Overview

Menopause officially marks the end of female reproduction. Although this life stage is well-known, there are actually different stages within menopause that are important to recognize and understand. Menopause itself officially occurs when you stop menstruating.

Perimenopause, on the other hand, is defined as “around menopause.” It’s also known as the menopause transitional phase, called such because it happens before menopause.

Although both part of the same overall life transition, perimenopause and menopause have differences in terms of symptoms and treatment options. Any abnormal symptoms or concerns should be discussed with your OB-GYN.

Premenopause vs. perimenopause

Premenopause is when you have no symptoms of going through perimenopause or menopause. You still have periods (whether they’re regular or irregular) and are considered to be in your reproductive years. Some hormonal changes may be occurring, but there are no noticeable changes in your body.

On the other hand, during perimenopause you will start to experience symptoms of menopause (for example, changes in period cycle, hot flashes, sleep disturbances, or mood swings).

Premenopause and perimenopause are sometimes used interchangeably, but technically they have different meanings.

Timelines for perimenopause and menopause

Perimenopause occurs well before you officially hit menopause. In fact, according to the Cleveland Clinic, women enter this stage 8 to 10 years ahead of menopause. This happens during your 30s or 40s.

Perimenopause is marked by a drop in estrogen, which is the main female hormone produced by the ovaries. The estrogen levels can also go up and down more sporadically than a normal 28-day cycle, which can cause irregular periods and other symptoms.

During the final stages of perimenopause, your body will produce less and less estrogen. Despite the sharp drop in estrogen, it’s still possible to get pregnant. This phase of menopause can last for as little as a few months and as long as four years.

Menopause officially kicks in when the ovaries produce so little estrogen that eggs are no longer released. This also causes your period to stop. The Cleveland Clinic says that your doctor will diagnose menopause once you’ve not had a period for a full year.

You may enter menopause earlier than normal if you:

  • have a family history of early menopause
  • are a smoker
  • have had a hysterectomy or oophorectomy
  • have undergone cancer treatments

Symptoms of perimenopause and menopause

When it comes to menopause, most people think about the symptoms more than anything else. These can include those infamous hot flashes, but there are many other changes you might experience during this transition.

Symptoms of perimenopause may include:

  • irregular periods
  • periods that are heavier or lighter than normal
  • worse PMS before periods
  • breast tenderness
  • weight gain
  • hair changes
  • increase in heartbeat
  • headaches
  • loss of sex drive
  • concentration difficulties
  • forgetfulness
  • muscle aches
  • urinary tract infections
  • fertility issues (in women who are trying to conceive)

As estrogen levels drop, you might start experiencing symptoms of menopause. Some of these can occur while you are still at the perimenopause stage. You might experience:

Perimenopause and menopause can also increase cholesterol levels. This is one reason why women in postmenopause are at an even higher risk for heart disease. Continue to have your cholesterol levels measured at least once a year.

When to call a doctor

You don’t necessarily have to call your doctor to obtain a perimenopause or menopause diagnosis, but there are instances when you should definitely see your OB-GYN. You might already be experiencing some early symptoms, but there are other signs that should be addressed with a doctor. Call right away if you have:

  • spotting after your period
  • blood clots during your period
  • bleeding after sex
  • periods that are much longer or much shorter than normal

Some possible explanations are hormonal imbalances or fibroids, both of which are treatable. However, you also want to rule out the possibility of cancer.

You should also call your doctor if the symptoms of either perimenopause or menopause become severe enough to interfere with your daily life.

Treatments for perimenopause and menopause

Your doctor can provide prescription relief for menopausal symptoms. Estrogen (hormone) therapy can help treat both perimenopause and menopause. These medications work by normalizing estrogen levels so sudden hormonal spikes and drops don’t cause uncomfortable symptoms. Some forms may even help reduce the risk of osteoporosis.

Estrogen therapy is readily available in many forms, including:

  • pills (oral route)
  • creams
  • gels
  • skin patches

Shop for over-the-counter estrogen therapy.

Other menopause medications are more targeted. For example, prescription vaginal creams can alleviate dryness as well as pain from intercourse. Antidepressants can help with mood swings. For migraines, gabapentin (Neurontin), a seizure medication, can be an option.

There are also methods you can use to alleviate your symptoms at home. Regular exercise can help improve your mood, weight gain issues, and even (ironically) your hot flashes. Make it a plan to get some form of physical activity in your daily routine. Just don’t work out before bedtime, as this can increase insomnia.

Getting enough rest can seem impossible if you’re dealing with insomnia. Try doing a relaxing activity right before bed, such as gentle yoga or a warm bath. Avoid daytime naps, as this can interfere with your ability to sleep at night.

Here are a few other methods you can try to relieve symptoms:

  • Avoid large meals.
  • Quit smoking.
  • Avoid alcohol.
  • Limit caffeine to small quantities (and only in the morning).

Learn more about the perimenopause diet.

Outlook

Both perimenopause and menopause are transitional phases that indicate an end to your reproductive years. There are certainly adjustments to be made, but remember that not all aspects are negative. With all of the treatments that are available, you can get through these stages more comfortably with a bit more freedom too.

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