Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Usually painless bleeding at perimenopausal age group could be due to hormonal imbalance. Other possibilities are structural causes like fibroids, adenomyosis etc, but these are usually associated with pain. By clinical examination and ultrasound the exact cause of the problem can be identified. If you are having heavy flow your doctor may not clinically examine you but ultrasound helps in finding the possible cause. Antifibrinolytic drugs like tranexamic acid helps in reducing the bleeding. Hope I have answered your query. Let me know if I can assist you further.