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How to Tell the Difference Between Perimenopause and Menopause

Hot flashes, decreased libido, forgetfulness are symptoms of both

Women going through perimenopause or menopause exercising together

Hot flashes, decreased libido, forgetfulness are symptoms of both

Hot flashes, night sweats, insomnia and mood changes are symptoms that affect a lot of women when they reach a certain age.


On average, American women enter menopause around 51. But it can occur as early as your 40s. It’s called perimenopause and it shares many of the classic menopause symptoms, including hot flashes, decreased libido and forgetfulness.


Perimenopause may also manifest in worsening PMS, weight gain and infertility. It’s a little different from menopause, which can be clinically diagnosed after a year without a period.


Tresa Lombardi, MD, an OB-GYN at Scripps Clinic Rancho Bernardo, says the menopausal transition is a spectrum. The years before and after period cessation share many of the same symptoms.


“Menopause is a normal transition that comes with age, but bothersome symptoms that disrupt your daily life can warrant treatment,” Dr. Lombardi says.


While not all perimenopausal or menopausal women will require treatment, it's important to know what to expect and when to seek care.


Women experiencing the symptoms that often accompany declining hormone levels have options to help bring relief.


Learn more about these approaches and check with your doctor for the right one for you.

1. Make lifestyle modifications

  • Lose weight 
  • Exercise 
  • Switch to a plant-based diet 
  • Increase your calcium and vitamin D intake 
  • Avoid spicy foods, alcohol, caffeine and other dietary triggers 
  • Practice mindfulness 
  • Try cognitive behavioral training

2. Take supplements

  • Black cohosh for hot flashes 
  • Vitamin E to reduce inflammation and regulate symptoms 
  • Phytoestrogens, like estroven, to relieve symptoms 
  • Evening primrose oil lessens symptoms

3. Try hormone replacement therapy

  • Systemic estrogen and progesterone (oral, transdermal) 
  • Systemic progesterone (oral, intramuscular) 
  • Vaginal estrogen

4. Try non-hormonal medication

  • Low-dose paroxetine, treats moderate-to-severe menopause symptoms 
  • Gabapentin, an antiepileptic drug, alleviates hot flashes 
  • Alpha agonist clonidine treats hot flashes
Scripps Clinic vice president of primary care and internist Siu Ming Geary, MD. is featured on the cover of the September issue of San Diego Health.

This content appeared in San Diego Health, a publication in partnership between Scripps and San Diego Magazine that celebrates the healthy spirit of San Diego.