What is the Difference Between Menopause, Perimenopause and Postmenopause?

The phases of menopause — typically referred to as menopause, perimenopause and postmenopause — mark a significant transition time in a woman’s life and overall health. Menopause is triggered by a decrease in female hormones, particularly estrogen.

Menopause occurs when a woman stops having monthly periods and can no longer get pregnant. You are menopausal when you’ve gone a full year without a period or your period stops permanently as the result of a medical treatment. At this point, your ovaries no longer release eggs and you can’t get pregnant.

Perimenopause (pre-menopause) is the stage right before menopause. This phase can actually last quite a long time — up to 10 years. This stage, before full menopause, usually starts when women are in their 40s. It typically lasts four years, but can run up to 10 years for some women. Perimenopause officially ends when you experience a consecutive 12 months without your period.

Postmenopause, or after-menopause, describes the years of a woman’s life after menopause occurs. Once you’ve experienced menopause, this final phase lasts the rest of your life. 

At Baptist Health, we understand that a woman’s reproductive health is closely linked to many other aspects of her physical and emotional health. That’s why we focus on treating the “whole you,” not just your menopausal symptoms. 

We’ll also carefully monitor you for related health issues once you’re in menopause. For instance, hormonal shifts that come with “the change” can be linked to issues ranging from mood swings and depression to fragile bones, or osteoporosis.

What Are Common Symptoms of Menopause, Perimenopause and Postmenopause?

The physical symptoms you’ll experience during the early stages of menopause compared to the later stages can be slightly different. However, some women have the same menopausal symptoms throughout their transition. Here are the symptoms at each phase, in the order you’ll likely experience them:

• Perimenopause: Common perimenopause symptoms include:
• Irregular periods (shorter, longer or uneven gaps between them) and/or more intense premenstrual syndrome (PMS) symptoms
• Hot flashes, night sweats and difficulty sleeping (insomnia) 
• Fatigue and mood changes; learn more about depression
• Vaginal and bladder changes, such as vaginal dryness or urine leakage 
• Breast tenderness
• Decreased interest in sex
• Menopause: In addition to the perimenopause symptoms, some women may experience:
• Occasional racing heartbeat
• Weight gain
• “Brain fog” or difficulty concentrating — a symptom that usually passes over time
• Hair thinning or loss
• Unexplained joint and muscle aches
• Postmenopause: Symptoms in this stage do not differ from menopausal symptoms, but you may experience symptoms of menopause for a number of years. 

Menopause, Perimenopause and Postmenopause: Related Conditions

Once you enter menopause, your body produces much less estrogen, an important women’s hormone. As a result, you may be at higher risk of developing certain health conditions, such as osteoporosis in women (weakened bones) or women’s heart disease. Those conditions are connected to estrogen levels in your body. 

How Are Menopause, Perimenopause and Postmenopause Diagnosed? 

Your monthly period may give you the most direct information about where you are in the menopausal process.

If your periods are more sporadic than they used to be, or lighter or heavier than before, you may be perimenopausal. Once you’ve gone a whole year without a period (unless you’re on medication that is suppressing it), you’re officially considered to be in menopause. Postmenopause is the term used to describe the phase you’re in from the onset of menopause to the end of your life.

Your Baptist Health provider can also do a simple blood test, called a follicle-stimulating hormone (FSH) test, to help determine if you’re menopausal. However, this test isn’t always conclusive. Most women’s hormone levels go up and down throughout perimenopause. This can make the FSH test somewhat unreliable.

Treatment for Menopause, Perimenopause and Postmenopause

Menopause is a natural part of each woman’s aging process. It isn’t something that typically requires medical treatment. However, if the symptoms of menopause, perimenopause or postmenopause significantly interfere with your life, talk to your Baptist Health provider. Your doctor may offer dietary, exercise and lifestyle suggestions to help make the transition a bit easier. 

In some cases, your doctor may also recommend hormone replacement therapy (HRT). However, HRT is not the common menopause treatment option it was in the 1980s and ‘90s. Talk to your Baptist Health provider about how HRT could affect your heart health and breast or reproductive cancer risks.