Stages of Menopause: What Are the Symptoms of Premenopause?

The most commonly asked question among menopausal people, aside from “How can I rock my sex life during midlife?” is: “How do I know when I’m in menopause?” Because it’s common for people to confuse the stages of menopause, we’re here to break it down for you, starting with a little myth-busting about the symptoms of premenopause. 

What Are the Symptoms of Premenopause?

So, what are premenopause signs? Let’s bust some myths right off the top. Myth Buster #1: Premenopause isn’t an official stage of menopause. Myth Buster #2: There are no symptoms of premenopause as it relates to menopause. Mind-blowing, right?! As this article from Healthline states, “Premenopause and perimenopause are sometimes used interchangeably, but technically they have different meanings. Premenopause is when you have no symptoms of perimenopause or menopause.” So, why is it used? Let’s take a little dive into the wonderful world of menopausal lingo, which consequently, will help you know when you’ve embarked on your menopausal journey, and as a bonus prize, will get you learning a bit more about your libido.

symptoms of premenopause

What’s the Difference Between Premenopause and Perimenopause? 

How do premenopause and perimenopause differ? Premenopause is the span of time from puberty (onset of menstrual periods) to perimenopause. Perimenopause, on other hand, is when your body starts to go on the magical menopausal journey. Well, not “magical,” so much as “biological,” but biology is pretty mesmerizing, yeah?


The super-smart peeps over at Very Well Health stated that “Premenopause takes place before perimenopause, which leads up to menopause. More specifically, it’s the time between a person’s first period and the onset of perimenopause. Premenopause is not a medically accepted term.” They continue on, “Premenopause is generally not accompanied by symptoms. If you’re not sure you have reached perimenopause but suspect so, contact your doctor to discuss symptoms and seek a diagnosis to rule out other potential causes for your symptoms.”

During premenopause, you still have periods—whether regular or irregular depending on how they’ve been your whole life—and you are still powering through your reproductive years. Think of it as adult PMS (AKA something you’ve been most likely dealing with your whole adult life). Premenstrual syndrome (PMS) is a combination of symptoms that many women get about a week or two before their period. Most women say they get some premenstrual symptoms such as bloating, headaches, and moodiness.

Premenopause is simply the time when you’re still having periods and are fertile before your estrogen (or, spoiler alert: lack thereof) decides to throw you a curveball.


This is when the menopausal fun actually begins—the very first stop on The Big M Express. Your body is about to embark on an epic journey in three parts. Let’s break down The Big Three:

  1. Perimenopause — It’s starting to happen! Your body enters the menopause transition. 
  2. Menopause — It’s happening! You go 12 consecutive months without menstrual cycles. 
  3. Postmenopause — It happened! Your menopausal symptoms begin to subside (typically 24 to 36 months after your last period). C’est bon! 

Although millions of people experience menopause at the same time, no two people experience it the same way, including the age of onset. The average age of onset is 51, but you may notice perimenopausal symptoms as early as your 40s. To complicate things further, some women notice changes as early as their mid-30s. I guess the phrase “around menopause” is pretty accurate, if “around” includes a whopping 20-year spread! 

What Are Perimenopause Symptoms?

So, what are the signs of perimenopause? Now that you know that there are no symptoms of premenopause, you’re probably wondering what the symptoms of perimenopause are. Perimenopause occurs well before you officially hit menopause. During this stage, estrogen and progesterone levels—which are the main female hormones produced by the ovaries— in your body will rise and fall. As an added bit of drama, they will fall … unevenly. Think of it as a lava lamp from the good ‘ole days: The ominous bubble in the lamp rises and falls as big and small blobs. You never know if the blob is going to be huge (increase in estrogen) or small (decrease in estrogen). What you do know is it will be relaxing exciting!

Below are some of the most common perimenopause symptoms.

Irregular Menstrual Cycles

As ovulation becomes more unpredictable, the length of time between periods may be longer or shorter, your flow might be heavier or lighter, and you might even skip periods. If you have a space of 60 days or more between periods, then you’re most likely going through perimenopause. 

Hot Flashes

Your body may experience mild or intense hot flashes. The frequency of these hot flashes varies, but the average duration is from 30 seconds-10 minutes. I know! That “average” has a pretty wide gap. If nothing else, perimenopause will keep you on your toes. And hopefully, those toes are parked in a bucket of ice to help cool you and your hot flashes down.

