Perimenopause vs Menopause: What's the Difference?

What Is Perimenopause?

Perimenopause is the transition leading up to menopause. During this stage, ovarian hormone patterns change and ovulation may become less predictable.

Periods often become one of the first noticeable changes. They may become more frequent, less frequent, heavier, lighter or unpredictable.

Symptoms can also include hot flushes, night sweats, sleep problems, mood changes, vaginal dryness and changes in concentration. Not everyone experiences the same symptoms.

What Is Menopause?

Menopause is reached after you have gone 12 consecutive months without a period, when the absence of periods is not caused by another reason such as hormonal contraception.

Menopause is therefore a point in time that can be identified after the fact. The stage after menopause is called postmenopause.

The age at which menopause occurs varies, but it commonly happens between 45 and 55. Menopause can happen earlier, and symptoms or absent periods before 45 should be discussed with a healthcare professional.

The simplest difference is that **perimenopause is the transition**, while **menopause is reached after 12 months without a period**.

During perimenopause, ovulation may still happen and pregnancy can still occur. After menopause, natural ovulation has stopped.

Symptoms can overlap between the two stages, so symptoms alone cannot always tell you exactly where you are in the transition.

Some hormonal contraceptives can make periods lighter, irregular or absent. That can make it difficult to use bleeding alone to decide whether menopause has occurred.

If you use hormonal contraception and think you may be approaching menopause, speak with a healthcare professional about your options. Do not assume that an absent withdrawal bleed or missed period means you can stop contraception.

When Should You Get Advice?

Talk to a healthcare professional if symptoms are affecting your sleep, work, relationships or daily life. You should also seek advice for very heavy bleeding, bleeding between periods or any vaginal bleeding after menopause.

Perimenopause and menopause are normal stages of life, but support and treatment are available when symptoms become difficult to manage.

Think of perimenopause as the transition and menopause as a milestone reached after the transition. During perimenopause, your ovaries may still release eggs, periods may still occur and pregnancy can still be possible.

Menopause is confirmed retrospectively after 12 consecutive months without a period when another explanation is not responsible. Once menopause has been reached, the stage that follows is called postmenopause.

The transition can be gradual. You may notice cycle changes before hot flushes or other symptoms appear, or symptoms may begin without dramatic changes in bleeding. Hormonal contraception can make the picture harder to interpret because some methods change or stop bleeding.

You do not need to identify the exact day perimenopause begins. Instead, pay attention to patterns and symptoms. If changes are affecting sleep, mood, work, relationships or daily activities, professional support is available.

If you have bleeding after menopause, do not assume it is simply another hormonal fluctuation. It should be checked even when the bleeding is light or happens only once.

Perimenopause is the transition. Menopause is reached after 12 consecutive months without a period when another cause is not responsible.