Perimenopause vs. Menopause

Learning How to Identify the Difference

As women grow older, their bodies go through natural changes. Two important stages are called perimenopause and menopause. These stages happen to all women and are a normal part of aging. Learning the difference can help women understand what is happening in their bodies. Research shows that hormone changes are the main reason for symptoms during this time.^1-2

What Is Perimenopause?

Perimenopause is the time before menopause. It is a transition phase when the body slowly moves toward menopause. During perimenopause, hormones such as estrogen change a lot. These changes can cause many physical and emotional symptoms.¹

Perimenopause usually begins in the mid-30s to 40s and can last for several years. During this time, many women notice weight gain, mood changes, hot flashes, vaginal dryness, and trouble sleeping. Menstrual periods may also become irregular, heavier, or lighter than before. These symptoms happen because hormone levels are not steady.^1-2 

When Does Menopause Officially Begin?

Menopause officially begins when a woman has not had a menstrual period for 12 months in a row. Doctors use this rule to confirm that menopause has occurred.¹

What Is Menopause?

Menopause is a single point in time, not a long stage like perimenopause. After menopause, the ovaries stop releasing eggs, and hormone levels become lower and more stable. Fertility ends at this stage.^1-2

Menopause usually happens between the mid-40s and early 50s, with most women reaching it around age 51. After menopause, women move into postmenopause, which lasts for the rest of life. 

Symptoms During Postmenopause

Once menopause has been reached, postmenopause is the phase that a woman will remain in immediately following this point. Some symptoms from perimenopause may decrease or stop during postmenopause. However, some women may still have hot flashes. 

Estrogen levels stay low during this phase as well. Lower estrogen can affect bone strength, heart health, and vaginal health. In addition, low estrogen levels contribute to a maintained insulin resistance. This may result in weight gain, changes in metabolism, and greater risk for disease. Healthcare providers may suggest healthy habits or treatments to help manage these changes.^1-2

Understanding the Difference

Perimenopause happens before menopause and is marked by frequent hormone changes and irregular periods. Menopause happens after 12 months without a menstrual period, when hormones stay low and steady, periods stop completely, and fertility ends.

Why This Information Matters

Understanding the difference between perimenopause and menopause can help women know what stage they are in, understand their symptoms, and talk with their healthcare provider. Both stages are normal and part of healthy aging.^1-2 

References

1. 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. Menopause. 2012;19(4):387-395. doi:10.1097/gme.0b013e31824d8f40

2. Santoro N, Epperson CN, Mathews SB. Menopausal symptoms and their management. Endocrinology and Metabolism Clinics of North America. 2015;44(3):497-515. doi:10.1016/j.ecl.2015.05.001