Perimenopause vs. Menopause: Curious About What to Expect?
It’s calm for now but what’s coming next?
What’s Happening to Your Hormones During Perimenopause, Menopause, and Aging
Have you ever wondered if your brain fog is a sign of stress, aging, or something more? What about those moments when you suddenly snap at your kids or yell at your partner—surprising everyone, including yourself? You’re not alone.
Common Perimenopause Symptoms You Might Be Experiencing
Sweaty, uncomfortable hot flashes (or flushes), sleep-destroying night sweats, brain fog that never clears, irritability about absolutely everything, crying at nothing, hair growing in places you definitely don’t want it (and disappearing from where you do!), not-so-subtle weight gain, and a complete lack of energy to do anything about any of it.
And the list (unfortunately) goes on. And on.
Perimenopause vs. Menopause: How Do You Know the Difference?
Perimenopause throws your hormones out of whack, creating a ton of physical and emotional havoc in your life. Even if these changes surprise you (and the people around you), they’re predictable when you look at the science. The problem is, no one talks about it!
Hormone levels can feel like a moving target when it comes to treatment, but luckily, we don’t always need those lab numbers to guide care. And even though your hormones will eventually settle at permanently lower levels (post-menopause), before you get there, you’ll experience days when they’re lower than ever—and others when estrogen is higher than it’s ever been!
Being “middle-aged” (or over 40) can feel frustrating enough. Yes, your body is aging, but there’s more than just aging at play here. The good news? You don’t have to suffer through it.
But before we get into what you can do, let’s break this all down with some definitions and stats. And don’t forget about postmenopause—(but trust me, you won’t forget it when you get there!).
We may feel like this, but it’s coming for us anyway!
Perimenopause vs. Menopause: What’s the Difference?
What Is Perimenopause?
So, what exactly is perimenopause, and why should you care?
First off, it hits during one of the most productive times in a woman’s* life—her 40s. It typically starts 4–10 years before menopause, and since the average age of menopause in the U.S. is 51, that means perimenopause can begin as early as the mid-30s or as late as the 50s. Super fair, right?
Perimenopause is driven by fluctuating hormone levels, leading to irregular periods and an unpredictable mix of symptoms. Constipated? Joint pain? Can’t sleep but always exhausted? Yep, all part of the ride.
And because your hormone levels aren’t declining in a straight line—but instead spiking and crashing—your symptoms can feel just as inconsistent. The unpredictability alone can cause its own stress!
What’s Happening Inside Your Body During Perimenopause?
You might know what it feels like on the outside—but what’s actually happening inside?
Ovarian function starts to decline, leading to wildly fluctuating hormone levels—especially estrogen, progesterone, and follicle-stimulating hormone (FSH).
Your periods become irregular—even if you were clockwork-regular before.
Perimenopause can last anywhere from a few months to a full decade—with an average duration of 4 years.
You start experiencing menopause-like symptoms—hot flashes, a slowed metabolism, and vaginal dryness—while still getting periods.
The Two Phases of Perimenopause
Perimenopause isn’t just one big transition—it’s divided into two phases:
Early Perimenopause – Your cycles are still mostly regular but start to have occasional interruptions.
Late Perimenopause – The time between periods lengthens to 60+ days, and hormone fluctuations become even more extreme.
And finally, menopause officially begins when you’ve gone 12 consecutive months without a period—marking the end of perimenopause. Yay?
Hot flash much?
Perimenopause Statistics to Consider
If you’ve tried researching perimenopause, you’ve probably encountered two extremes:
Every symptom you have is labeled “just perimenopause.”
Or you’re told, “It’s natural, stop whining.”
Neither is particularly helpful.
The reality? Getting a clear picture is tough because research studies use different methods and terminology, and perimenopause symptoms vary wildly from person to person.
But we do have some pretty interesting statistics…
How Common Are Perimenopause Symptoms?
76% of women experience at least one perimenopause symptom—often fatigue, insomnia, or mood changes. That’s over 30 million women in the U.S. alone dealing with this right now!
Hot flashes + night sweats (aka vasomotor symptoms) affect 50–82% of women going through natural menopause (meaning they haven’t had a hysterectomy or oophorectomy).
Sleep problems spike in perimenopause:
56% of perimenopausal women struggle with sleep.
Compare that to 32.5% of premenopausal women and 40.5% of postmenopausal women.
Because what we really need right now is even less sleep. Eye roll.
For 1 in 8 women aged 40–65, hot flashes are the most disruptive symptom.
No wonder midlife comedy sketches always include a sweaty woman fanning herself.
Way to kick a girl when she’s down. And sweaty.
These stats show just how common and disruptive perimenopausal symptoms are. No worries, just 4–10 years to go! (Another eye roll here)
But with knowledge and support, there are ways to navigate this phase with a little more grace. (Or at least less torture.)
