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How to Tell the Difference Between Perimenopause and Menopause

| Women’s Health

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, but 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 obstetrician and gynecologist (OB-GYN) with Scripps Clinic 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.”


Although not all perimenopausal or menopausal women will require treatment, there are tips for women experiencing the symptoms that often accompany declining hormone levels.

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

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

Try hormone replacement therapy

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

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.