Perimenopause and menopause are two key concepts in the transition period of a woman’s reproductive life. Although many women still do not have a clear idea about them, their body often realizes the difference very early. Perimenopause is the period of hormonal changes leading up to menopause, the definitive end of menstruation. Unlike menopause, which is diagnosed up to 12 months after the last menstrual period, perimenopause involves years when hormones fluctuate, cycles are irregular and symptoms can be intense and variable.

The hormonal transition can last from 2 to 8 years. However, there are known cases where it has lasted even longer. Many people do not realise that they are experiencing any changes, often until halfway through the transition period. Some women do not notice problems at all. It is only when their periods are finally over that they begin to realise that they have felt some changes over the last few years.

What is perimenopause and what is menopause?

Perimenopause is a natural physiological phase during which there is a gradual decline in ovarian function and fluctuations in the levels of estrogen, progesterone and other hormones. These hormonal changes can begin as early as age 40 and are manifested by irregular menstrual periods, hot flashes, mood swings and sleep problems.

Menopause, by contrast, is a clearly defined moment. It is diagnosed after 12 months without menstruation in the absence of other causes. In most Western countries, women reach menopause around the age of 51. While perimenopause marks a transition, menopause represents a new phase of life. In perimenopause, ovulation can still take place and it is therefore still possible to conceive, but not in menopause.

How the body signals changes

During perimenopause, hot flashes, night sweats, irregular menstrual periods, mood changes, anxiety, and difficulty sleeping are most common. These symptoms are caused by fluctuations in estrogen and progesterone levels. Studies show that 80 to 90% of women during perimenopause and menopause experience symptoms that bring them to the doctor, and more than 60% of women report hot flashes, especially late in the transition.

Compared to perimenopause, where cycles are constantly changing, menopause brings stable low estrogen levels, which means that some symptoms (such as vaginal dryness, risk of osteoporosis, or changes in body fat distribution) may intensify.

One of the signs that women's hormones are changing is often psychological problems. Unfortunately, this includes depression and anxiety. ━━ One of the signs that women's hormones are changing is often psychological problems. Unfortunately, this includes depression and anxiety. ( Source: Dmitry Schemelev /  Unsplash+ )

Mental and physical health

Hormonal changes in perimenopause affect not only the body, but also the brain. Research shows that perimenopausal women have up to 40% higher risk of depression than premenopausal women. This is very likely linked to fluctuating estrogen levels affecting brain function. Similarly, sleep disturbances often occur during perimenopause and menopause. In addition, the fact that many women still lack knowledge about what to expect during this life change is often overlooked.

Research has shown that almost a third of women are not familiar with perimenopause at all, and more than half are unaware of the treatment options available. Often, women are physically unwell or feel mentally unwell, but do not understand what is happening to their bodies. Experts say that the general population needs to be made more aware of the issue to avoid unnecessary confusion.