Menopause is a natural transition that every woman goes through, yet understanding exactly where you are in this journey—whether it’s premenopause, perimenopause, or postmenopause—can be surprisingly complex. According to a recent research survey for Doctor’s Best, three in five women (60 percent) are entirely self-taught on menopause, with many feeling there’s more information on pregnancy than menopause. While many of us admit to knowing very little, each stage brings unique hormonal shifts and symptoms and knowing how to manage them can make a real difference. Here, experts break down each phase and share tips to help you support your body and mind along the way.
Featured Experts
- Dr. Tara Scott is a board-certified OBGYN and Versalie menopause expert in Akron, OH
- Dr. Molly McBride is a board-certified OBGYN in New York
What Is the Difference Between Pre- and Peri- Menopause?
Premenopause is the time when you are still in your reproductive years, experiencing regular menstrual cycles without significant hormonal fluctuations due to aging. “Premenopause is a general description of your reproductive years before any hormone shifts caused by aging,” explains Akron, OH OBGYN Tara Scott, MD of Versalie, a menopause support site. Some hormonal imbalances can still occur during premenopause, but they’re often unrelated to menopause and could be due to conditions like PCOS or insulin resistance.
In contrast, perimenopause is the transitional period leading up to menopause, often beginning in your 40s but sometimes as early as your mid-30s. “Perimenopause is the most challenging time because of the inconsistent hormone fluctuations that cause a wide range of symptoms,” says New York OBGYn Molly McBride, MD. Symptoms can range from irregular periods to mood changes, hot flashes and even sleep issues. Hormone levels begin to rise and fall unpredictably, creating a complex landscape of symptoms that may come and go.
How Do I Know If I’m in Perimenopause?
Knowing you’re in perimenopause can be tricky because symptoms often appear gradually and are easily mistaken for other conditions or just life stress. According to Dr. Scott, one key indicator is an irregular menstrual cycle that extends by a week or more. “Perimenopause can last over a decade and symptoms are typically more intense than those experienced during menopause,” she explains. These fluctuations can lead to severe hot flashes, mood swings, brain fog and even increased anxiety or depression.
Perimenopause’s impact on mental well-being shouldn’t be underestimated, says Dr. McBride. “Women in perimenopause are at an increased risk for anxiety and depression,” she notes, adding that perimenopause is a complex transition that requires an individualized treatment approach. If you notice sudden mood changes, brain fog or other symptoms that feel unusual, a healthcare provider can help you determine if perimenopause might be the cause.
What’s the Difference Between Pre- and Post-Menopause?
You know you’re in menopause because it marks the end of your menstrual cycles, officially occurring after 12 consecutive months without a period, usually in your late 40s or 50s. At this point, your body’s production of estrogen and other reproductive hormones declines significantly. “Menopause brings about a notable decline in ovarian function, which means a decrease in estrogen production,” says Dr. McBride. Symptoms like those in perimenopause—like hot flashes, night sweats and sleep disturbances—may persist but tend to be less intense.
Once menopause is complete, you enter postmenopause. During this stage, maintaining bone health and muscle mass becomes crucial as estrogen levels remain low. Dr. Scott recommends focusing on strength training and a protein-rich diet in postmenopause to support muscle and bone health, saying, “Weight training can be especially beneficial in maintaining strength and mitigating bone density loss.”
What Not to Do During Perimenopause
While it’s tempting to stick to your usual habits, perimenopause requires adjustments to support your changing body. Dr. Scott advises prioritizing a balanced diet, exercise and sleep, as these can significantly improve quality of life. “Limit alcohol, sugar and processed foods, as they can worsen bloating and mood swings,” she suggests.
Maintaining a healthy routine can help reduce perimenopausal symptoms and keep energy levels stable. Sleep, often disrupted during perimenopause, is another area to address. “Good sleep hygiene is essential,” says Dr. McBride. She recommends establishing a nighttime routine and avoiding caffeine and screens before bed. It’s also wise to consult a healthcare provider if sleep issues persist, as various therapies and treatments can help.
Hormone Replacement Therapy (HRT) may also be an option for those struggling with severe symptoms, though it’s essential to work with a knowledgeable doctor to assess risks and benefits. “The most effective treatment for perimenopause and menopause is Hormone Replacement Therapy if not contraindicated,” Dr. McBride notes. For women who cannot take estrogen, non-hormonal options are available.
Preparing for the Transition
Going from perimenopause into menopause can be daunting, both physically and emotionally. Dr. Scott encourages developing a strong support system of friends and family to help navigate the challenges of this stage. “Having a support system around you is incredibly helpful,” she says. Education is also key; familiarizing yourself with symptoms and discussing them with your doctor can help you feel more prepared and empowered. “For medical support, I recommend Versalie Care, where individuals can book one-on-one, secure virtual care visits with menopause-trained clinicians to discuss their symptoms, hormonal and non-hormonal prescription options and everyday care considerations to find the best solutions for their journey.”
A balanced diet rich in protein, vegetables and essential vitamins, like Vitamin D and magnesium, is also vital. “Eating more protein is important as you lose muscle mass with age,” says Dr. McBride. Building strength and maintaining muscle health can improve physical and emotional resilience as your body adapts to all the changes.
With these adjustments, you can navigate the different stages of menopause with a little more clarity. The key is to listen to your body and find the right resources to make this natural transition less mysterious. “Find a doctor who will listen,” adds Dr. McBride. “Be prepared with a list of questions for your doctor and ask for options for treatment. These days, you don’t have to suffer.”