What About the More… Quirky Symptoms?
Ever noticed…
Sudden food sensitivities?
Electric shock sensations?
Ringing in your ears (tinnitus)?
Random burning tongue feeling?
Weird body odor changes?
Yup. Those can be peri too.
But before we dive into all the strange and unexpected symptoms, let’s quickly cover menopause—then we’ll get into what you can actually do to SAIL through this phase of life with more ease.
What Can You Do About Perimenopause Symptoms?
6 Quick Strategies to Feel Better Now:
Prioritize Sleep – Sleep disruptions are common, but CBTi techniques (cognitive behavioral therapy for insomnia) and better sleep habits can make a huge difference.
Manage Stress – Perimenopausal anxiety is real. Try therapy, breathwork, or mindfulness to keep cortisol (your stress hormone) in check.
Adjust Your Diet – Blood sugar crashes, inflammation, and gut health changes can worsen symptoms. Focus on protein, healthy fats, and lots of fiber.
Get Moving (But Smartly) – Strength training + walking support bone health and metabolism without spiking stress hormones like HIIT sometimes can.
Consider Hormonal + Non-Hormonal Treatments – hormone therapy (if safe for you), antidepressants, or other medications can help with symptoms like hot flashes, mood swings, and sleep issues.
You Don’t Have to Suffer – Whether it’s medication, lifestyle tweaks, or expert guidance, options exist to help you feel like yourself again.
What’s the right next step for you on your perimenopause trip?
Next Up: What the Heck Happens in Menopause?
(Spoiler: It’s different from perimenopause!)
The perimenopausal period ends when you’ve gone a full 12 months in a row without a period. At that point, congratulations—you’ve officially reached menopause!
So What Actually Happens in Menopause?
Menopause marks the end of ovarian hormone production, with the biggest hormonal drop being estrogen. And without estrogen, you can expect… well, a lot.
But estrogen isn’t the only hormone that changes. Here’s what else stops (or significantly decreases) production—and the effects you’ll likely feel:
Estrogen – Responsible for temperature regulation, mood stability, vaginal and skin health, and bone strength.
Progesterone – Helps with sleep, anxiety, and cycle regulation. With low levels, insomnia and mood swings can get worse.
Testosterone (Yes, women have this too!) – Supports muscle mass, energy, and libido. A drop in testosterone can mean lower sex drive and more fatigue.
And that’s it! Menopause itself is just one single day—the exact day that marks one full year since your last period. Everything after that? That’s postmenopause.
Menopause by the Numbers
Menopause typically happens between ages 45 and 55, with the average age being 51 in the U.S.
It’s a normal part of aging, caused by declining ovarian function and a sharp drop in estrogen and progesterone.
It means no more periods and no more pregnancy risk (though birth control may still be needed for a bit if you're in perimenopause and irregular).
How Is Menopause Diagnosed?
It’s diagnosed in hindsight: If you’ve gone 12 months without a period, you’re in menopause.
There’s no single test or scan—just the one-year rule (unless you’re taking hormonal birth control, which can suppress periods and make diagnosis tricky).
Menopause can happen naturally or be induced by surgery or medical treatments (like hysterectomy, radiation, or chemotherapy).
Welcome to Postmenopause—Forever.
Once you’ve made it through menopause day, you’re now postmenopausal for the rest of your life.
At least the phrase rolls off the tongue so effortlessly, right? Postmenopausal stage… Yep, definitely needs a cooler name. We should work on that.
Now… What Can You Expect in Postmenopause?
(Spoiler: Some things get easier, but new challenges arise!)
Postmenopause: The Rest of Your Life
Unfortunately, the crazy symptoms you’ve been dealing with up to this point don’t necessarily stop after menopause. They may improve or change, but they don’t just disappear overnight. (But eventually, the chaos will steady.)
STEADY HO!
Postmenopause is the phase of life that begins after menopause—meaning you’ve gone 12+ months without a period and your ovaries have stopped making estrogen and progesterone.
Some good news? Many women experience a reduction in menopausal symptoms, like hot flashes and night sweats (yay! fingers crossed!).
AW, DAMN IT.
But here’s the less exciting part: Without those hormones, some health issues will gradually worsen unless you take steps to adjust your lifestyle and offset the effects.
While some symptoms fade, others can continue or even get worse, like:
Vaginal dryness (yep, still a thing… boo).
Urinary issues (also still a thing).
The Most Concerning Long-Term Health Risks
From a medical standpoint, consistent low estrogen puts you at higher risk for:
Osteoporosis + fractures – Less estrogen means weaker bones.
Cardiovascular disease – Estrogen was protecting your heart, now it’s gone.
Type 2 diabetes – Metabolism slows, insulin resistance rises.
Postmenopause ≠ The End of Being Awesome
Yes, postmenopause marks the end of your reproductive years, but it’s also a new chapter—one where women often step into powerful leadership roles in their families, careers, and beyond.
