What is the Difference Between Premenopause and Perimenopause?

August 10, 2023

What is the Difference Between Premenopause and Perimenopause?


Menopause is a well-known time in a woman's life that marks the end of her reproductive years. But what isn't as known is that menopause has different stages before and after the transition. Two of these stages are premenopause and perimenopause. While technically, they are used interchangeably, they actually have distinct differences. In this article, we'll look at the differences between premenopause and perimenopause and the options for treatment.

Understanding Premenopause

Premenopause is the time frame before officially going into perimenopause and menopause. It varies from woman to woman, but typically, most health organizations state it can start in a woman's 30s and 40s or at least 8-10 years before menopause. 

Premenopause is the same as perimenopause in that the ovaries produce less estrogen, but the symptoms of this decrease aren't noticeable to the body. You're not having any of the hallmark signs of perimenopause since the drop in estrogen isn’t as severe.


Understanding Perimenopause

Perimenopause is before menopause, usually in the decade preceding official menopause. The definition of menopause is when a woman hasn't had a period for 12 months or more. 


Women still have periods in perimenopause, but they may be irregular and vary in strength and length. For example, a typical length of menstruation was 5-7 days for many years, then it becomes shorter one month and longer the next. Ovaries produce less estrogen in some months, so this affects period lengths.

Symptoms of Perimenopause

Women experience different symptoms at different intensity levels, but here is a list of common perimenopausal symptoms.

  • Irregular periods
  • Fertility issues for women trying to become pregnant
  • Weight gain
  • Headaches
  • Increased premenstrual syndrome (PMS)
  • Hair changes
  • Breast tenderness
  • Lighter or heavier periods
  • Muscle aches
  • Forgetfulness
  • Urinary tract infections (UTI)
  • Loss of sex drive
  • Heart palpitations
  • Hot flashes
  • Night sweats

The drop in estrogen causes these symptoms, but it's important to note that women can still become pregnant. Estrogen is lower, but having a period means that an egg ready for fertilization is dropped from the ovaries in expectation of becoming fertilized. If this isn't the desired outcome, you will still need to use a birth control method to stop pregnancy. Also women who want to become pregnant may find it harder or have difficulties sustaining a pregnancy.

Critical Differences Between Premenopause and Perimenopause

Premenopause is a drop of estrogen without experiencing the symptoms of perimenopause. You're noticeably experiencing symptoms in perimenopause, and the hormonal changes are more drastic.

The early 50s is the average age that women go through menopause, but perimenopause symptoms are reported 8-10 years before this occurs. The symptoms become even more noticeable 4-5 years before menopause.

Some women can have perimenopause symptoms in their 30s and may struggle with fertility. This can come from genetics, lifestyle habits, and certain medical conditions.

Medical and Lifestyle Interventions

Treatment for perimenopause and menopause usually combines hormone therapy and dietary changes. Hormone therapy comes in different forms.

Estrogen hormone replacement therapy includes estrogen-like molecules that naturally replace the missing hormone from your body. It is sometimes called bioidentical hormone therapy due to its mimicking power. 


Natural Hormone Therapy

Natural hormone therapy is available without a prescription and is made from 100% natural ingredients. The ingredients are plant-based and derived from wild yams or other earth sources. There are no fillers, chemicals, parabens, or harmful preservatives. The hormone blends naturally with the body's ecosystem to soothe perimenopausal symptoms.

Natural hormone therapy comes in many types, with various hormones infused. You can find it in pills, injections, or topical applications. Topical applications are applied directly to the skin and come in a lotion-like consistency that's easy to use. There are no bulky pills to swallow, and the time it takes to reach your bloodstream and soothe symptoms is shorter, making it an ideal choice for hormone therapy. 

Conventional Hormone Therapy

The opposite of natural hormone therapy is conventional in terms of ingredients. Traditional hormone therapy is usually prescribed by your doctor and contains synthetic ingredients and other fillers, preservatives, and parabens. The main ingredient for the estrogen hormone is usually equine or horse urine.

Lifestyle Changes to Treat Perimenopause

Besides hormone therapy, women can change their diet, exercise, and sleep habits to treat perimenopause.

Dietary Changes


What you eat matters at any time, but even more critical when battling a medical condition. Some women find some relief from perimenopause and menopause when changing their diet. Moving towards a whole-food, whole-grain approach helps the body manage symptoms. 


Some evidence also points to a ketogenic diet of low carbs, higher protein, and healthy fat as one that improves hormonal imbalances. The idea is to increase ketones and lower insulin resistance to balance hormones.

Other research indicates that eating certain foods considered phytoestrogen may improve symptoms. Here are some common phytoestrogen foods.

  • Plums
  • Pears,
  • Apples
  • Grapes
  • Berries
  • Beans
  • Sprouts
  • Cabbage
  • Spinach
  • Soybeans
  • Whole grains
  • Hops
  • Garlic
  • Onion
  • Red wine
  • Certain teas

While dietary changes are significant, changing the intensity and types of exercise can improve perimenopausal symptoms.

Rethink Exercise

Women usually love aerobic exercise over strength training, believing it's more of a man's world. But lifting weights and building muscle is vital to managing perimenopausal symptoms. Estrogen helps build healthy bones, and women who have gone through menopause have an increased risk for osteoporosis, the brittle bone disease. Lifting heavy to build muscles for women is critical to improve bone density and spur the body to produce more estrogen.

Adding 20-30 minutes of weight lifting three times a week will be more effective than running five miles a day, five to six times a week. The effect on the body will help women feel better and fight pesky menopausal symptoms like weight gain. 


The difference between premenopause and perimenopause is a simple one. Premenopause is a drop of estrogen without consciously experiencing perimenopausal symptoms. Finding a solution is a must regardless; hormone therapy and dietary and exercise changes make management livable. Grow into your golden years with ease rather than needlessly suffering.