Perimenopause vs. Menopause: How to Tell the Difference

If you're in your 40s or 50s, you may be asking yourself this question: Am I in perimenopause, or have I reached menopause? While the two are closely related, they're not the same thing.

This month, Dr. Houmam Al-Hakeem and our team of gynecology specialists at Westover Hills Women's Health explain more about perimenopause, menopause, and how to tell the difference between the two.

What is perimenopause?

Fun fact: 2 million women enter perimenopause each year. 

Perimenopause is the transitional phase leading up to menopause. In fact, “peri-” means “around” or “near.” During this time, your ovaries gradually produce less and less estrogen, which causes your hormone levels to fluctuate.

These hormonal ups and downs can start years before menopause officially occurs. In fact, many women begin noticing symptoms in their 40s, though some experience changes even earlier.

Perimenopause can affect each woman differently, but common symptoms include:

• Irregular or even heavy periods
• Hot flashes
• Night sweats
• Mood swings
• Brain fog
• Trouble sleeping
• Vaginal dryness
• Changes in your libido
• Weight gain

Some months your symptoms may seem mild, while other months they can feel impossible to ignore. About 20% of women experience symptoms that severely impact their quality of life.

How to tell if you’re in perimenopause

Here’s the easiest way to tell if you’re in perimenopause: If you're still having periods, even irregular ones, you're likely in perimenopause.

What is menopause?

You’re officially in menopause when you've gone 12 consecutive months without a period. Most women reach this milestone between the ages of 45 and 56.

At this point, your ovaries have significantly reduced hormone production, and ovulation has stopped. 

How to tell if you’re in menopause

If you've gone 12 months in a row without a period, you're likely in menopause, not perimenopause. We may also order blood tests to check your hormone levels and rule out other causes of your symptoms. 

Why it's easy to confuse the two

Many of the symptoms associated with menopause actually begin during perimenopause. In fact, they can start 4-7 years before you finally reach menopause.

That's because fluctuating estrogen levels can trigger symptoms long before your periods stop completely. Hot flashes, mood changes, sleep disturbances, and vaginal dryness can all occur during both stages.

In many cases, the biggest difference comes down to whether you're still having menstrual cycles.

Can hormone testing tell you for sure?

Many women assume a blood test can definitively determine whether they're in perimenopause, but the reality is a bit more complicated.

Because hormone levels fluctuate dramatically during perimenopause, a single hormone test doesn't always provide a clear answer. Your symptoms, age, and menstrual history are often just as important as laboratory testing when determining where you are in the transition.

Plus, other conditions, like fibroids, can contribute to heavy periods. Regardless, we can determine what is causing your symptoms, whether that’s perimenopause, menopause, or other conditions like fibroids or polycystic ovarian syndrome (PCOS).

How we can help you manage your symptoms

With all this in mind, the bigger question often becomes: How can I manage these symptoms?

At Westover Hills Women's Health, we know there's no one-size-fits-all approach to perimenopause and menopause, and that regardless of which phase you’re in, we can help you get relief from bothersome symptoms.

During your appointment, we take the time to understand your symptoms, health history, and goals before creating a personalized plan. Depending on your needs, that may include menopause hormone therapy or guidance with lifestyle changes.

Are you ready to get answers?

Whether you're just starting to notice symptoms or you're well into menopause, our team is here to help.

Schedule an appointment with us at Westover Hills Women's Health at one of our four San Antonio, Texas, offices to learn more about your options and create a plan that helps you feel your best through every stage of life.

Prefer to chat? You can reach us by phone, too.