What’s the difference between perimenopause and menopause?


What’s the difference between perimenopause and menopause?

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Menopause is often associated with a host of physical and emotional changes. But many people don’t realise that the journey to menopause is typically preceded by a transitional phase, known as perimenopause. The differences between these two life phases are distinct, but not always well understood. So what are the key physical and emotional differences experienced during perimenopause and menopause?

Perimenopause – the precursor to menopause

Perimenopause is often referred to as the menopausal transition period, and this phase marks the time leading up to menopause. Women typically become perimenopausal several years before they go through menopause itself – while the average age for menopause is around 51, perimenopause can begin as early as the late 30s or early 40s for some, though its onset can vary broadly.

What are the key characteristics of perimenopause?

Fluctuating hormonal levels – During the perimenopausal period, the body undergoes fluctuations in hormone levels, particularly oestrogen and progesterone. These hormonal shifts can result in patchy, irregular menstrual cycles along with a host of physical and emotional symptoms.

Menstrual changes – One of the main indicators that perimenopause is occurring is the appearance of irregular periods. Women may notice that their menstrual cycle becomes shorter or longer, while their flow may be sparser or heavier. Some women may even skip periods altogether, while others will have more frequent ones.

Hot flushes and night sweats – These are the most common symptoms of perimenopause and they can be deeply uncomfortable to experience. Hot flushes are characterised by sudden feelings of intense heat and are often accompanied by sweating, while night sweats are hot flushes that happen during sleep, leading to disrupted rest.

Vaginal changes – Declining oestrogen levels can create vaginal dryness, itching, and discomfort. This can affect sexual health and satisfaction as it can lead to pain or serious discomfort during intercourse.

Mood swings – The hormonal fluctuations during perimenopause can be severe and dramatic and experiencing these peaks and troughs can lead to mood swings and irritability, as well as heightened emotional sensitivity.

Sleep disturbances – During the perimenopause, many women experience sleep problems and have difficulty falling or staying asleep. This sleep disruption can have a serious impact on quality of life, contributing to fatigue and impacting day to day existence.

Libido changes – Hormonal changes can also influence sexual desire as well as levels of satisfaction, leading to a drastic drop in libido for some women.

Other physical symptoms – When they enter the perimenopausal period, it can be fairly common for women to experience additional physical symptoms, such as breast tenderness, weight gain, and hair thinning or receding.

Menopause – the end of the fertile years

Menopause is a natural biological event that marks the end of the reproductive part of a woman’s life and this period of time brings about some major changes. Technically, it’s defined as the point in time when a woman has not had a menstrual period for 12 consecutive months, as once a woman reaches menopause, her ovaries stop releasing eggs and she is no longer able to conceive naturally.

What are the key characteristics of menopause?

Total cessation of menstruation – The main hallmark of the menopause is the complete absence of menstrual periods for one full year. After this point, women are considered postmenopausal, so the menopausal phase itself is not that long in duration – and typically shorter than the perimenopausal phase.

Stable hormone levels – After menopause, hormone levels, particularly oestrogen, stabilise out, as the wild fluctuations and irregularities of perimenopause make way for a more consistent hormonal environment.

Reduction of perimenopausal symptoms – Many of the most common symptoms experienced during perimenopause, like hot flashes and irregular periods, tend to decrease or disappear after reaching menopause.

Ongoing vaginal changes – While some vaginal symptoms may improve once the menopausal transition is complete, vaginal dryness and discomfort can persist, or even worsen and may require treatment. 

Bone and heart health – After menopause, the chances of bone density decreasing and cardiovascular disease developing are both raised, due to declining levels of calcium, vitamin D and oestrogen. As a result, women need to take steps to maintain their bone density and safeguard their heart health, as the risk of osteoporosis and heart disease increases.

7 tips to navigate the perimenopause and menopause phases

Though perimenopause and menopause are natural phases of a woman’s life, but these phases both come with multiple challenges. There are some strategies which can be employed to help manage symptoms and decrease their severity, while boosting physical and mental wellbeing.

1. Stay informed – Becoming aware of the changes that happen during perimenopause and menopause is the first step to being able to address symptoms. Understanding the physical and emotional changes helps women manage them more effectively, so getting the proper information and advice is paramount.

2. Seek support – Women need the right amount of support as they journey through perimenopause and menopause, so it’s vital for them to speak to friends, family, or healthcare professionals about what they’re going through. Sharing experiences and seeking out support helps to boost wellbeing, making the journey more manageable.

3. Make self-care a priority – During perimenopause and menopause self-care should become a priority, with regular exercise, a healthy diet, and sufficient rest all helping to ease some of the physical and mental symptoms that are associated with this transition.

4. Consider hormone replacement therapy – For some women, hormone replacement therapy (HRT) can be a good option, as it can help control and lessen symptoms like hot flashes and vaginal discomfort. HRT doesn’t come without risks though, so it’s important to consult with a qualified healthcare provider first to discuss the potential benefits and downsides.

5. Maintain heart and bone health – The period following menopause is the time it’s most important to concentrate on safeguarding good heart health and maintaining bone density. Embracing a healthy lifestyle that includes regular exercise and a balanced diet, along with avoiding smoking and decreasing alcohol intake can help lessen the risks associated with these two aspects of postmenopausal health.

6. Embrace the transition – While menopause ushers in some dramatic changes, it’s also a completely natural phase of life. Though it may bring about shifts, it can also be a liberating time, free from the challenges of menstruation and pregnancy and it’s important for women to navigate all the opportunities that this new phase offers them.

Those who experience severe or persistent symptoms that interfere with their quality of life shouldn’t suffer in silence. Consult your GP or a healthcare professional, who will be able to outline support and your treatment options.

If you’d like support with your menopause symptoms, you can book an online consultation with one of our menopause specialists. Click below to learn more: