What factors contribute to heavy periods during perimenopause in individuals with PCOS?

During perimenopause, individuals with PCOS may experience heavy periods due to several factors. Hormonal changes play a significant role as the body undergoes fluctuations in estrogen and progesterone levels. These hormones are crucial for regulating the menstrual cycle. When they are imbalanced, it can lead to irregular ovulation or even anovulation, where ovulation does not occur. This results in a thicker uterine lining, which can cause heavier bleeding when it sheds.

Irregular ovulation is another contributing factor. In PCOS, the ovaries may not release eggs regularly, which can lead to prolonged periods of time where the uterine lining builds up. When menstruation finally occurs, it can be heavier due to the increased amount of lining that needs to be shed.

Additionally, the thickening of the uterine lining, also known as endometrial hyperplasia, can occur. This condition is more common in individuals with PCOS and can further contribute to heavy menstrual bleeding. Managing these symptoms often involves addressing the hormonal imbalances and regulating the menstrual cycle through medical interventions.