Perimenopause vs. Menopause: A Look at the Difference | Everyday Health

Perimenopause and menopause are normal and natural stages that typically occur when a woman is in her forties and fifties, toward the end of what is considered her reproductive life. The word "peri" comes from the Greek word meaning "about." This is the stage around menopause but before you officially go through it. During perimenopause, which many women experience during their forties, menstrual cycles are irregular,fertility is declining, but conceiving a child may still be possible.

The Two Stages or Phases of the Perimenopause Transition

Scientists divide perimenopause into two stages. Early-stage perimenopause is when your menstrual cycle, which was regular before, starts to become erratic. (If you have always been erratic, it can be difficult to tell when you have entered this phase.) You are in early-stage perimenopause when, in the course of several months, your period comes a week or more later than usual.

You enter late-stage perimenopause when there are at least 60 days between some periods. This can happen soon after the early stage begins or, more commonly, not for several years. The hormones in a woman’s system are in flux during this time, and the fluctuations may trigger symptoms such as hot flashes.

What Brings on Perimenopause and Perimenopausal Symptoms?

Since an egg that has ovulated and not been fertilized is what triggers amonthly period, or menstrual bleed, it makes sense that a woman’s eggs are the central reason she enters perimenopause.

Some background: When a baby girl is born, she has all the eggs she’ll ever have, and over the years, the quality of these eggs declines, explainsNanette Santoro, MD, the chair of obstetrics and gynecology at the University of Colorado School of Medicine in Aurora and a longtime menopause researcher. When the degeneration reaches a critical stage, follicle stimulating hormone andluteinizing hormoneramp up to try to force these lackluster eggs to ovulate. “The hormones are going up because they’re trying harder and harder to get the ovaries to work,” she says. The rise in these two hormones is typically associated with being in perimenopause.

The age that perimenopause begins varies. In the United States, the average woman is 49. Some women are in their mid-thirties when perimenopause starts, while a few don’t begin the process until their mid-fifties.

When, Exactly, Are You in Menopause?

Menopause is identified after the fact, Dr. Santoro says. When you look back at your calendar and see that you have gone one full year with absolutely no menstrual bleeding, then you are in menopause. You might go a long stretch of months without getting a period, but if one eventually comes before 12 months have passed, you are still perimenopausal.

Most American Women Reach Menopause Around Age 51

In the United States, women typically enter menopause between ages 40 and 58, with the average being 51,according to the North American Menopause Society (NAMS). Some women are even in their sixties. Typically, women reach menopause around the same age as their mothers or other women in their family.

When Are You Most Likely to Experience Perimenopausal Symptoms?

Women in perimenopause experience a variety of symptoms. The most common are hot flashes,trouble sleeping(often from flashes at night),vaginal dryness, and mood changes, sometimes including depression. But women complain of a widevariety of symptoms that strike them during this time, including having an odd taste in the mouth or the feeling of zaps under their skin.

女性最大的研究之一the menopause transition, theStudy of Women’s Health Across the Nation (SWAN), found that themost common time for symptoms to occur is the late perimenopause stage. Of course, some women get them earlier.

Hot Flash Symptoms May Start in Perimenopause but Continue After Menopause

Women who have moderate to severe hot flashes may experience them beyond the perimenopause stage. In fact,research published in September 2014 in the journalMenopausefound that many women continue having hot flashes for nearly a decade after menopause, although the severity of the symptoms begins declining after about two years.

Women who are younger when they start perimenopause typically experience symptoms longer than women who are older, Santoro says.

Hormone therapyis still the best treatment for most perimenopausal symptoms. Other women find relief from making lifestyle changes or trying natural remedies.

Premature and Surgical Menopause, Also Known as Induced Menopause: What to Know

A small number of women enter menopause much earlier than the average.When it occurs in women age 40or younger, it is termed premature menopause,according to NAMS. This happens to about 1 percent of women in the United States.

In some cases, menopause is surgically induced, such aswhen a woman has her ovaries removedforcancer preventionor treatment. Women with induced menopause often experience more intense symptoms than women going through the process naturally.

Early Menopause May Mean Early Disease Risks

Because a woman’s health risk for certain diseases increases after she goes through menopause, women going through the process at a younger age — whether induced or naturally — need to be more closely monitored for these health conditions, NAMS advises.

Stopped Periods Are Not Always Caused by Menopause

Not all missed period are from menopause, Santoro cautions. Especially if you’re younger than 45, you should check with your physician if your periods become wildly erratic or stop altogether, she says. Although it may be from something such as stress, serious diseases including a tumor in thepituitary glandcan cause your periods to cease, she says.

Some Menstrual Symptoms Are Wrongly Attributed to Perimenopause

You also want to get checked by a physician if your periods become heavier during perimenopause rather than getting lighter periods as is most common, Santoro says. Medical conditions includingendometriosisor cancer are sometimes confused with perimenopause in midlife women because they can alter your menstrual cycle.