Difference between perimenopause and menopause

Reviewed by our clinical team

For most women in the UK, the menopause occurs around the age of 51. Before this happens, however, you’ll go through a phase where you have menopausal symptoms but still have periods This is known medically as perimenopause.

What does perimenopause mean?

Perimenopause means “around menopause”. It refers to the transitional time during which your hormone levels change, but before you stop having periods. Until your periods stop completely, any menopausal symptoms you experience can be described as perimenopausal.

You’ll have reached the menopause when you haven’t had a period for 12 months.  

When does perimenopause start?

On average, women have perimenopausal symptoms for about four years before they stop menstruating – however for some, this period may be much shorter or much longer.

The average age for the menopause in the UK is 51, so many women will start to experience perimenopausal symptoms around the age of 47. 

What are the symptoms of perimenopause?

A change to your periods 

One of the key symptoms of perimenopause is a change to your periods. You might have irregular periods or spotting between periods. You might also have periods that are heavier and longer, or shorter and lighter. Sometimes you might miss a period altogether.

When it comes to the perimenopause, all of this is normal. However, it’s worth noting that there can be other things that affect your menstrual cycle, so it’s worth speaking to your GP if you notice a change to your periods – particular if you’re having very heavy bleeding. 

As an example, a missed period can be a sign of pregnancy, which is possible even if you’re going through the perimenopause. 

Hot flushes and night sweats

Hot flushes are the characteristic symptom of the menopause, and you can start getting them months or years before your periods stop. They feel like sudden, intense bursts of heat throughout your body and can last for a few minutes before passing. You might also have palpitations and become red in the face and very sweaty.

When they occur at night, hot flushes can cause night sweats. You might sweat so much that you soak through your pyjamas or bedding. A result of this is that lots of women going through perimenopause have trouble sleeping.

Vaginal dryness

A fall in oestrogen levels can make the vagina drier and more sensitive. This in turn may make it harder to have sex without it being uncomfortable or even painful.

Other symptoms

Aside from those listed above, there are many other symptoms that can occur during the perimenopause, including:

• Mood changes 
• Anxiety and low mood 
• Headaches and migraines 
• Trouble with concentration and memory 
• Joint pain 
• Weight gain

How long do perimenopausal symptoms last?

Most women will have these kinds of symptoms for about four years before their periods come to end. Unfortunately, the symptoms won’t stop overnight once you’ve finished having periods. 

The NHS advises that most women will continue to have symptoms for around four years after their periods stop – although some may have them for even longer. In other words, it’s not unusual to have these kinds of symptoms for eight to 10 years in total.

What treatments are there for perimenopause symptoms?

If you think you’re experiencing perimenopausal symptoms, and if they’re getting in the way of your daily life, it’s a good idea to speak to a doctor.

If you’re having symptoms before the age of 45, you might need a blood test to check your hormone levels – otherwise, a diagnosis of perimenopause or menopause can be reached by discussing your symptoms.

The main prescription treatment for symptoms like hot flushes, mood changes and vaginal dryness is HRT (hormone replacement therapy). There are lots of different types of HRT – some, for instance, are designed just to treat vaginal symptoms – so there may be a type that’s right for you.

Other prescription treatments including antidepressants, which can help with mood changes as well as some of the physical symptoms. 

Medication aside, there are some lifestyle changes you can make which may help with some of your symptoms:

• Get more active – exercise can help combat weight gain, reduce the risk of osteoporosis, and boost your mood 
• Eat a healthier diet to ensure you’re a healthy weight and properly nourished 
• Manage hot flushes by cutting out or reducing triggers like spicy food, caffeine and alcohol and by sleeping in a cooler bedroom 
• Use vaginal moisturisers and lubricants

References

https://www.mayoclinic.org/diseases-conditions/perimenopause/symptoms-causes/syc-20354666
https://patient.info/news-and-features/are-you-going-through-perimenopause
https://www.nhs.uk/conditions/stopped-or-missed-periods/
https://www.nhs.uk/conditions/night-sweats/
https://www.nhs.uk/conditions/menopause/
https://www.nhs.uk/conditions/menopause/treatment/