Perimenopause vs Menopause: Best Tips for Symptom Relief in Both Stages

brainmd
2025-02-19T21:00:00-08:00

Until recently, menopause has been culturally perceived as a shameful event in a woman’s reproductive life. Even in medicine, it has been a neglected area of study with most medical schools and residency programs lacking menopause education.

Thankfully, menopause stigma has lessened, and education and awareness are growing. It’s not surprising though that there’s still a lot of confusion about this important phase of a woman’s reproductive life.

In particular, confusion remains about how perimenopause and menopause differ. Part of the same overall reproductive life transition, perimenopause and menopause have unique features and symptoms.

Here’s an overview of the differences between perimenopause and menopause for women so that you can understand your reproductive life phases better and take better care of your health. (Men, this is for you too! It’s helpful for us all to understand what happens in a woman’s body.)

What Is Perimenopause?

Perimenopause is a natural phase in a woman’s reproductive life. It literally means “around” or “near” menopause. Hence, perimenopause is the transitional phase before menopause occurs. Menopause marks the end of a woman’s reproduction.

Perimenopause begins with the onset of irregular periods and ends after a woman has gone 12 consecutive months without a period. Statistical research shows that perimenopause usually begins around age 45,¹ but it can start earlier (as early as mid-30s) or later (as late as mid-50s) for some women.

In terms of duration, perimenopause usually lasts 4 to 5 years. But again, it can vary. While some women can go through perimenopause within a few months, others may be symptomatic for as long as 8 years before menses stop completely.

What Happens to You During Perimenopause?

Perimenopause has two phases: an early phase and a late phase.

During the early phase of perimenopause, your estrogen levels start to fluctuate, which causes fluctuations in progesterone. It’s marked by changes in your menstrual flow and in the length of your period.

In the late stages of perimenopause, estrogen levels start to decline significantly. You’ll begin missing periods as ovulation becomes irregular and eventually stops. Without adequate estrogen, you’ll likely experience vaginal dryness. You may have pain during intercourse as the lining of your vagina thins. You may begin to have hot flashes. These occurrences usually start about 6 months before your last period. The symptoms can last from 6 months to 5 years after the onset of menopause.

You might experience any of the following symptoms during perimenopause:

Night sweats

Sleep problems

Mood changes

Irregular periods

Vaginal dryness

Pain during intercourse

Hot flashes

Mental fog

Fatigue

Breast soreness

Dry skin/acne

Hair loss

Headaches and dizziness

Joint pain and muscle tension

What Is Menopause?

Menopause marks the end of your reproductive life. The name menopause is derived from the Greek words pausis (pause) and men (month). You’re considered to have reached menopause when you’ve gone a full 12 months without a menstrual period. It occurs naturally after your ovaries stop producing eggs. As you enter menopause, your ovarian production of estrogen and progesterone declines until it eventually stops altogether. Once menopause is reached, you become postmenopausal for the remainder of your life.

The average age of menopause in the U.S. is 51, but the range is between 45 and 58. In some cases, a woman may enter menopause prematurely. The causes of early and premature menopause aren’t always known. More often, early menopause is a result of medical treatments such as surgical removal of the ovaries or uterus or chemotherapy or pelvic radiation.

Menopause is no doubt a critical phase in a woman’s life because multiple areas of health are impacted, and symptoms can be very challenging.

What Are the Symptoms of Menopause?

Many of the symptoms of perimenopause continue or increase in menopause. Research² shows that vasomotor (affecting the narrowing and widening of the blood vessels) symptoms are the most commonly experienced symptoms during menopause. Approximately 75% and up to 80% of women experience:

Hot flashes

Night sweats

Palpitations

Migraines

Approximately 50% to 75% of women experience vaginal and urinary problems. As mentioned, with the estrogen loss, your vaginal lining thins and becomes less elastic, which may cause dryness, burning, and irritation. This may become even more pronounced in menopause as ovarian estrogen production ceases. You may also experience greater frequency and urgency of urination. Low estrogen increases the risk of vaginal and urinary tract infections as pH changes occur in the vagina and urinary tract reducing the good bacteria that help keep infectious bacteria in check.

