Perimenopause Symptoms vs. Menopause Symptoms

Perimenopause Symptoms vs. Menopause Symptoms

One question we often hear is, “What are perimenopause symptoms, and how are they different from menopause symptoms?” This can be a very annoying question for many women looking for signs of perimenopause. Well, the answer is that it depends on a matter of 12 months.

Starting in your 30s or 40s, you will produce less of the hormones estrogen, progesterone, and testosterone. This stage is called perimenopause. Eventually, with the continued drop of these hormones’ levels, your menstrual periods will stop. Once a woman has had 12 consecutive months of no menstrual period – then you have completed menopause and are in postmenopause. 

The symptoms you’ll experience during perimenopause compared to menopause can be different, but most women have the same menopausal symptoms throughout their menopause transition. This article will review the subtle differences between perimenopause and menopause and introduce you to Menopause Transition.

Menopause in the US

Every year in the US alone, 1.3 million women enter menopause, and yet so many women are still asking the most basic question, “When does menopause start?” Meanwhile, without a clear answer, a whole host of symptoms are often ignored by their families, healthcare providers, and even by themselves. When peri- and menopause symptoms hit it can feel like it did when we stumbled into puberty. There is no need to stumble, there are lots of answers and solutions.

What is the Menopause Transition?

The full transition that takes place with menopause is called the  ‘Menopause Transition’ (MT) and is spread out for some 20 years or more. MT includes the phases of perimenopause (typically age 35-45), menopause (somewhere between 45-58), and postmenopause (the rest of your life).  MT is triggered by a decrease in hormones, estrogen, progesterone, and testosterone.

In the United States, women typically enter menopause between ages 45 and 58, with the average being 51, according to the North American Menopause Society (NAMS). In general, perimenopause is the lead-up to menopause that most women experience during their forties.

Perimenopause, menopause, and postmenopause are normal and natural stages. If you’re between the ages of 35-65, you are likely suffering symptoms related to the ongoing, steady decrease of the hormones associated with MT.  With hormone receptors all over our bodies, it is critical to keep hormones balanced. The MT is a spectrum, and the years before and after the end of your menstrual periods share many of the same symptoms.

What is Perimenopause?

With perimenopause, suddenly waking up at night in a sweat, or having heavy, irregular periods is a new normal.  Some women feel overwhelmed by hot flashes and exhausted by heavy periods, while others have no obvious perimenopause symptoms. The average duration of perimenopause is 5-7 years but can range from a few months to a decade. Even though periods are irregular and fertility is declining during perimenopause, conceiving a child is still possible.

The perimenopause phase shares many of the common menopause symptoms, including hot flashes, decreased libido, and forgetfulness, but often includes weight gain, vaginal dryness, joint pain, UTIs, and significant skin and hair changes. (1-4)

Perimenopause starts earlier than most people expect. About 10% of women go through perimenopause before they turn 40! If the drop in hormones that occur in perimenopause is not corrected, women are at a greater risk of heart attack, diabetes, colon & breast cancer, stroke, bone disease, dementia, and even suicide. (1)

Some scientists divide perimenopause into two stages.

  1. Early-stage perimenopause is when your menstrual cycle becomes erratic. For example, it is heavy and then very light, or your period comes a week or more later than usual.
  2. Late-stage perimenopause is that stage where you can have at least 60 days between some periods. Most commonly, this happens after several years in early perimenopause. This is when hormones are really in flux, and may trigger symptoms like hot flashes. (5)

Untreated perimenopause can serve up debilitating symptoms and serious side effects that can completely derail a woman’s life and cause serious problems in her relationships. The reality is that 80% of women in perimenopause have far-reaching symptoms – including brain fog, anxiety, weight gain, low libido, depression, sleeplessness, exhaustion, and stiff joints. (5,6). The good news is that they can achieve effective treatments for perimenopause available at Winona. Don’t suffer in silence.

“Until I met menopause and its dastardly little sister,  perimenopause, I thought I’d be fine and was told… Whatever you do, don’t take HRT.

I was so wrong.

My own journey, which was more a Thelma and Louise car crash as my hormones went off a cliff…  (was) midlife’s magnificent shitshow.” (7).

What is the Difference in Symptoms of Perimenopause & Menopause?

The MT symptoms you’ll experience during perimenopause compared to the later stages of MT can be different, but most women have the same menopausal symptoms throughout their transition. Here are the symptoms at each phase, but of course it varies from woman to woman.

Common perimenopause symptoms include : (6)

  • Changes in weight distribution
  • Skin and hair changes
  • Irregular periods (shorter, longer, or uneven gaps between them) and/or more intense premenstrual syndrome symptoms
  • Hot flashes, night sweats, and difficulty sleeping (insomnia)
  • Fatigue and mood changes including depression
  • Vaginal and bladder changes (vaginal dryness and incontinence)
  • Decreased interest in sex

Common menopause symptoms include all of the above and:

  • Weight gain
  • “Brain fog” or difficulty concentrating
  • Hair thinning or loss
  • Occasional racing heartbeat
  • Tingling or electric shock feelings
  • Unexplained joint and muscle aches
  • Painful sex

Regardless of if it is Perimenopause or Menopause

Refuse to “Endure It” or “Suck-It-Up.”  Why Should You? A big part of the problem is that family, friends and sadly our doctors just aren’t prepared to talk about peri- and menopause. Our moms rarely want to go into any details, likely because (like childbirth) they want to forget it.

Surveys of thousands of women in peri- and menopause show that the majority of women felt better about life after treating their menopause symptoms than they did 10 years ago. They experienced more hope, increased happiness with their bodies, newfound optimism about careers, and were excited about their family (8).

“The compounded estrogen, progesterone, and testosterone worked brilliantly…  Within four days, my hot flushes and palpitations disappeared forever, my memory returned, and – unexpectedly – my mood lifted and my joints became supple. Estrogen was the oil I needed in my engine. I just wish my GP had told me about bio-identical HRT in the first place.”  Katie Muir


Once we accept that peri- and menopause symptoms are treatable, we can move into a phase of life that is far more welcoming. Perimenopause symptoms are not very different from menopause symptoms, maybe a bit more subtle for some women.

Signs of perimenopause will also vary from woman to woman, but should not be ignored. If the drop in hormones that occur in perimenopause is not corrected, you can be at a greater risk of heart attack, diabetes, colon & breast cancer, stroke, and osteoporosis (bone disease).(1)

Safe, natural, bio-identical HRT is available to everyone with Winona if prescribed. Winona was created by peri – and menopausal women, for peri – and menopausal women – and their partners and families. A simple question, “Is it perimenopause or menopause?” can lead to so many answers. Reach out to our Winona physicians for your free consultation today at


Read Also: Why Is My Bladder Leaking and What Can I Do About It?

Perimenopause Symptoms vs. Menopause Symptoms

One thought on “Perimenopause Symptoms vs. Menopause Symptoms

  1. Great blog and thanks for sharing all this information. In this era of stress and tension, hectic lifestyle and wrong food choices affecting our health, this blog is very helpful and useful.

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