Difference Between Premenopause, Perimenopause, Menopause

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Premenopause, Perimenopause, Menopause: What Is The Difference?

A woman reaches menopause when she no longer menstruates and cannot conceive a child anymore. Simply, it marks the end of her reproductive age. Menopause is challenging, but the run-up to it is not easy either. From irregular periods, hot flashes, night sweats to irritability and mood swings, she experiences a lot. Experts say that the hormonal changes that occur around menopause may begin even seven to eight years before the actual menopause. As a result, the period can be divided into different stages, viz. premenopause, perimenopause, and menopause. Each stage brings with it its own set of symptoms and challenges, and knowing about them and preparing is crucial. Hence, to understand these stages in detail, Onlymyhealth spoke to Dr. Rashmi Varshney Gupta, Principal Consultant, Obstetrics & Gynaecology, Max Super Specialty Hospital, Dehradun.

What Are Premenopause, Perimenopause & Menopause?

Menopause marks the end of a woman's reproductive age

(Photo Credit: WomanLog)

Premenopause and perimenopause are often used interchangeably, said Dr. Gupta. However, technically, these are different, she added. 


During this phase, you experience no symptoms associated with perimenopause or menopause. You still have periods, whether regular or irregular. You can still get pregnant, the chance, however, may be slim. Some hormonal changes can occur, however, no major change shows on the body.


This phase is right before menopause. During perimenopause, you start experiencing symptoms of menopause.


Once you don’t menstruate for 12 months straight, it means you have reached menopause. Your reproductive age is over, you no longer have periods or get pregnant.

Symptoms During Premenopause, Perimenopause & Menopause

Menopause symptoms can be intense

(Photo Credit: Lifespan)

Some of the symptoms across these stages are the same, while others are different.

Premenopause Symptoms

During premenopause, a woman doesn’t experience the classic symptoms (hot flashes, night sweats, mood swings, etc.) associated with menopause. She still gets periods, whether regular or not. Hence, she is still in her reproductive age. Some hormonal changes, however, may start to occur.

Perimenopause Symptoms

Some of the symptoms of perimenopause are similar to menopause. Here is what you might experience:

  1. Irregular periods
  2. Periods heavier or lighter than normal
  3. Worse premenstrual syndrome (PMS) symptoms
  4. Breast tenderness
  5. Weight gain
  6. Heart palpitations
  7. Lack or loss of sex drive
  8. Headache
  9. Body ache
  10. Difficulty concentrating
  11. Forgetfulness
  12. Urinary tract infection (UTI)
  13. Also, a woman has difficulty conceiving

Menopause Symptoms

As estrogen level dips, you might experience some subtle, some not-so-subtle changes. You might experience some of the menopausal symptoms during perimenopause, too. The symptoms include:

  1. Hot flashes
  2. Night sweats
  3. Mood swings
  4. Depression
  5. Anxiety
  6. Irritability
  7. Fatigue
  8. Insomnia
  9. Dry skin
  10. Vaginal dryness
  11. Frequent urination

How To Manage Symptoms?

Since you experience no major symptoms during premenopause, you might need to manage them. However, this isn’t the case with perimenopause and menopause, during which you experience major bodily changes and symptoms. There are both home-based and medical options available to manage these.

Home-Based Ways To Manage Perimenopausal & Menopausal Symptoms

These require you to make lifestyle tweaks and embrace health in general. Here is what you need to do:

  • Diet: Have a balanced and nutritious diet consisting of lots of seasonal fruits and vegetables, whole grains, complex carbohydrates, healthy fats, and proteins.
  • Exercise: Dr. Gupta recommends weight-bearing exercises to be performed by perimenopausal women. Options include walking, hiking, and strength training.
  • Sleep Hygiene: Since several women experience sleep-related issues during perimenopause and menopause, taking care of sleep hygiene is crucial. Hence, follow the following:
  1. Go to bed and wake up at the same time every day, including weekends.
  2. Avoid screens while in bed.
  3. Avoid stimulants, like caffeine and alcohol, in the evening.
  4. Similarly, avoid heavy foods close to your bedtime.
  5. Follow a nighttime routine that helps you relax and doze off easily.
  • Stimulants: Limit intake of stimulants like alcohol and caffeine.
  • Stress Management: Since women experience stress, anxiety, irritability, and depression-like symptoms, stress management is crucial. You can do it by doing yoga, deep breathing exercises, and meditating.
  • Weight Management: Many perimenopausal women gain weight, especially around the abdomen. Maintaining a healthy weight is crucial for your overall health. At the same it, it can help with some of the perimenopausal and menopausal symptoms such as hot flashes and night sweats. It improves sleep and boosts energy levels.

Medical Ways To Manage Perimenopausal & Menopausal Symptoms

Hormone replacement therapy is one of the ways to manage menopause

(Photo Credit: Office on Women’s Health)

In case of intense symptoms, you must consult a doctor. The expert will recommend you treatment as per your symptoms and intensity. Here are some of the treatment options:

  • For treating bothersome symptoms like hot flashes and sleeplessness, treatment options are available. Hormone replacement therapy is one such option. Even a few months of hormone replacement therapy can help you relieve some of the extreme symptoms associated with menopause.
  • For those prone to anxiety and depression, you must know that perimenopause can bring all of them back to the surface. Hence, having a solid support network can help. In some cases, antidepressants may also be given. However, it is advisable to not take any drugs without the recommendation of your doctor.
  • Menstruation becomes irregular during these phases. Hence, maintaining a menstruation diary noting the duration, flow and gap can help you understand the situation better. It might also help you to communicate your situation with the doctor. 

Hence, as you saw, menopause brings with it several changes and experiences. The period preceding it is no easier either. So, what you need is to develop a healthy lifestyle. Osteoporosis and high cholesterol level are some of the ailments women get prone to during this time. Hence, taking care of overall health is crucial. In case the symptoms worsen, do not shy away from consulting the doctor. The doctor will prescribe you the treatment accordingly.

(With inputs from Dr. Rashmi Varshney Gupta, Principal Consultant, Obstetrics & Gynaecology, Max Super Specialty Hospital, Dehradun)

Photo Credit: Freepik

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