What are the differences between perimenopause and menopause?

Written in association with: Dr Mirka Slavska
Published:
Edited by: Conor Lynch

In this article below, distinguished consultant obstetrician and gynaecologist, Dr Mirka Slavska, provides us with a comprehensive overview of perimenopause, as she outlines the main differences between perimenopause and menopause, and reveals how long perimenopause generally lasts.

What are the symptoms of perimenopause?

Perimenopause is the transitional period that precedes menopause, marking the decline in reproductive hormones like oestrogen. It typically begins in a woman's 40s but can start earlier for some. Symptoms of perimenopause can vary widely among individuals, but common signs include:

 

  • Irregular menstrual cycles
  • Hot flashes and night sweats
  • Sleep disturbances
  • Mood swings
  • Vaginal changes
  • Changes in libido
  • Fatigue
  • Memory and concentration issues
  • Joint and muscle pain
  • Changes in hair and skin

 

How long does perimenopause typically last?

The duration of perimenopause varies from woman to woman, and it can last anywhere from a few months to several years. On average, perimenopause lasts for about four years, but again, this is just an average, and individual experiences can differ.

 

The onset of perimenopause often begins in a woman's 40s, but it can start earlier or later. Perimenopause concludes when a woman reaches menopause, which is defined as 12 consecutive months without a menstrual period. Menopause typically occurs around the age of 51, but it can happen earlier or later.

 

What are the differences between perimenopause and menopause?

Perimenopause and menopause are distinct phases in a woman's reproductive life, each characterised by specific hormonal and physical changes. Here are the key differences between perimenopause and menopause:

  • Perimenopause: This is the transitional phase leading up to menopause. It begins when a woman's ovaries gradually start producing less oestrogen, usually in her 40s, but it can start earlier. Perimenopause lasts until menopause.
  • Menopause: Menopause is officially declared when a woman has gone 12 consecutive months without a menstrual period. It typically occurs around the age of 51, but the age can vary.
  • Perimenopause: Irregular menstrual cycles are a hallmark of perimenopause. Periods may become irregular, with variations in flow and duration.
  • Menopause: Menstruation ceases during menopause, and a woman no longer has periods.
  • Perimenopause: Hormone levels, particularly oestrogen, fluctuate during perimenopause. Oestrogen levels may rise and fall unpredictably.
  • Menopause: Oestrogen levels remain consistently low during menopause, as ovarian function declines.
  • Perimenopause: Women may experience a range of symptoms, including hot flashes, night sweats, mood swings, sleep disturbances, and changes in libido. These symptoms are a result of hormonal fluctuations.
  • Menopause: While some symptoms may persist into menopause, they often stabilise as hormone levels become more constant. Vaginal dryness and changes in bone density may become more noticeable during menopause.
  • Perimenopause: On average, perimenopause lasts for about four years, but the duration can vary. It ends with the onset of menopause.
  • Menopause: Menopause is a point in time, marked by 12 consecutive months without a menstrual period.
  • Perimenopause: Fertility decreases during perimenopause due to irregular ovulation and hormonal changes, but pregnancy is still possible.
  • Menopause: Fertility is essentially lost during menopause, as the ovaries no longer release eggs.

 

What lifestyle changes can help manage perimenopause symptoms?

Managing perimenopause symptoms often involves a combination of lifestyle changes and, in some cases, medical interventions. Here are some lifestyle changes that may help alleviate perimenopause symptoms:

 

  • Regular exercise
  • Healthy diet
  • Hydration
  • Stress management
  • Adequate sleep
  • Limiting caffeine and alcohol
  • Smoking cessation
  • Weight management
  • Hormone therapy (HT)

 

When should someone seek medical help for perimenopausal symptoms?

Individual experiences of perimenopause can vary, and while some women may manage their symptoms effectively with lifestyle changes, others may find their symptoms more challenging to handle. It's advisable to seek medical help if you experience any of the following situations during perimenopause:

 

  • Heavy or prolonged menstrual bleeding lasting for more than three months
  • Concerns about fertility
  • Bone health concerns
  • Emotional well-being
  • Vaginal health issues
  • Concerns about hormone therapy

 

To book an appointment with Dr Mirka Slavska today, simply head on over to her Top Doctors profile.

By Dr Mirka Slavska
Obstetrics & gynaecology

Dr Mirka Slavska is an obstetrics and gynaecology consultant and a BMS-accredited menopause specialist, with over 15 years of experience, who aims to provide evidence-based holistic care. Her focus is on supporting, educating, and empowering women to understand treatment options for optimised health, quality of life, and happiness. Her areas of expertise include the menopause, the perimenopause, fibroids, menstrual disorders, heavy periods, and hormone replacement therapy (HRT).

Trained in Wales, Dr Slavska developed a passion for managing non-cancerous gynaecological problems and obtained an advanced certificate in the management of benign gynaecological conditions. She believes perimenopausal and postmenopausal health is of prime importance. Dr Slavska advises on complex perimenopausal and menopausal issues, and prescribes HRT, having accomplished an Advanced Menopause Specialist certification with the British Menopause Society. To support her clinical practice, Dr Slavska obtained an Ultrasound Assessment Proficiency Certificate from the Royal College of Obstetricians and Gynaecologists. To be able to provide well-rounded care for women, she also acquired a Diploma in Family Planning and Sexual Health.

Within Dr Slavska's NHS organisation, she holds the role of simulation education lead for Gynaecology. Co-founder of the GEMS (Gynaecological Emergencies Multidisciplinary Simulation) training, Dr Slavska is accredited by the Association for Simulation Practice in Healthcare and an author of MRCOG exam revision books, as well as a registered trainer for early pregnancy and benign gynaecological disease modules. Dr Slavska won the Welsh award for the Trainer of The Year in 2023.

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