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Perimenopause vs Menopause vs Postmenopause: What's The Difference?

by — 2019-02-04 in Women's Health
A lot of menopause-related terms get thrown around, but what do they all mean? Let's take a look!

Women might talk about being premenopausal, perimenopausal, menopausal, and postmenopausal — but what do all these things really mean? Let's take a look. 

What is the perimenopause?

The perimenopause marks the start of your menopausal transition — the "peri" bit means "around" or "near", so it means you're approaching the menopause, but aren't quite there yet. The ovaries' estrogen production begins to decline — in a fluctuating downward way — at this time, which typically lasts around seven years though it can go on for more than a decade in some women, while others experience it for a much shorter period of time. 

The perimenopause, or premenopause, will start somewhere in the forties for most women, but it can also come earlier. This depends on numerous factors, such as the age at which your female relatives went through the menopause, your ethnicity, whether you smoke, and if you've ever received cancer treatment.

You may have entered this phase if you've noticed symptoms like:

  • Irregular menstrual periods — some women will have longer cycles, while others have shorter ones and many just find that the timing of their periods becomes unpredictable.
  • Hot flashes. 
  • Vaginal dryness. 
  • Fatigue and trouble sleeping. 
  • Sore breasts, like many women have before periods.
  • A decreased libido. 
  • Needing to pee more often, and even leaking a bit when you laugh or sneeze.
  • Some women suffer from mood swings, and as many as two in 10 will become clinically depressed. 

During the perimenopause, some of your menstrual cycles will be anovulatory — meaning you don't ovulate. That doesn't mean you can say goodbye to birth control quite yet if you're trying to avoid pregnancy, though, as some women do conceive naturally during this time. 

So, do you need to go to the doctor when you notice symptoms typical of the perimenopause? You certainly can — it won't do any harm. But remember that the perimenopause isn't a medical condition, and instead a natiral process. Unless your menstrual bleeding becomes heavy and prolonged, you are depressed, or your symptoms impact your daily life negatively, it's also OK not to seek medical attention. 

What is the menopause?

As you go through the perimenopause, you'll notice that your periods gradually become rarer and rarer. At some point, they'll stop completely. Once you've been period-free for 12 months, the menopausal transition is complete and you've entered the menopause. This means your reproductive years are over. Your ovaries no longer produce eggs, and your estrogen production has also been toned down to a minimum.

Most women will reach the menopause somewhere between their late forties and mid-fifities, but it can also come early, because of:

  • Natural reasons — some women will go through the menopause before age 45, in which case it's considered early, while some even enter the menopause before their 40. This can happen even in teenagers in some instances, and it's called a premature menopause.
  • Surgical reasons — if you have to have your ovaries removed (an operation called an oophorectomy), you'll enter a surgically-induced menopause.

How do you know when you've entered the menopause?

There's no party poppers or anything. If you didn't keep track of your menstrual periods, you may not even realize you've entered the menopause, a milestone that's officially reached after you haven't menstruated in a year. Because this designation is relatively arbitrary, you need to know when you last had a period to be able to tell if you're now post-menopausal. Women who have entered the menopause will, however, notice that the symptoms that plagued them during the perimenopause gradually taper off and come to a halt, so that can be another clue. If you're not sure, you can always see your doctor for a follicle stimulating hormone (FSH) level test. 

Once you're "on the other side", you'll no longer be bothered by periods, PMS, or the risk of pregnancy — so there are certainly good things about the menopause. Because you now have much lower estrogen levels you are, on the other hand, at an increased risk of suffering from adverse health ouctomes like heart disease and osteoporosis (brittle bones). 

If you used hormone replacement therapy to manage your perimenopause symptoms, you may, research has found, be more liklely to develop breast cancer and suffer a heart attack, stroke, or blood clots. Hormone replacement therapy also, however, appears to lower a woman's risk of bone fractures and colorectal cancer. 

Postmenopausal women can look after their health by eating healthy and varied diets that include plenty of calcium, and exercising. Your doctor may also recommend that you take vitamin D supplements to help prevent osteoporosis. Though you no longer have periods, you still need regular pelvic exams, PAP smears, and mammograms. Ask your doctor how often you need checkups, and stick to the recommended schedule.

Sources & Links

  • Photo courtesy of SteadyHealth.com

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