Your brain has estrogen receptors in a variety of regions. These areas regulate cognition and mood. Decreased estrogen may cause any of the following:

Anger or irritability

Feelings of anxiousness; tension

Low mood

Loss of concentration

Low self-esteem; loss of confidence

Low libido

Most concerningly, the loss of estrogen and progesterone in menopause may increase your risk of:

Sleeplessness

Bone loss

Abdominal weight gain

Heart health issues

Brain health problems

Menopause Symptom Relief

It’s not all doom and gloom! There are many measures you can take to reduce the symptoms of perimenopause and menopause including any of the following:

1. Estradiol Cream

If you’re experiencing vaginal pain or dryness, or an increase in vaginal or urinary infections, talk to your doctor about trying a topical estradiol cream. It replenishes estrogen to these areas, which can reverse the conditions and is considered to be safe.

2. Hormone Replacement Therapy

One of the most effective ways to counter symptoms associated with perimenopause and menopause is to start hormone replacement therapy (HRT). Its risks were overstated in past years due to a flawed conclusions drawn from longitudinal research. There are still risks, particularly for women who’ve had breast health issues, but not as great as once thought.

HRT can help protect against bone loss and reduce vasomotor symptoms, research³ shows. Some women choose to take bioidentical hormone replacement therapy, which are compounded from plant hormones. However, they aren’t regulated by the FDA. Talk to your OB/Gyn or medical doctor to learn more.

3. Natural Menopause Relief

Herbal remedies and nutritional supplements may help to minimize hot flashes, boost mood, support bone health, or help with other issues. Alternative medicine such as acupuncture may help with symptoms. Discuss options with your medical doctor.

Make Changes to and Improve Lifestyle

Making some lifestyle adjustments and adding activities can go a long way for minimizing symptoms for both perimenopause and menopause. They also tend to make you healthier! Try any of the following:

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Exercising regularly. This can help boost mood, reduce hot flashes, and promote restful sleep. Be sure to incorporate strength-training exercises to help protect against bone loss as well.

Eat lots of fruits, vegetables, legumes, and whole grains. Rich in phytoestrogens (plant compounds with estrogen-like properties), eating lots of these foods can help reduce hot flashes.

Eat calcium-rich and vitamin D-rich foods or take a natural menopause supplement - like BrainMD's Menopause Essentials+. These nutrients are needed to maintain your bone health. Yogurt, spinach, kale, tofu, beans and sardines are examples of calcium-rich foods. Salmon and trout are rich in vitamin D.

Stay hydrated. Estrogen loss can be dehydrating and drinking water can keep bloating associated with hormonal changes to a minimum.

Eat plenty of protein-rich foods. Your body needs it to maintain muscle mass. If you are doing strength training, your body needs more protein to build muscle.

Reduce or eliminate consumption of spicy food, caffeine, chocolate, sugar, fatty foods, refined carbs, and alcohol. They’re inflammatory and can make hot flashes worse.

Incorporate a mindful practice like yoga or meditation or walks in nature. Take time to enjoy hobbies or read a book. These activities can help ease anxious feelings.

Practice good sleep hygiene; take a natural sleep supplement.

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Postmenopausal Life

It’s important to remember that while the end of your reproductive cycle is challenging and indeed a milestone in aging, it’s also a beginning to a new and wonderful chapter of life. Many women experience increased happiness and productivity during this phase of life as they can focus on their own needs, desires, and interests.

Note: As with any dietary supplement, be sure to consult with your healthcare practitioner before beginning any wellness regimen, especially if you’re currently taking any medications.

At BrainMD, we’re dedicated to providing the highest quality supplements to improve your physical health and overall well-being. For more information about Menopause Essentials+ and our full list of brain healthy supplements, please visit us at BrainMD.

*These statements have not been evaluated by the FDA. This content is for informational purposes only. It is not meant to substitute for medical or healthcare advice from a physician, nor is it intended to diagnose, treat, cure, or prevent any disease. Consult your healthcare provider before beginning a new health regimen.

References:

1. Gold, E. B. (2011). The timing of the age at which natural menopause occurs. Obstetrics and Gynecology Clinics of North America, 38(3), 425–440. https://doi.org/10.1016/j.ogc.2011.05.002

2. Peacock, K., Carlson, K., & Ketvertis, K. M. (2023, December 21). Menopause. In StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK507826/

3. Harper-Harrison, G., Carlson, K., & Shanahan, M. M. (2024, October 6). Hormone replacement therapy. In StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK493191/