Perimenopause vs Menopause: What's the Difference?

The terms perimenopause and menopause are often used interchangeably, but they aren’t the same thing. Do you know the difference and what to expect?

The two are a natural stage of life for all women, but there are key differences between the two. Perimenopause is when your periods begin to become irregular and menopause is when your periods stop altogether.

We’re exploring exactly what you need to know about them both, the stages and what’s happening to your body.

What Is Perimenopause?

Perimenopause happens when your hormone levels start to change and takes place before your period stops completely. People often confuse the two and may say they have the menopause when it’s actually perimenopause.

Perimenopause usually happens for most people between the ages of 44 and 55, however, it can start earlier for some people.

It usually lasts for around four years on average, however, it all depends on the person, it could last anywhere from eight months to 10 years.

During the perimenopause, a number of things happen, including:

• Periods can become longer, shorter, heavier or lighter or you may even skip some cycles completely
• You may experience hot flushes or night sweats
• You may have difficulty falling or staying asleep
• You may experience weight gain, particularly around the stomach or upper body
• It may cause mood swings, brain fog and fatigue
• It can cause bladder issues

It can be helpful to understand what is happening to your body during perimenopause and why it is happening.

Perimenopause happens when your ovaries are aging and slowing down. It’s a natural midlife transition that happens to every woman. Whilst this is happening your levels of oestrogen and progesterone are going up and down more unpredictably than they were before.

Simply put, perimenopause is the transition period before periods stop completely.

What Is Menopause?

Menopause is defined as when you have gone 12 consecutive months without a period. As your ovaries stop releasing eggs, they also make fewer hormones like oestrogen, which is why the periods stop completely.

This often happens between the ages of 44 and 55, with the average age of women reaching menopause in the UK is 51.

During the menopause, you can often expect (though everyone is different):

• Periods stopping completely
• Hot flushes and night sweats
• Body changes such as a slower metabolism, hair thinning or dry skin
• Joint stiffness and muscle pain

A lot of the time, symptoms tend to gradually improve as you move from perimenopause to the menopause, but symptoms often can continue.

Menopause can be defined by the point where periods have stopped for 12 months.

Perimenopause vs Menopause: A Comparison 

It can help to look at the two in comparison, to understand what stage you are at, or what to expect.

What's Actually Happening to Your Body?

It can be useful to understand exactly what is happening to your body during these two important stages of life for women.

Your Hormones Are Changing

The main thing that’s happening during the perimenopause and menopause is that your oestrogen and progesterone levels are starting to decline. This is due to natural life transitions, where your ovaries age and stop releasing eggs and they become less responsive to brain signals.

Oestrogen and progesterone affect a lot more than your reproductive system, these hormones also affect:

• Your bones, brain and heart
• Your heart and circulation
• Your skin and metabolism
• Your brain and mood

Your Brain Feels the Effects

When you go through perimenopause and menopause your brain is feeling the effects of these changes. It can affect your brain in a number of ways including:

• Brain fog – as oestrogen and progesterone impacts brain energy and memory
• Difficulty concentrating – as lower oestrogen reduces brain cell energy and the changes in hormones affects serotonin and dopamine
• Anxiety or mood changes – can be affected by the fluctuations and drop of hormone levels, sleep disruption and added life stress

Your Sleep May Change

You’ll often find during perimenopause (which can continue into menopause) that your sleep schedule and quality of sleep may change. Common symptoms are night sweats, insomnia, waking during the night and  daytime fatigue.

This is because the drop in oestrogen and progesterone levels disrupt the bodies internal thermostat, brain chemistry and sleep-wake cycles. They typically make it harder to fall or stay asleep.

Your Body May Feel Different

Some of the most common symptoms that happen during the perimenopause and menopause stage includes hot flushes, weight changes, joint aches, hair thinning and dry skin.

Why Everyone's Experience Is Different 

When it comes to perimenopause and menopause, everyone will handle it differently and experience different symptoms, it's not the same for everyone so it's best to try and avoid comparing!

Some people may experience minor symptoms, whilst others can experience symptoms that significantly affect their daily life.

Genetics can play a role in the level of symptoms you experience and how they affect you. Genetic markers control your internal thermostat so can alter how often or the severity of your night sweats and hot flushes.

They also affect when you’re likely to hit menopause or perimenopause, for example, you usually hit it around the same age or within a year of when your mother did.

Lifestyle factors can also play a role in the effects of menopause, having a higher body mass index or smoking can trigger menopause early or result in more severe symptoms.

Stress can also be a factor in making menopause symptoms worse or more severe and even lead into menopause happening earlier.

What Can Help During Perimenopause and Menopause?

There are some small changes that can help make dealing with these symptoms a little bit easier to manage.

Healthy Nutrition

Focusing on and prioritising nutrition during perimenopause can help to manage the systems.

In particular, ensuring you consume enough calcium can help to protect your bone health. Having enough vitamin D can also help with low moods and anxiety. Vitamin D will also support metabolism and bones.

Staying hydrated is really important during menopause symptoms as it helps to regulate your body temperature, which can reduce the severity of hot flushes, skin dryness and ease joints.

Regular Movement

Having regular movement or exercise is a good way to support symptoms too. By walking, swimming or weight training you can help to boost your mood and ease hot flushes caused by menopause. Weight-bearing exercises can also help to combat rapid bone loss.

Exercise can also support with weight management, particularly as menopause can slow your metabolic rate down.

Prioritising Sleep

As perimenopause can affect your sleep, prioritising your sleep is essential in combating these symptoms.

You can do this by, having a consistent bedtime routine, it can help you to sleep by reading, reducing light before bed and doing somethings to wind down such as meditation.

Having a cool, comfortable room can help with night sweats, and overall a good night's sleep will help to reduce the feelings of fatigue throughout the days.

Perimenopause and menopause are different stages of the same journey. Perimenopause is a longer stage and mainly where the symptoms begin to show and menopause is the moment your period or menstrual cycle stops for good.

Understanding what's happening to your body, and understanding everyone reacts differently can help to make symptoms feel less overwhelming and allow you to be kinder to yourself when going through these stages.

Support, lifestyle changes and medical advice can all help to navigate through the transition with ease and confidence.