Perimenopause vs Menopause: Symptoms, Timing, and What Most Women Get Wrong
If you’re in your late 30s, 40s, or early 50s and feeling “off”, exhausted, anxious, foggy, or unlike yourself, then you might be wondering:
Is this perimenopause… or menopause? And how do I even know the difference?
You’re not alone. And I get this question a lot.
Perimenopause and menopause are often confused, misunderstood, or dismissed — even by healthcare providers. Yet understanding where you are hormonally is the key to getting the right care, at the right time.
Let’s break it down clearly…
What Is Perimenopause?
Perimenopause is the transition leading up to menopause. It can begin as early as your late 30s or early 40s and often lasts several years.
During perimenopause:
Hormones (especially estrogen and progesterone) fluctuate unpredictably
Ovulation becomes irregular
Symptoms can come and go, sometimes dramatically
Many women are told, “Your labs are normal” or “You’re too young for menopause” during this phase, which is one of the most common (and frustrating) misconceptions.
Common Perimenopause Symptoms
Perimenopause symptoms are often subtle at first, then progressively disruptive:
Irregular or heavier periods
Fatigue or low energy
Anxiety or mood changes
Brain fog or memory issues
Sleep disturbances
PMS worsening
Weight changes (especially midsection)
Decreased stress tolerance
Lower libido
IMPORTANT: You can still be getting periods and be in perimenopause.
What Is Menopause?
Menopause is a diagnosis, not a phase.
You are considered officially menopausal when you’ve gone 12 consecutive months without a menstrual period, with no other medical cause.
The average age of menopause is around 51, but it can happen earlier or later.
At menopause:
Ovaries significantly reduce estrogen production
Hormone levels are consistently low (rather than fluctuating)
Symptoms may stabilize or worsen if left untreated
Common Menopause Symptoms
Hot flashes or night sweats
Vaginal dryness or discomfort
Sleep disruption
Mood changes
Joint pain
Brain fog
Changes in skin, hair, or metabolism
Perimenopause vs Menopause:
Key Differences at a Glance
PERIMENOPAUSE
Hormones fluctuate
Periods are irregular
Can last years
Often misdiagnosed
Symptoms vary month to month
MENOPAUSE
Hormones remain consistently low
Periods have stopped for 12+ months
A defined point in time
Often diagnosed too late
Symptoms may feel more constant
What Most Women Get Wrong
…and Why It Matters
✖️ Myth #1: “If I’m still getting my period, it’s not hormonal”
False. Many women in perimenopause still have regular cycles, especially early on.
✖️ Myth #2: “Hormone tests will always tell me where I am”
Hormone levels fluctuate daily in perimenopause. A single blood test can look “normal” even when symptoms are real.
✖️ Myth #3: “I should just wait it out”
Waiting often leads to years of unnecessary suffering, misdiagnosis, or being prescribed treatments that don’t address the root cause.
✖️ Myth #4: “Menopause care = hormones only”
Thoughtful menopause care is individualized and may include lifestyle support, supplements, targeted therapies, and, when appropriate, hormone therapy.
How a Menopause Specialist Approaches This Differently
Perimenopause and menopause are clinical diagnoses, not just lab results.
A menopause specialist looks at:
→ Your symptoms
→ Your cycle history
→ Your age and life stage
→ Your health goals
→ Your risk factors
This context-driven approach is what allows women to finally feel seen, heard, and properly supported.
When Should You Make an Appointment?
Consider booking a consultation if:
You feel dismissed or unheard
Symptoms are affecting your quality of life
You’re unsure whether you’re in perimenopause or menopause
You want proactive, preventive care — not just symptom management
You don’t need to “wait until it gets worse” to deserve care.
About Dr. Jila Senemar
Dr. Jila Senemar is a board-certified OB-GYN and menopause specialist with a focused, compassionate approach to midlife women’s health. She provides personalized, evidence-based care for women navigating perimenopause, menopause, and beyond.
Her practice is designed for women who want:
Answers — not dismissal
Time — not rushed appointments
Thoughtful, individualized treatment plans
Join the JilaMD Waitlist
If you’re ready to better understand your body and explore personalized menopause care, we invite you to join the JilaMD waitlist.
Spots are limited to ensure each patient receives the level of care they deserve.
