, stopping, doubling or re-timing any medicine (including painkillers and anything for iron, thyroid, blood pressure or hormones) without the prescriber; aspirin-type painkillers or anti-inflammatories on your own while bleeding heavily; new powders, tonics, herbs or supplements bought online; anything inserted in the vagina; driving yourself if you are dizzy; "just push through it" plans.

24-hour success markers (behaviour, not cure)

These are things you can tick tonight that are not promises that the bleeding will stop:

• ✅ You know your Tier 1 signs by heart and your emergency route is written down and the phone is charged and within reach
• ✅ The appointment is booked or requested, with "heavy bleeding, prior flooding and dizziness" in your words
• ✅ Your pad log is filled in for today, including the last change time
• ✅ You have eaten, drunk water, and are lying down rather than standing and cooking
• ✅ One person knows what is happening and has your medicine boxes, pad log and this page
• ✅ Your medicines are untouched since yesterday
• ✅ You got through tonight without anyone having to plan around a flood

Kitchen and routine (foods you already have)

• Regular protein meals and water through the day. Iron-containing everyday foods: dark green leaves, lentils and beans, eggs, meat, fortified cereal, dried fruit — paired with a vitamin-C food such as orange, tomato or peppers. Keep tea and coffee to another hour around iron-rich meals. (This is general eating advice, not a treatment for your bleeding.)
• Heat pack wrapped in a towel for cramps, 15–20 minutes at a time.
• Lie on your side with a pillow under your knees; when getting up, do it in stages — sit, pause, stand, pause, walk. This is what stops the "stand up and gush" moment.
• If you feel faint: lie down, get your legs up, and do not be alone in the bathroom.

Scripts you can send tonight

To a partner or family member:
> "My period is much heavier than it used to be and I've had flooding and dizziness with it. I'm booking a doctor appointment this week. Could you cover the school run and [name] tomorrow from [time]? If I haven't messaged by [time], please call me. If I go faint or can't get up, call the emergency number."

To work:
> "I need to see a doctor this week for heavy bleeding, and I may need to attend an appointment at short notice. Could we plan for me to be contactable and to step away if needed this week? I'll keep you updated and hand over anything outstanding before I go."

At the appointment:
> "I've been having increasingly long and heavy periods, and I've had at least one episode of flooding and dizziness. I'd like a blood test — full blood count and iron — and I'd like pregnancy ruled in or out. Could we also talk about what treatment is available for the bleeding itself, and what should make me come back tonight rather than wait?"

Bring with you

☐ Pad log ☐ Medicine boxes (all of them, in one bag) ☐ Photo of a soaked pad if you have one ☐ List of anything you take, including supplements ☐ This page ☐ Last period start date

---

*This is practical preparation for a visit, not a diagnosis or a treatment plan. What is causing the bleeding and what to do about it is for the clinician who examines you and reads your results — I cannot diagnose it here.*

Source: nhs-conditions https://www.nhs.uk/conditions/heavy-periods/
(NHS public information, Heavy periods, checked this turn. Figures above — pad saturation every 1–2 hours, periods over 7 days, clots around 2.5 cm — are from that page; the coin size is my rough comparison.)