What’s the difference between perimenopause and menopause
In this article
What's the lowdown?
Perimenopause is the time during your life before menopause when hormone levels are changing
Menopause is technically one day and happens once you have not had a period for 12 months
The age at which perimenopause starts and when you reach menopause itself varies hugely between different women
Some women go through perimenopause and menopause with very few symptoms, but many women find they suffer either physically or emotionally, or both
There are lots of options you can use to help with symptoms of perimenopause and the changes that occur after menopause is over
- In perimenopause, hormone levels are changing, but women are still having periods.
- Once your periods have naturally stopped and you have not had one for twelve months, you have gone through the menopause and are officially postmenopausal.
- The symptoms of perimenopause are varied, and for many women they stop once perimenopause is over and you have had your last period.
- Once you are postmenopausal, your hormones enter a new baseline level, which is naturally lower than it was before perimenopause.
So, perimenopause vs menopause? It can be hard to know exactly where you are in the hormonal spectrum. Read on for some more detail….
What is perimenopause?
Perimenopause is the time during your life before menopause. During this time, levels of your female hormones – oestrogen and progesterone start to fluctuate and gradually decline. You have fewer eggs and your hormones have to work harder to cause your ovaries to release an egg each month. As a result, lots of women suffer hormonal symptoms during this time.
The hormonal changes that lead up to menopause can take place over many years. The average age of starting perimenopause can vary widely and is thought to be influenced by your genetics and some lifestyle factors, such as nutrition, stress, and sleep deprivation1.
It is very important to speak to your GP if you think you may be perimenopausal under the age of 40, especially if you haven’t had a period for 4 months. This is because untreated premature or early menopause can impact your long-term health so an accurate diagnosis is key to getting the right support.
Symptoms of perimenopause
There are many symptoms of perimenopause, and everyone’s experience varies. However, about 85% of women will experience some kind of symptom during perimenopause2. They can come on gradually, or suddenly. For many women these symptoms come and go, and can vary in severity 3,4.
Because of the huge hormonal shifts that are going on during perimenopause, the first symptoms of perimenopause often include irregular or skipped periods.
Other common symptoms include;
- Sleeping problems
- Hot flushes
- Night sweats
- Joint pain
- Changes to mood
- Changes to memory
- Vaginal dryness
- Painful sex
Treatments of perimenopause
The good news is that there are lots of medical treatments and supplements that can be used to relieve the symptoms you might have in perimenopause.
If you are looking for help with a specific physical symptom, such as vaginal dryness, hot flushes, or bloating, over the counter treatments for menopause are a good place to start.
Hormone-replacement treatment (HRT) is an option to treat perimenopausal symptoms. It replaces the oestrogen that reduces during perimenopause. The combined hormonal contraceptive pill can also be used to regulate hormone levels.
The choice of hormonal treatment is an individual one which also depends on your medical history. Your healthcare professional can help talk through options.
If you would like to avoid medications or supplements for your perimenopause symptoms, there are other tips and tricks that you could try. For example, improving your sleep in perimenopause, changing your diet or changing exercise might impact your symptoms. You may also like to read about other women’s perimenopause experiences and what has helped them.
What is menopause?
Menopause occurs once you have not had a natural menstrual period for twelve months (if you’re not using hormonal contraception). The average age for this to happen in the UK is 513. Once this day has occurred, you are officially in the postmenopausal period of your life, and you will no longer have periods. Depending at what age this happens for you, many women live at least a third of their lives in the post-menopausal period!
If you have not had a period for 12 months and you are in your 40s or 50s, it is possible that you are menopausal, even if you have been lucky enough not to have any of the perimenopause symptoms that many women suffer.
Hormonal contraception such as the pill, coil or contraceptive implant can stop or lighten your periods. This can make it difficult to know if you have reached menopause. Your healthcare professional can help work out if you have reached menopause and are able to stop contraception.
Symptoms of menopause
Thankfully, many women find that in the post-menopausal period, a lot of the symptoms of the perimenopause may have passed. However, some unlucky women continue to have symptoms for up to twenty years after menopause. Other than the changes that happen with your periods, the symptoms of perimenopause and menopause are very similar.
Menopause produces so many physical and emotional changes in women’s bodies that there is no predictable way to know what symptoms may persist into your post-menopausal period, but there are lots of options to ease the symptoms you may be struggling with.
Treatments of menopause
Lifestyle measures such as eating a healthy diet, exercising regularly, having a good sleep routine and stopping smoking can help manage symptoms of the menopause and improve long term health and wellbeing4. Most of the supplements and medical treatments that are suitable for helping with perimenopause symptoms can also be used safely in the postmenopausal period.
It is common for women who are post-menopausal to have thinning of the vulval skin, which can make sex uncomfortable5, or sometimes cause a small amount of bleeding after sex. Vaginal lubricants and vaginal oestrogen.
Hormone replacement therapy (HRT), can be used in the postmenopausal period. If you are considering whether to either start HRT or continue it after you have gone through menopause, speak to your doctor. The risks and benefits of this medication can vary based on other health conditions that you may have6.
If you are not sure where you are on the perimenopause or menopause spectrum, or whether your symptoms could be due to something else that is going on with your health, speak to your doctor.
We know that doing this can be daunting, but doctors really are there to help. You can prepare for the appointment by tracking your symptoms and noting how they are affecting your quality of life. Prepare for your first perimenopause appointment using our handy guide.
Remember that if you think you have gone through the menopause and you have symptoms such as vaginal bleeding, a change in your bowel habit, or weight loss, you shouldn’t assume that this is down to menopause, and you should always see a doctor urgently.
Dr Gemma Dovey
Medical Copywriter
Dr Gemma Dovey is a GP with a passion for women's health with experience of these issues herself as a patient. She loves communicating complex medical issues in a way that patients understand. She also have experience in writing and editing medical information, both for patients and for doctors.
Our medical review process
This article has been medically reviewed for factual and up to date information by a Lowdown doctor.
