Doctors help explain and demystify perimenopause

Understanding menopause can be confusing because of the many terms that encapsulate the process. Medically, it’s 12 months after your last period, but it is often used to describe the entirety of the stages you go through when your body transitions to no longer having periods.

There are three stages – premenopause or perimenopause, menopause and postmenopause. This can be confusing because premenopause and perimenopause mean very similar but slightly different things and they sound almost the same.

To explain the stage where the bulk of the changes and symptoms are occurring, perimenopause, we spoke with the experts: Dr. Jen Gunter, a San Francisco Bay Area-based board-certified OB-GYN and author of “The Menopause Manifesto;” Dr. Bryan Jick, MD, FACOG, NCMP, a board-certified OB-GYN affiliated with Huntington Hospital in Cedars Sinai; and Dr. Elaine Waetjen, a board-certified OB-GYN and professor in the Department of Obstetrics and Gynecology at UC Davis Health.

What is the difference between premenopause and perimenopause?

All of our experts gave similar descriptions of premenopause and perimenopause. In short:

Premenopause and perimenopause are almost the same things – they are referring to the period of time leading up to menopause, or the menopause transition. Perimenopause also includes the one year following your last menstrual period.

What is the typical age for perimenopause?

The typical age of onset for menopause is a broad range – typically from 45 to 55. But perimenopause generally starts a few years earlier.

What are the first signs of perimenopause?

A common theme that arose from our experts was that any symptoms that arise around the time of menopause should be evaluated by a physician because it shouldn’t be an automatic assumption that it’s menopause.

“First, it’s important for people to know that if you’re not having any symptoms and you’re doing great and you’re perfectly fine, you don’t need to have any treatment,” Gunter explains. “It’s also important to see your doctor and get an evaluation because menopause is also happening while you’re aging and you want to make sure it’s not something else, right? Or it could be two things at once. So you just always want to be mindful of that,” she emphasizes.

How does your body feel in perimenopause?

Waetjen explains, “Women may have symptoms that can be related to perimenopause, but may also be related to just getting older or to having other medical conditions that arise in this age group such as difficulty sleeping, brain fog, weight gain (especially around the middle), mood swings, sexual pain.”

The symptoms also could be complicated and secondary. Jick says, “It (menopause) starts to interfere with your sleep. You are waking up multiple times a night. And we call it a night sweat, but it’s the same thing – it’s a hot flash that occurs while you’re asleep. Then you start to see after a few months a lot of symptoms that arise due to sleep deprivation – that’s what gets people to the doctor. It affects so many things – your mood, your memory, your concentration, your attention span, you forget things, (brain fog) you’re tired, and loss of sleep can cause weight gain – this is well documented. A lot of this is indirect. It’s not exactly menopause itself doing this – it’s loss of sleep that’s doing this.”

While there are different terms and myriad symptoms, this holds true for everyone: menopause is not a disease; it’s a natural process. It does not diminish your worth as a person or partner, and you don’t have to suffer silently through distressing symptoms because there are treatment options.