51- menstrual cycle - 2 week periods, heavy, clots, one week no bleeding then repeat. had ultrasound, small fibroid. blood test show not menopausal?

Perimenopause: B"sd the main medical issue would be iron defiency anemia. Generaly this can be a problem at menarche (start up of menses) and as with you in peri-menopause. Gyn will work to limit bleeding. My recommendation is keep a check on blood count and iron levels to avoid need for IV iron, transfusion. Blood tests usually will not show menopause till periods have stopped.