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Perimenopause and Menopause - What's the difference?

Updated: Sep 4, 2020

Menopause, while most women know about this significant life stage, they often aren't aware of the transitional phase, known as perimenopause, that starts in the 40’s and ends with menopause, normally reached when a woman hasn't had a period for 12 consecutive months. While perimenopause and menopause are both part of the same overall transition, their differences in terms of symptoms and treatment options are crucial for women to understand, in order for them to make the transition as easy as possible, allowing them to thrive and not just survive.

What is Perimenopause?

This is the phase during which your body makes the natural transition into menopause. It’s widely recognised as the most noticeable stage in the menopausal process, yet the majority of women don’t recognize or understand the symptoms associated with it. Perimenopause is different for all women, but normally starts anywhere from the early to late forties, and can last for up to 10 years, in the lead up to menopause. For those unaware of the perimenopause phase, it can be an overwhelming, painful and emotional time, dealing with sudden hormone fluctuations. During this unpredictable phase symptoms of menopause may be experienced (such as, changes to periods, hot flashes, sleep disturbances, and mood swings). It is important to note that the experience of perimenopause will be different for all women, ranging from mild to severe.

What is Menopause?

Menopause is reached when a woman hasn’t menstruated for 12 consecutive months, and can no longer concieve naturally. The average age menopause normally occurs is around 51, however various factors including genetic, lifestyle, history of hysterectomy and cancer treatments can effect a woman's ovary health, and potentially lead to early onset menopause. Menopause can last anywhere from a few months to several years, with some women bypassing perimenopause altogether, entering menopause suddenly. Around 1% of women will begin menopause before the age of 40, which is called premature menopause or primary ovarian insufficiency. Additionally, around 5% of women will undergo menopause between the ages of 40 and 45, being referred to as early menopause. For a lot of women, menopausal symptoms can make functioning normally in daily life extremely difficult, robbing them of their vitality.

Hormonal Changes

Perimenopause is marked by a sharp dip in estrogen, the main female sex hormone produced by the ovaries. Estrogen levels start to sporadically fluctuate, causing irregular periods and disrupting normal patterns of estrogen and progesterone production. During the final phases of perimenopause, minimal estrogen is produced. During this time it is important to note that despite lower estrogen levels, it is still possible for women to conceive. Menopause is officially reached when levels of estrogen produced by the ovaries is so low that eggs are no longer released, causing periods to stop. Menopause is formally diagnosed once menstrual cycles have stopped for a full year.

Perimenopausal and Menopausal Symptoms

Apart from changes to menstruation, perimenopausal and menopausal symptoms are generally the same. Reductions in estrogen levels during this transition can negatively impact on women's metabolism, which is why during this period women often experience weight-gain. Additionally, during this transitional phase women's cholesterol levels can increase, being a major reason why postmenopausal women may have a higher risk of heart disease. Ensuring cholesterol levels are checked on an annual basis, should be included in all women's annual health check-ups.

Perimenopausal Symptoms:

  • irregular periods

  • heavier or lighter than normal periods

  • increased PMS before periods

  • vasomotor symptoms: hot flashes, night sweats, flushing

  • weight gain

  • breast tenderness

  • lack of sex drive

  • headaches

  • muscle aches

  • memory fog

  • hair changes

  • urinary tract infections

Menopausal Symptoms:

Declining estrogen levels can increase symptoms of menopause, with some occuring during the perimenopausal phase. Symptoms are normally more severe during this phase, particularly if menopause occurs suddenly or over a shorter period of time.

  • vaginal dryness

  • insomnia

  • vasomotor symptoms: hot flashes, night sweats, flushing

  • weight gain

  • anxiety

  • depression

  • irritability

  • loss of sex drive

  • mood swings

  • fatigue

  • dry skin, mouth and eyes

  • frequent urination

  • increased heart rate

  • breast tenderness

  • painful joints

  • reduction in bone mass

  • reduced muscle mass

  • hair loss or thinning

  • facial, neck, chest, and upper back hair growth

  • headaches

  • difficulty concentrating

  • memory problems

Seeking Advice and Support

For some women the transition from perimenopause to menopause will be an easy one, potentially needing no support, but for the majority of women, seeking professional advice can help support their physical, mental and emotional wellbeing during this transitional period. If you are experiencing symptoms severe enough to impact on your daily life, or have concerns about abnormal symptoms, I encourage you to seek professional healthcare advice about ways best to support you.

Natural Perimenopausal and Menopausal Supports

There are numerous things you can do to naturally support your hormones, to help minimise symptoms and increase vitality.


Evidence shows that during this transition there are certain foods that may help relieve some of the symptoms caused by menopause, including hot flashes, poor sleep and low bone density. It is critical that your body gets the right nutrients it needs in order to support hormone production. Consuming foods high in whole grains, quality protein, healthy fats, calcium, fruits and vegetables, will provide your body with the nutritents it needs to support optimal hormone production. Avoid or limit alcohol, caffeine (morning only), added sugars refined carbohydrates, high-salt foods, and spicy foods.


Making sleep a top priority should be a given, but it is even more important during perimenopause, in order to support optimal hormone balance. Having a great sleep hygeine routine is a must - have a consistent sleep/wake schedule, going to bed and waking at the same time; reduce technology use at least 1-2 hours before bed; make sure your bed is supportive and comfortable and that your room is kept dark while you sleep.


Keeping active throughout all life stages is a must, and it is no different during the perimenopausal and menopausal phase. During this time hormonal issues can make it difficult to stay fit, which is why I recommend light daily exercise such as walking, swimming, pilates or yoga, as a safe way to support hormone health. Remember that consistency is key, so make time each day to do at least 30mins of exercise, paying attention to what your body can handle.

What Next

Perimenopause and menopause mark an important transitional phase in a woman's life, indicating the end of the reproductive years. Understanding what's going on with your body during this time will make health and lifestyle adjustments easier, and can be a great opportunity to take stock of your life, looking at what changes can be made to support your health, as well as acknowledging what no longer serves you, to ensure that you are your most vital self.

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