Perimenopause vs Menopause: Understanding the Differences and How to Manage Both

Understanding the Differences and How to Manage Both (Menopause vs Perimenopause)

For many women, the menopause journey begins in their early 40s. The all-but-inevitable decline in estrogen gradually brings on those dreaded symptoms such as hot flashes, night sweats, and mood changes.

Menopause is a journey that is characterized by three different stages; perimenopause, menopause, and post-menopause. In a time where your physiology seems like it's freaking out, it's hard to know exactly where you are in the process.

In this article, we will discuss perimenopause versus menopause, covering the key differences, symptoms, hormonal changes, and management strategies to guide you through the process.

Defining Perimenopause and Menopause

First, let’s uncover what perimenopause and menopause actually are, and highlight the key differences.

What is Perimenopause?

Perimenopause is the early stages of menopause where you begin to experience the symptoms, but your menstrual cycle hasn’t stopped yet. This typically occurs between 40-44 years of age, however, some women may begin experiencing it earlier.

What is Menopause?

Menopause is when your period stops due to lower hormone levels. It begins when you have not had your menstrual cycle for 12 months. This can happen between 45-55 years of age, however, it too can vary from person to person.

Timeline and Stages

When it comes to perimenopause and menopause, timelines can be unclear. However, some approximate guidelines can help you determine whether you are entering menopause.

When Does Perimenopause Begin?

Perimenopause begins between 40 and 44 years of age. However, some women can experience it in their 30s or 50s. With an average duration of four to eight years, research indicates four to be the average.

Onset of Menopause

Menopause begins when you have not had your period for 12 months.

Post-Menopause Period

Postmenopausal bleeding is abnormal bleeding that can occur after 1 year of permanent cessation of your menstruation.

Hormonal Changes

As we enter perimenopause, our hormones begin to fluctuate and decline. This is when symptoms will arise. The key difference here is that during perimenopause our hormones fluctuate, however, once we reach menopause, hormones are 50% of their peak levels.

Common Symptoms of Perimenopause and Menopause

During perimenopause we will begin to experience the onset of irregular periods due to fluctuations in estrogen levels. When this happens, we can also experience symptoms such as hot flashes, night sweats, mood swings, and vaginal dryness. Below, we provide greater detail of the difference to inform you of the potential physiological changes.

Hot Flashes and Night Sweats

Hot flashes and night sweats effect up to 75% of women.  They occur due to decreased estrogen levels, which increases inflammation.

Hot flashes in particular are one of the primary reasons why many women seek care, as it can significantly impact quality of life and cause disruptions to sleep, work and other daily activities. These symptoms can last for 1-2 years after menopause, with some women experiencing them for up to 10 years or longer.

Mood Changes

Mood changes in part are the result of fluctuating estrogen levels. Estrogen increases the effects of feel good hormones,  which are closely linked to depression.

Sleep Problems

These hormonal changes may also affect sleep, as mood changes encompasses feelings of anxiety, stress and tension.

This can lead to cases of insomnia, which effects 40-50% of women during menopause.

Decreased Bone Density

As estrogen decreases, our bone turnover increases, resulting in an imbalance of bone resorption and bone formation. This leads to bone loss, which can result in osteoporosis, causing fractures, frailty, and impairing quality of life.

Increase of Chronic Disease

The fluctuation and decrease in estrogen can also lead to an increase in inflammation.

Estrogen has been shown to have an anti-inflammatory effect, and when our levels decline during menopause there can be an increased risk of chronic disease.

This includes conditions such as cardiovascular disease, tumors, type 2 diabetes, obesity and osteoporosis.

Management Strategies for Perimenopause and Menopause

Perimenopause and menopause have a serious impact on all facets of our health.

While these physiological changes can impair our quality of life, there are several strategies we can employ to reduce symptoms.

Diet and Nutrition

Making alterations and adjustments to your diet and nutrition is one of the easiest and most effective ways to reduce the symptoms of menopause and perimenopause. We have created an in-depth guide for you so you know what is the best menopause diet and what to avoid.

The decrease in estrogen takes its toll on your body, reducing your metabolism, increasing appetite, affecting bone health, and increasing inflammation.

That being said, many of these dreaded symptoms can be addressed in part with nutrition.

Increasing protein intake can help to maintain muscle mass and metabolic rate, calcium, and vitamin D can boost bone health, and omega-3 fatty acids, combined with an increased intake of fresh fruits and vegetables can reduce inflammation, while reducing processed and refined foods and drinks can further support reductions in inflammation.

These vitamins and minerals can be found in a range of healthy, nutrient-dense foods.

Exercise

Exercise is the closest thing we have to a magic health and well-being pill.

Capable of increasing muscle mass, and bone density, exercise is also an amazing mood and metabolism enhancer.

Getting up and going for a walk, run or workout is an incredible way to reduce feelings of depression, and anxiety while helping you burn extra energy.

Maintaining a Healthy Weight

Managing and maintaining a healthy weight is a great way to reduce the risk of poor health.

The weight we gain during menopause carries an increased risk of cardiovascular disease and metabolic disease.

While many women may experience minor weight increases, those who are already overweight or obese can encounter greater burdens.

This is due to the association of belly fat and cardiovascular disease, with obese women being at four times greater risk of death.

To maintain a healthy weight, eat a high-protein, nutrient-dense diet, and add exercise to your routine. For more specific guidance, consider following our Perimenopause Weight Loss strategies. This will allow you to manage your energy intake and reduce belly fat and risk of chronic illness.

Stress Reduction Techniques

Stress reduction techniques can be a game-changer for women during menopause. Women in menopause may experience mood changes, anxiety, and depression.

Adding stress reduction techniques including exercise, meditation, and yoga were found to be excellent for reducing stress and psychological symptoms.

Medical Treatments

Medical treatments such as hormone replacement therapy in the form of estrogen as tablets, patches, gels, and sprays have all been shown to relieve symptoms.

Non-hormonal medications can also be used to directly treat symptoms instead of addressing hormonal deficits.

Blood pressure medication can help reduce hot flashes and night sweats. While antidepressants can improve mood.

Alternative Therapies

Alternative therapies such as mind-body practices, hypnosis, and cognitive-behavior therapy are safe and effective for treating symptoms such as hot flashes, sexual dysfunction, and sleep.

Expert Advice and Resources

Perimenopause and menopause can often feel like a solo journey. However, let us assure you that it doesn’t have to be. Below, we have listed resources that are available to you that can help guide you through.

Consulting with Healthcare Providers

One of the best resources we have are healthcare providers. Doctors, nutritionists, dieticians, and pharmacists can all provide valuable recommendations for managing symptoms.

Support Groups and Communities

Support groups and communities are amazing resources where you can connect with other women, to share your experience.

Whether it is online, in person, or just simply venting to a friend, sharing your experiences can help you process your feelings and experiences. Who knows, you may even be able to help someone else who is struggling.

Conclusion

Perimenopause and menopause share many similarities. From the hot flashes and night sweats to the mood changes, and sudden weight gain, they both present in very similar ways.

This makes management a little simpler, allowing you to address your biggest symptoms, and begin to refine your management patterns.

If you are currently going through perimenopause or menopause, please reach out to your friends or healthcare professionals. They will be able to help you along the way.

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