Premenopause simply means ‘before menopause’ while perimenopause means ‘around menopause.’ Menopause occurs in women when the body stops producing estrogen and other sex hormones. Menopause is final once a woman doesn’t get her periods within 12 months. Doctors usually use perimenopause to refer to the time before menopause.
Premenopause vs. Perimenopause
Despite being used interchangeably amongst people, the terms have different meanings. Premenopause can be explained as the time before any signs of perimenopause or menopause. During the premenopausal stage, you will get your regular or irregular periods, and you will still be able to reproduce. While hormonal changes may be occurring, there are no visible changes in your body. 
However, perimenopause is different. During this, you may face certain symptoms such as:
- Hot flashes
- Lack of sleep
- Changes in the menstrual cycle
- Mood swings
Are Perimenopause and Premenopause the same thing?
There is a significant difference between premenopause and perimenopause. While these both occur before menopause itself, premenopause is the stage before perimenopause. Since both occur before menopause, doctors refer to both as perimenopause. For healthcare workers, there are 2 stages: perimenopause and menopause.
What’s the Difference Between Premenopausal and Perimenopausal
Perimenopause typically starts 4 to 5 years before menopause. Many women feel that they have entered the menopause stage while it’s perimenopause. Perimenopause typically begins in the 40s for most women, but it could also begin earlier for some depending on various factors. During perimenopause, women start to experience most of the symptoms that occur in menopause. These happen because of the hormonal changes that begin in the body, and varying levels of estrogen and progesterone may also cause weight gain.
During perimenopause, the menstrual cycle is very irregular. You might have heavy bleeding or have no periods for a month or 2. The severity of symptoms during perimenopause also varies in women, with some going through all of them and some not feeling anything at all. 
Premenopause is different since, during this stage, there are little to no changes occurring in the body, and there are no symptoms during this period. This stage is considered to take place before perimenopause itself. Hence, there is no age bracket for this stage, which is mainly why doctors also disregard it.
What comes first: Perimenopause or Premenopause?
Premenopause is the time before perimenopause, and there is no time limit set for it. Perimenopause is the stage right before the menopausal stage sets in and normally begins in the early 40s for most women. Hence, both begin before menopause, but premenopause comes before perimenopause.
Is Menopause Easier than Perimenopause?
Menopause starts at 50, but it can begin earlier in certain cases. Since perimenopause is the beginning of the symptoms of menopause, there is still a chance of conceiving since fertility starts declining during it. However, menopause is a complete end to your fertility. Menopause can be described as a stage where you haven’t had menstrual bleeding for 12 months. It will be described as perimenopause if you get periods after a long interval, such as a year.
While symptoms begin during the perimenopausal period, they increase and become frequent in menopause. Women start getting hot flashes in perimenopause, but according to research, many women continue to get hot flashes up till almost a decade after menopause. However, other symptoms become less frequent after 2 years of menopause. 
Perimenopausal symptoms may worsen as one gets closer to menopause. Since the hormones fluctuate, the body undergoes serious changes, which cause symptoms to increase as menopause gets close. Perimenopause is the beginning of the cycle that increases up until menopause and starts declining within 2 years.
Symptoms of Perimenopause at 44
Perimenopause begins within the age bracket of 40-44 for most women but can even start in the 30s for some. Since estrogen levels are changing, here are a few symptoms that women go through in perimenopause:
- Hot flashes
- Tender breasts
- Irregularity in the menstrual cycle
- Mood swings
- Urine leakage because of sudden coughing and a greater urgency to urinate
- Low sex drive
- Sleeping trouble
Stages of Perimenopause
Perimenopause can be divided into 2 stages leading up to the final menopause:
This is the beginning of the onset of menopausal symptoms with changes in estrogen levels in the body. It usually starts in the early 40s for most women but can also start in the late 30s for others. Due to changes in estrogen, there are changes in the menstrual cycle that mark the beginning of perimenopause.
This stage is usually defined for women in their early 50s or late 40s. Due to continuous changes in estrogen levels, their menstrual cycle is almost ending. Six months before menopause, there is a massive drop in estrogen levels which causes vaginal dryness and hot flashes. These symptoms can last for up to 5 years till the end of the menopause period. 
The Average Age of Perimenopause
On average, women in their early 40s, typically between 40 and 44, start facing symptoms leading to perimenopause. This age can vary for many reasons, and some women may enter the perimenopausal stage in their 30s. Perimenopause normally begins 8 to 10 years before menopause, but it can also start early due to various factors.
On average, the perimenopause stage can last for 4 years up till the stage of menopause begins. This transition phase may only last for a couple of months for some women.
Signs Perimenopause is Ending
The late stage of perimenopause is a sign that it is ending and menopause is beginning. There is a higher irregularity in periods, and women also start skipping their cycles. Other symptoms also increase, such as hot flashes and irritability due to mood swings.
Despite having a significant difference, both perimenopause and premenopause are treated the same by doctors. Intake of hormones and improvement of diet can decrease the symptoms of perimenopause, making the process slightly easier.
Disclaimer: This article is only a guide. It does not substitute the advice given by your own healthcare professional. Before making any health-related decision, consult your healthcare professional.
Editorial References And Fact-Checking
Editorial References And Fact-Checking
- Santoro N. (2016). Perimenopause: From Research to Practice. Journal of women’s health (2002), 25(4), 332–339. https://doi.org/10.1089/jwh.2015.5556
- Freeman, E. W., Sammel, M. D., & Sanders, R. J. (2014). Risk of long-term hot flashes after natural menopause: evidence from the Penn Ovarian Aging Study cohort. Menopause (New York, N.Y.), 21(9), 924–932. https://doi.org/10.1097/GME.0000000000000196
- Paciuc J. (2020). Hormone Therapy in Menopause. Advances in experimental medicine and biology, 1242, 89–120. https://doi.org/10.1007/978-3-030-38474-6_6
- Barnabei, V. M., Grady, D., Stovall, D. W., Cauley, J. A., Lin, F., Stuenkel, C. A., Stefanick, M. L., & Pickar, J. H. (2002). Menopausal symptoms in older women and the effects of treatment with hormone therapy. Obstetrics and gynecology, 100(6), 1209–1218. https://doi.org/10.1016/s0029-7844(02)02369-4