Perimenopause or menopause? What’s the difference and how do you know if you’re in it?

Perimenopause or menopause? What’s the difference and how do you know if you’re in it?

There’s a lot of confusion around perimenopause. Often people hit it and they don’t even know what it is.

What is menopause?

Menopause, officially, is the end of your last ever period – so it’s one day in time. But we use the word menopause to describe the whole transition to stopping our menstrual cycle, which is where it can get confusing.

So, what is perimenopause?

Perimenopause is the phase leading up to that last period where your hormones fluctuate and you experience menopausal symptoms. It’s often hard to know for sure that you’re in perimenopause, especially early on, because many of the symptoms are a bit vague, such as headaches, joint pain, low energy, and brain fog. It’s common for this perimenopause phase to last a few years.

Is there a blood test for perimenopause?

Unfortunately, no. In perimenopause, your hormones fluctuate drastically, so taking a measure of your hormones is not very reliable. While some doctors might send you for a blood test, and this can be useful to rule out other potential causes of symptoms, the blood test won’t be able to confirm or rule out perimenopause.

Then how do you know if you’re in perimenopause?

Given that the symptoms can be vague, and that every women’s experience is different, it can be hard to know. Identifying perimenopause is really drawing together the data you have – your age and your symptoms – as well as ruling out other potential causes of your symptoms.

When will I go through perimenopause?

Most commonly in your 40’s and 50’s. The average age to reach menopause (remember, that’s your last ever menstrual cycle) is 51, with anything between 45 and 55 considered normal. Perimenopause can start several years before then, so if you’re in your 40’s, 50’s or even late 30’s and noticing menopausal symptoms, it may well be the cause. If you’ve had surgery to remove your ovaries or are undergoing chemotherapy or radiation, these medical interventions can kick start menopause regardless of your age.

What are the symptoms?

Many women expect hot flushes and changes to their menstrual cycle. These are common symptoms, but around 20% of women won’t get hot flushes, and other symptoms can come on sooner than change to your menstrual cycle, so look out for other symptoms too.

Here’s a list of symptoms to look for. Estrogen is used by cells throughout the entire body, and as a result the symptoms come in all different areas. You may experience very few or many of these symptoms.

Physical symptoms

  • Heart Palpitations
  • Breathing difficulties or shortness of breath
  • Dizziness or feeling faint
  • Hot flushes
  • Sweating at night
  • Muscle and joint pains, stiffness in joints
  • Breast tenderness
  • Headaches or migraines
  • Tinnitus
  • Disrupted sleep patterns and poor sleep
  • Feeling tired or lethargic, low in energy
  • Weight gain
  • Digestive symptoms, such as bloating, constipation or indigestion
  • Changes in menstrual periods, e.g. less regular menstrual cycle, heavier periods
  • Needing to urinate more often, or having leaks of urine
  • Recurrent urinary tract infections (UTIs)
  • Vaginal dryness or soreness
  • Discomfort during sex
  • Dry or itchy skin, sensation of crawling under the skin
  • Oily skin or adult acne
  • Dry mouth and eyes
  • Sore gums
  • Thinning hair
  • Increase in facial hair

Psychological symptoms

  • Anxiety, feeling tense or nervous
  • Attacks of physical anxiety or panic
  • Low mood
  • Irritability/ anger
  • Mood swings
  • Memory problems
  • Difficulty concentrating
  • Brain fog
  • Fatigue
  • Low motivation
  • Loss of interest in most things
  • Loss of confidence
  • Reduced self-esteem or loss of sense of self
  • Loss of interest in sex or low arousal

I know that list of symptoms can feel daunting, but remember you won’t have all of those symptoms! And there are lots of things which can help you manage your symptoms and stop them getting in the way of important things in your life.

HRT can make a big difference for many women. Lifestyle behaviours like diet, exercise, and hydration can help a lot. And noticing how many psychological symptoms there are, psychological approaches also play an important role. If you’re interested in managing emotional symptoms like anxiety, irritability, and low mood, check out my course on overcoming anxiety and difficult emotions in menopause.