Ask the Doctor: What does a change in menstrual cycle mean?

Dear Doctor, I am 43 years old and my menstruation cycle seems to have changed these last two months. My cycle has gotten a lot heavier and with more clotting. I also now have cramping. What do changes in a woman’s menstrual cycle mean? Is this a sign of menopause or maybe a health complication?
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Dr. Rachna Pande