Sleep Issues

If you thought hot flashes were fun during the day, then you’ll LOVE them at night. Night sweats, among other menopausal symptoms, may give you trouble when it comes to sleep. I’m talking about falling or staying asleep, waking up early, getting less sleep overall, and experiencing fatigue during the day. But who wouldn’t experience daytime fatigue when they spent the night feeling like a heating pad that was busy being plugged in/unplugged in 30 second-five minute increments?

Mood Changes

Hellooooo hormones! Do you remember that song you learned in middle school to help you remember the names of all the US States? I’m thinking of writing one for all the mood-based symptoms of perimenopause. Sing it with me: Irritability, mood swings, increased risk of depression, and anxiety, plus lack of motivation! They can all happen, due to your changing volume of estrogen, progesterone, and testosterone. So, get ready to jump on the hormone roller coaster and go for the ride of your life. 

Vaginal Dryness and Urinary Incontinence

According to the Mayo Clinic, “When estrogen levels diminish, your vaginal tissue may lose lubrication and elasticity, making intercourse painful. Low estrogen may also leave you more vulnerable to urinary or vaginal infections. Loss of tissue tone may contribute to urinary incontinence.” Perhaps the sexiest of symptoms, no? That last speculation is according to me, not the Mayo Clinic. (That last speculation is also totally sarcastic.)

Bone Loss 

Perimenopausal Madams, heed my advice: Protect. Your. Bones! Your declining estrogen levels make it so that you lose bone more quickly than you replace it. This means your bones become more fragile, increasing your risk of osteoporosis. I hope you find calcium calci-yum.

Sexual Health

As David Bowie sang, 🎵Ch-ch-ch-changes🎵! With everything your body is going through and/or preparing to go through, you might realize a difference in your sexual arousal and desires, including a decreased sex drive. Even though you must “turn and face the strange,” that “strange” is totally an NBP! 

I want to be super clear, so I’m saying it again: Every person’s menopausal journey is different. Think of it as a road trip. You have some families who stop at every single attraction, get gas when the tank is 50% empty, and check out every hole-in-the-wall diner along the way to find the best burger joint. Other families are a pedal to the metal kind and don’t stop for anything but gas (with a tank that is toeing the empty line). Each journey is different, with a potential for surprises. And guess what? That’s totally OK. We’re all going to get to the final destination (postmenopause) at some point. Just like the race to kiss your first boy at summer camp, Some might get there earlier than others. Whatever you do, just make sure you try to enjoy the journey as much as possible.

How Can I Treat Perimenopause Symptoms?

During menopause (the Big Three stages), your entire body—both the physical you and emotional you—will feel the impact. So how can you manage menopause and the ways it may (or may not) impact your life? Whether you choose the self-informed healthcare route, see a naturopath or holistic doctor, or visit with your OBGYN or other physician, taking advantage of the many available menopause treatments is critical to enjoying (and let’s be honest, simply surviving) the journey. I compiled a list of ways to treat the most common symptoms to help you arrive at your final destination in one comfortable piece.

How Will I Know When I’ve Hit Menopause?

So, you had no symptoms of premenopause (because premenopause doesn’t have menopausal symptoms). You battled through perimenopause like the warrior that you are. What’s next? The Big M: Menopause. How do you know when you’ve reached this magical land? According to Healthline, “menopause occurs when a woman hasn’t menstruated in 12 consecutive months and can no longer become pregnant naturally. It usually begins between the ages of 45 and 55, but can develop before or after this age range.”

In non-medical speak: The Big M Has Begun.

What Are Changes I Can Expect During the Menopausal Transition?

You will most likely undergo quite a few changes during the menopausal transition. Your body is going through a big milestone, so what else would you expect? To help you better understand the various changes, I thought I would share some info and tips to help you navigate your way on this road trip:

Yes, your body will be going through some pretty massive changes. And, guess what? That’s totally normal. So normal, we call it an NBP. Give yourself some grace; you and your ovaries deserve it.

It’s a Wrap!

To be blunt, you won’t experience any menopause-related symptoms during premenopause. Why? Because it’s a phase when you’re still having regular periods and you’re still going through your reproductive years. So, the only health effects you’ll experience will be those related to your menstrual cycles.

In fact, there’s generally nothing to worry about in terms of menopause during premenopause because it’s “before Menopause.” If you’re an English teacher, or the child of an English teacher, you already knew what the prefix “pre” meant. Symptoms such as hot flashes, irregular periods, weight gain, and insomnia only start popping up after you enter perimenopause.

So, go on with your bad self and enjoy the fun years of premenopause while staying educated on what happens during the menopausal transition. By reading this, you’ve already begun! Congrats, you’re one smart cookie. Speaking of cookies … off to the pantry to see what I can find, yum.



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