Your doctor will want to know what triggers the bleeding and what makes it stop. Getting the right diagnosis is crucial if you want to avoid unnecessary procedures such as a hysterectomy, says Michelle Warren, MD, medical director of the Center for Menopause, Hormonal Disorders, and Women's Health at Columbia University in New York City. The troubling fact is that they could signal a hormonal imbalance, thyroid disease, uterine fibroids (enlarged by the surge of estrogen as you approach menopause), uterine polyps (noncancerous growths in the endometrium), or even cervical or uterine cancer.

Simon, MD, clinical professor of obstetrics and gynecology at The George Washington University School of Medicine and Health Sciences in Washington, DC. 'Frequently these symptoms are left unquestioned and untreated for an inordinate amount of time,' says James A.

Periods that last more than 7 days, or 2 or more days longer than usual.

Periods that are very heavy and gushing, or bleeding with clots.Menstrual changes that are considered abnormal and need to be checked out include these: Keeping a diary to track changes in your menstrual pattern is a good idea, so you can see when and where changes occur and share them with your health provider, says Prouty. Irregular means periods with bleeding that is lighter or heavier than usual, periods that are closer together, bleeding for fewer or more days than usual, or missed periods altogether. 'But if something isn't familiar to you and represents a change, you need to see a health provider to check it out,' she warns. Prouty, of Fall River, MA, a registered nurse and chairperson of the consumer education committee for The North American Menopause Society.

'We expect periods to become irregular and differ from a woman's usual pattern,' says menopause specialist Jennifer L. Prevention Premium: 5 Eye Symptoms You Should Never Ever Ignore But as you approach menopause, what's normal can seem to take on a whole new definition. Every woman has a unique pattern to her periods and knows what's normal for her. Irregular menstrual periods, one of the most common and predictable signs of menopause, most often occur because of the erratic levels of estrogen and progesterone and less-frequent ovulation. If you're between the ages of 40 and 60 and are troubled by hot flashes, skipped periods, achy joints, and mood swings, don't let your doc send you home with a flip 'It's only menopause.' It could be something more serious.

Painful or irregular periods