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Perimenopause vs. Menopause

Menopause, the time in a women’s life when she no longer has a period, doesn’t happen overnight. The changes leading to menopause happen gradually. Prior to menopause, some women in their 40s may experience irregular periods for months, get hot flashes and have trouble sleeping. This menopause transitional phase, called perimenopause (“around menopause”), takes place as estrogen levels shift and fluctuate in the months or years leading up to menopause. Although perimenopause is a normal part of aging, some women don’t experience the symptoms and move straight into menopause.

The Difference Between Perimenopause and Menopause

Perimenopause and menopause are both part of the same overall transition and indicate an end to women’s reproductive years.

Menopause officially occurs after a woman goes 12 consecutive months without a menstrual period. At this time in a women’s life, the ovaries stop making estrogen and other sex hormones. This causes the menses, or period, to stop. Once a woman goes through menopause, pregnancy will not be possible without assistance. The two stages of menopause are perimenopause and post menopause, while menopause is actually the point at which a woman moves from one stage to the next.

The months or years leading to menopause are called perimenopause. This transition often begins between the ages of 45 and 55. The average duration is three to four years but can last up to 10 to 14 years.

Premenopause and perimenopause are terms sometimes used interchangeably. However, the medically accepted term used to refer to the time before menopause is perimenopause. During the menopausal transition, bones become less dense and fat cells change, making women more vulnerable to fractures and more prone to easily gaining weight.

After menopause, post menopause sets in around three to six years. Menopausal symptoms such as hot flashes can continue for several years. These symptoms usually resolve over time, but some changes can be long-lasting.

Because of the increased levels of cholesterol brought about by perimenopause and menopause, post-menopausal women are prone to heart disease and osteoporosis. It is important for women to eat a healthy diet and get lots of calcium to keep their bones strong.

Symptoms of Perimenopause

The following symptoms may become more noticeable as menopause approaches:

  • Hot flashes and night sweats
  • Longer or shorter menstrual cycle
  • Missing periods
  • Heavier or lighter periods
  • Sleep disturbances
  • Moodiness and irritability
  • Depression and anxiety
  • Vaginal dryness leading to pain during sex
  • Uterine bleeding problems
  • Short-term memory problems
  • Loss of concentration
  • Increased cholesterol levels that can lead to heart disease

Managing Perimenopause and Menopause Symptoms

There are several treatments available today to treat both perimenopausal and menopausal symptoms, such as prescription and over-the-counter (OTC) medicines, complementary therapies and home remedies, including the following:

  1. Hot flashes and night sweats are called vasomotor symptoms and occur when hormonal changes affect the circulatory system. Some ways to manage possible triggers of vasomotor symptoms include avoiding warm temperatures, spicy foods and hot beverages. Studies also show that a low dose of estrogen, either as a pill or patch, is the most effective treatment for severe hot flashes and night sweats.
  2. Taking oral birth control pills in small amounts can help manage irregular periods, heavy bleeding and cramping. Oral contraceptives may be taken until menopause.
  3. Vaginal estrogen in cream, ring, tablet or gel form and vaginal moisturizers can help relieve vaginal dryness as well as pain from intercourse.

Perimenopause and menopause may herald unwelcome changes, but it is important to remember that not all aspects of these transitional phases are negative. You may seek advice from a healthcare professional for supplements, dietary measures and lifestyle choices to help you get through these stages more comfortably. We’re here for you.

National Institutes of Health
Harvard Health Publishing
Medical News Today