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Pregnancy and menopause share a lot of similar symptoms. For women age 40 and older, telling the difference between pregnancy and menopause may be more difficult. Understanding the symptoms of menopause and pregnancy will help you figure out what you’re experiencing.

There are many symptoms that may accompany pregnancy and menopause. Symptoms in one pregnancy may differ from another pregnancy, even in the same woman. Likewise, menopause symptoms differ from person to person, and they also can change over time. The following are some general symptoms that you may have in perimenopause and pregnancy.

Comparing common perimenopause and pregnancy symptoms

SymptomSeen in perimenopauseSeen in pregnancy
A missed period
Bloating and cramping
Cholesterol changes
Decreased libido
Fatigue and sleep problems
Food sensitivity
Hot flashes and night sweats
Increased libido
Increased urination
Loss of bone mass
Loss of fertility
Mood changes
Sensitive and swollen breasts
Vaginal dryness
Weight gain

Changes in menstrual cycle

Women who are pregnant or in perimenopause will see shifts in their menstrual cycle because of hormonal changes. A missed period is a tell-tale sign of pregnancy, while irregular periods may mean the onset of menopause.

Signs of irregular menstruation include changes in blood flow, light spotting, and longer or shorter periods. It’s important to remember that irregular periods could indicate another condition. Speak with your doctors about any concerns.

Learn more about conditions that can lead to a missed period »

Fatigue and sleep problems

Fatigue and problems with sleep can occur in pregnancy and during perimenopause. In pregnancy, fatigue is caused by soaring levels of progesterone, which may cause you to become sleepy. In perimenopause, you are more likely to have trouble sleeping and staying asleep, which can cause you to become more tired than normal.

Mood changes

Hormonal changes cause mood swings in pregnancy and during perimenopause. In pregnancy, mood changes may cause you to be unusually emotional and weepy. In perimenopause, these changes may show as moodiness, irritability, or an increased risk of depression.


Headaches appear in both perimenopause and pregnancy. In both cases, headaches are caused by changes in hormones. In menopause, a loss of estrogen can cause headaches. During pregnancy, an increase in hormones may be the cause of increased headaches.

Headaches can also be caused by lack of sleep, stress, and dehydration, among other issues.

Weight gain

Weight gain happens gradually during pregnancy. As your baby grows, so does your belly. It’s recommended that women who are pregnant gain no more than 35 pounds, though your diet and other issues may cause additional weight gain.

During menopause, your metabolism slows down, which makes it harder to maintain a healthy weight. Hormonal changes may also cause you to gain weight around your abdomen.

Read more: Menopause and weight gain »

Problems with peeing

You may find that you are peeing more often during pregnancy. That’s because the increase in blood causes your kidneys to process more fluids, which end up in your bladder.

During menopause, however, loss of tissue tone may cause you to lose control of your bladder. Incontinence can also happen during pregnancy.

Changes to sex drive

Hormonal changes can affect your sex drive both in menopause and pregnancy. You’re more likely to have a low sex drive during menopause. During pregnancy, your libido can increase or decrease.

Bloating and cramping

Your uterus may cramp early in pregnancy. Changes to hormones can also cause bloating.

Bloating and cramping may also occur in perimenopause. In perimenopause, cramping may be a signal that you’re about to start your period.

Read more: Menopause and bloating: What’s the connection? »

Hot flashes and night sweats

Hot flashes and night sweats are commonly associated with menopause, but they may also be early signs of pregnancy.

During a hot flash, you’ll feel a quick rush of heat that can cause you to sweat and your face to become red and flush. You may also sweat excessively during sleep, which can wake you up during the night and lead to fatigue.

Sensitive and swollen breasts

Your breasts may feel tender and sore at the beginning of pregnancy. As your body adjusts to the hormonal changes, the feeling of discomfort will ease.

Nausea with or without vomiting

Morning sickness is a common symptom women experience in the first trimester of pregnancy. Although it’s commonly referred to as morning sickness, the feeling of nausea can occur throughout the day. Some women may never feel nausea or the need to vomit during their pregnancy.

Learn more: 17 early signs of pregnancy »


Changes in your body during pregnancy will slow down your digestive tract. That can lead to constipation.

Constipation can affect anyone, but it’s not specifically associated with menopause.

Food sensitivity

Your taste buds may change during pregnancy. You may stop eating your favorite foods or start to eat foods you haven’t had for years. You may also become sick after eating certain foods or smelling certain odors.

Loss of bone mass

Lower estrogen levels in perimenopause and menopause can cause a loss of bone density. That increases your risk for osteoporosis.

Bone mass is not affected by pregnancy.

Decrease in fertility

Ovulation becomes irregular during perimenopause, which decreases your chances of becoming pregnant. You can still become pregnant if you’re still having periods, however.

Learn more about pregnancy during perimenopause »

Vaginal dryness

Your vagina may lose lubrication and elasticity because your estrogen levels are decreasing. This can make sex painful. It can also cause bleeding after sex.

Cholesterol changes and increased risk of heart disease

A loss of estrogen can cause an increase in LDL cholesterol, sometimes referred to as “bad” cholesterol. It can also lead to a decrease in HDL, or “good” cholesterol. This increases your risk of heart disease.

More women are giving birth at older ages. Since the mid-1970s, birth rates for a woman’s first child have increased six-foldTrusted Source for women ages 35-44, on average. Birth rates have also increased for women over 45. Additionally, birth rates in this age range have increased by 5 percent in 2015. At the same time, many women start to experience menopause symptoms between 45 and 55 years old. The average age for perimenopause is 51, and an estimated 6,000 women in the United States reach menopause every day.

If you’re still having menstrual periods, it’s possible to become pregnant.

If you think you may be pregnant, take an at-home pregnancy test. Confirm the results with your doctor to make sure you did not receive a false positive or negative. If you are not pregnant, you should make an appointment with your doctor to figure out what may be causing your symptoms. If it’s menopause, work with your doctor to develop a treatment plan for your symptoms. In some cases, you may be able to manage symptoms with lifestyle changes. If those don’t work, your doctor may recommend hormone therapy.

Shop for at-home pregnancy tests.