Is It Menopause Yet? Key Differences Between Perimenopause and Menopause

(Audio) Is It Menopause Yet?

0:00

For many women, the journey through hormonal changes can feel confusing, unpredictable, and even overwhelming. Terms like perimenopause and menopause are often used interchangeably, but they refer to distinct stages in a woman’s reproductive life. Understanding the difference can help you take charge of your health, manage symptoms, and feel more empowered during this natural transition.

What Is Perimenopause?

Perimenopause means "around menopause" and refers to the transitional phase leading up to menopause. It typically begins in a woman’s mid-to-late 40s, but it can start earlier. During this time, estrogen and progesterone levels fluctuate unevenly, causing irregular periods and a range of symptoms.

Common Signs of Perimenopause:

• Irregular menstrual cycles

• Hot flashes and night sweats

• Mood swings or irritability

• Sleep disturbances

• Breast tenderness

• Decreased libido

• Vaginal dryness

• Changes in hair and skin textures

• Heart palpitations

This stage can last from a few months to over 10 years, and while ovulation becomes less predictable, pregnancy is still possible.

What Is Menopause?

Menopause is officially diagnosed after a woman has gone 12 consecutive months without a menstrual period. This marks the end of reproductive fertility. The average age of menopause in the U.S. is around 51 years.

Common Symptoms After Menopause:

• Continued hot flashes or night sweats

• Vaginal dryness and discomfort

• Increased risk of osteoporosis and heart disease

• Memory and cognitive changes

• Changes in skin elasticity and hair thinning

Unlike perimenopause, hormone levels remain consistently low after menopause, and symptoms may either continue or ease over time.

Perimenopause vs. Menopause at a Glance

Feature	Perimenopause	Menopause
Timing	Starts in 40s (sometimes late 30s)	After 12 months without a period
Hormone Levels	Fluctuating	Consistently low
Fertility	Reduced, but possible	No longer fertile
Symptoms	Irregular periods, mood swings, hot flashes	Hot flashes, vaginal dryness, bone loss, no bleeding
Diagnosis	Based on symptoms & cycle history	Retrospective (after 12 months no period)

Why Knowing the Difference Matters

Identifying whether you're in perimenopause or menopause can help guide treatment options, from lifestyle changes and natural therapies to hormone replacement therapy (HRT). Many women find relief through:

• Nutritional support (e.g., dietary modifications and nutrient therapies)

• Herbal remedies

• Stress reduction techniques like yoga and meditation

• Individualized medical or naturopathic care

When to Talk to a Healthcare Provider

If you're experiencing symptoms that disrupt your life, like heavy bleeding, severe mood changes, or intense hot flashes, a healthcare provider can help determine where you are in the transition and offer tailored support.

Disclaimer: The information provided in this article is for informational and educational purposes only and is not intended as medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider before making changes to your diet, lifestyle, or health care regimen.

References

1. North American Menopause Society. The 2022 Hormone Therapy Position Statement of The North American Menopause Society. Menopause. 2022;29(7):767–794. doi:10.1097/GME.0000000000002028

2. Santoro N, Epperson CN, Mathews SB. Menopausal symptoms and their management. Endocrinol Metab Clin North Am. 2015;44(3):497–515. doi:10.1016/j.ecl.2015.05.001

3. Freeman EW. Associations of hormone levels and menopausal symptoms with perimenopausal depression. J Clin Endocrinol Metab. 2010;95(9):3895–3901. doi:10.1210/jc.2010-0341

4. Harlow SD, Gass M, Hall JE, et al. Executive summary of the Stages of Reproductive Aging Workshop +10: addressing the unfinished agenda of staging reproductive aging. Fertil Steril. 2012;97(4):843–851. doi:10.1016/j.fertnstert.2012.01.023

5. National Institutes of Health. Menopause: Questions for Your Doctor. Office on Women's Health. https://www.womenshealth.gov

©2025 by Nazanin Safaei, ND, MS