What Could Heavy Menses Flow During Perimenopausal In Woman Suggest?

Hello, thanks for offering this service. I am a 46 yrs old female, perimenopausal, I am having really heavy menstrual period, changing soaked pads every hour for 12 hrs already, quarter size blood clots every time I use the bathroom, do you think I should go to the Emergency Room o this is just a result of perimenopause, last month my period (not heavy) lasted 21 days, I did not see a doctor that time. thanks in advance