Hormone health resources
What is perimenopause – and how does it differ from menopause?
An explanation of what perimenopause is, including when it may happen and symptoms you might experience
Think you might be perimenopausal and looking for a simple explanation of perimenopause?
Here’s what you need to know.
What is the difference between perimenopause and menopause?
The usual definition of menopause is a year after a woman’s last menstrual period. However, it’s not this simple for many women, including those who no longer have periods as they have had a hysterectomy, have a Mirena coil or are using some types of contraception where they do not have a monthly bleed.
Menopause is related to a decline of the hormones oestrogen, progesterone and testosterone, which are produced in the ovaries and also other organs and tissues, including the brain.
Perimenopause is when you first start experiencing symptoms right up to the ‘menopause’ point in time. During perimenopause, levels of oestrogen and progesterone can fluctuate hugely on a daily, even hourly basis. Perimenopause can vary in length from a few months to around a decade. Symptoms of perimenopause and menopause are the same.
At what age is perimenopause likely to happen?
The average age of menopause is 51, so as a rule, the perimenopause tends to begin in your early to mid-40s. However, it can happen later or earlier for reasons including genetics or due to surgery or medical treatment.
What sort of symptoms can I expect?
Symptoms are commonly felt before actual menopause occurs and some women find that they have more severe symptoms during perimenopause.
Your menstrual cycle will usually be affected and changing periods are often an early sign of perimenopause. Fluctuating oestrogen levels mean your ovaries may not release an egg as regularly as they used to. You may ovulate one month, but not the next, and the quality of eggs also declines as you get older.
In addition to changing periods, if you have experienced premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD) in the past, you may notice these symptoms become more severe.
Other symptoms you may experience in perimenopause include:
- Mood-related symptoms
- Hot flushes and night sweats
- Fatigue and insomnia
- Poor mental focus and concentration
- Headaches, including more frequent migraines
- Joint and muscle pains
- Reduced sex drive
- Vaginal dryness
- Urinary and bladder problems, including urinary tract infections (UTIs).
Some women don’t realise their symptoms are due to perimenopause – they may put them down to stress or being busy. It’s important to remember that everyone’s perimenopause is different: you may have no symptoms at all, or you may experience a range of symptoms.
How can I manage my perimenopause?
Taking a holistic approach to managing your perimenopause is key, which includes eating a balanced diet and getting plenty of exercise, reducing stress where possible and prioritising sleep. Hormone replacement therapy (HRT) is usually the first-line treatment for the management of perimenopause and menopause symptoms [1].
To discuss ways to manage your perimenopause, you can book an appointment to speak to a Newson Clinic clinician here.
References
- National Institute for Health and Care Excellence (NICE) (2024) ‘Menopause: identification and management’