Go get it!
Perimenopause Symptoms vs. Aging: What’s the Difference?
One of the biggest challenges of perimenopause is figuring out:
Is this a hormone issue?
Or just normal aging?
Let’s break it down:
Symptoms Directly Linked to Hormonal Changes
These symptoms are caused by fluctuating or declining hormone levels:
Hot Flashes + Night Sweats – Classic perimenopause symptoms, thanks to estrogen dips.
Vaginal Dryness – Estrogen keeps vaginal tissues healthy, and without it… things dry up.
Irregular or Heavy Periods – Hormonal chaos makes cycles unpredictable.
Decreased Libido – Lower estrogen and testosterone = lower sex drive.
Brain Fog – Estrogen helps with memory and focus—when it drops, so does clarity.
Irritability + Mood Swings – Hormones regulate mood, and when they fluctuate… so do you.
Depression + Anxiety – Perimenopause increases the risk of mood disorders.
Insomnia – Changing hormones disrupt sleep patterns.
Incontinence – Weaker pelvic muscles = bladder issues.
Symptoms More Likely Due to Aging (Not Just Hormones)
These may overlap with perimenopause, but aging plays a bigger role:
Hair Thinning – Aging + genetics are bigger factors than hormones here.
Weight Gain – Both metabolic slowdown + hormones can play a role, especially with belly fat.
Increased Abdominal Circumference – Hormonal shifts redistribute fat, but aging adds to it.
Unwanted Hair Growth – Aging + genetics impact this, not just hormones.
Memory Loss – Age-related cognitive decline is different from perimenopausal brain fog.
Word-Finding Difficulty – Common in both perimenopause and aging.
Skin Wrinkles – Aging + sun damage are the main culprits (except vaginal skin thinning—that’s all hormones).
Why Does It Matter Whether a Symptom Is Hormonal or Not?
Will knowing what’s hormonal actually help? Yes!
Studies show that simply understanding what’s happening to your body can make the experience less overwhelming. And if you want to test your knowledge, play the “Hormones Raging, or it’s just Aging” game with me on YouTube!
Knowing what to expect can:
Help you feel less alone (this is normal, even if it sucks).
Give you a clear direction for treatment, so you don’t waste time + money on the wrong solutions.
Reduce the risk of misdiagnosis, ensuring you get the right treatment for relief.
Empower you to take action ASAP, because knowledge = control.
Track your perimenopause symptoms to share with your doc!
Taking Action: What You Can Do
If you think your symptoms might be related to perimenopause, here are some simple steps to help you move forward:
Track Your Symptoms
Keep a journal or use an app to log patterns and triggers.
Look for trends in sleep, mood, energy, cycle changes, and physical symptoms.
Talk to Your Doctor
Bring your symptom notes to a primary care doctor, OB/GYN, or menopause specialist.
Find a certified menopause practitioner here:
NAMS Menopause Practitioner Directory
Consider Lifestyle Changes
Food, movement, sleep, and stress management can improve symptoms within weeks—without medication.
Small, targeted changes can have big results.
Explore Treatment Options
Both hormonal and non-hormonal treatments are available for specific symptoms.
Options include HRT, non-hormonal medications, supplements, and therapy.
She’s living her best life EVEN in perimenopause!
Conclusion: You’ve Got This!
Understanding what’s happening in your body during this phase is powerful. Every woman who reaches age 60 has gone through menopause, and over 75% experience at least one annoying (or unbearable) perimenopause symptom.
If half the population is going to go through this, let’s do what we can to make it easier. Don’t forget to:
Track your symptoms—use the list above or jot down what’s bothering you most.
Bring your notes to your doctor and ask direct questions about perimenopause and treatment options.
Remember, you’re not alone. With knowledge, support, and the right care, you can face perimenopause with confidence.
I’ve got your back—let’s tackle this together!
Let’s Find the Right Plan for You
You don’t have to struggle through perimenopause alone. If you’re feeling overwhelmed by symptoms, confused about treatment options, or just want a plan that actually works for your body, I can help.
I offer personalized, expert care for women in Florida, Texas, and Indiana through virtual appointments. It all starts with a free 15-minute consultation to see if we’re a good fit. Let’s talk about what’s going on, what’s working (or not), and what options might help you feel like yourself again.
Because you deserve real answers, real solutions, and a plan that puts you back in control of your brain, body, and life.
*In this article, I’ll often use the term 'women' to describe people born with a uterus and/or ovaries, as they are the group most commonly affected by perimenopause and menopause. However, I want to acknowledge that not everyone with these biological traits identifies as a woman, and not all women experience menopause. While I’ll use 'women' for simplicity and clarity, this information is meant for anyone navigating the hormonal changes associated with this life stage, regardless of how they identify.
