PMS and Perimenopause: What You Should Know
How Are PMS and Perimenopause Symptoms Different?
Women who have experienced PMS throughout their teens, 20’s and 30’s may be surprised to discover that the uncomfortable symptoms they have been coping with for years are suddenly no longer due to PMS, but are signs of perimenopause. That’s because many of the symptoms of perimenopause – backaches, breast tenderness, irritability, mood swings, bloating, brain fog and decreased libido — echo those of PMS.
However, PMS and perimenopause are different. According to Diana Hoppe, M.D., a gynecologist at Scripps Memorial Hospital Encinitas, women can usually predict when they will get their periods based on their menstrual cycles. Perimenopause, on the other hand, is linked to hormones and not a typical 28-day cycle. As a result, it can be annoyingly erratic.
Another difference is when the cycles of PMS and perimenopause begin. Most young women get their first period between the ages of 11 and 13, but the range can extend from as young as nine, to 16. It’s at this time that PMS symptoms can begin. According to the American College of Obstetricians and Gynecologists, 85 percent of women experience at least one PMS symptom per month. In the case of teenagers, many experience mood swings, irritability and anxiety, which is often attributed to changing hormones and their stage of emotional and physical development. However, mood swings and feeling down may stem from PMS. Many women in their 20’s, 30’s and early 40’s may also feel they are on an emotional rollercoaster right before their periods begin.
Whereas PMS starts at a young age, perimenopause begins later in life. According to the Mayo Clinic, perimenopause, which means “around menopause,” refers to the stage in a women’s life when she naturally transitions to menopause, marking the end of reproductive years. It typically occurs between the ages of 45 and 55.
Since the symptoms of PMS and perimenopause are similar, how can you tell which stage you are in? Let’s compare:
- Emotional symptoms. Irritability, anger and mood swings are common PMS and perimenopause symptoms. These emotional ups and downs usually begin a week or two before your period begins and then subside a day or two afterwards. In contrast, mood swings can happen at any time during perimenopause. Nearly 40 percent of women have mood swings during perimenopause, which can include anger, depression and anxiety.
- Irregular menstrual cycles. Although women typically get their period every 28 days, everyone’s body is different. More than thirty percent of women experience irregular periods, says Amy Autry, MD, a clinical professor of obstetrics-gynecology and reproductive sciences at the University of California, San Francisco. Sometimes this is due to a hormonal imbalance or other factors, such as extreme dieting or exercise, stress or illness.
Most women continue to get their periods during perimenopause, but their cycles may become inconsistent. In some cases, your period, which averaged between five to seven days, now only lasts two to three days. You may get your period again in two to three weeks, instead of following your usual 28-day pattern. You may even miss your period for a month or two, and then have it return on a more regular schedule. The bottom line is that it can be very unpredictable, and that goes for timing, as well as the heaviness of your blood flow.
For those women who already have irregular cycles, keeping track can be important in telling the difference between PMS and perimenopause. There’s no perfect science in telling the difference, but your body can change “how” it is irregular. Keeping a log can help you track your cycle.
- Heavy bleeding. Some women bleed more than others during their period. During perimenopause, some experience a dramatic increase in menstrual blood. Aside from being inconvenient, heavy bleeding can lead to anemia. Women with anemia may suffer from light-headedness, shortness of breath, chest pains, fast or irregular heartbeats, headaches, and a pale complexion. It’s important to see your doctor if you experience abnormally heavy bleeding.
- Hot flashes and night sweats. Although it’s possible to have hot flashes as a PMS symptom, they are most often associated with women experiencing perimenopause. The first few times you experience a hot flash you may simply think that the heat in your room is too high, you’re coming down with a fever, or your blood pressure may have skyrocketed. Suddenly, you go from feeling fine to feeling like you’re on fire. Beads of sweat may appear, and your face may become flushed. When it passes, you may feel a cold chill. It’s not clear why hot flashes occur during perimenopause, but it may be related to circulation. The good news is that hot flashes usually become less frequent with time.
- Brain fog. This symptom can occur before your period, a time during which your hormones are fluctuating, or during perimenopause. There does not seem to be much difference between women with PMS and those with perimenopause who experience brain fog. It’s equally frustrating for both! Fortunately, once a woman gets her period, the brain fog seems to clear.
Although many of these changes are a normal part of life, there are safe and effective non-hormonal supplements that can help to minimize symptoms such as irritability and mood swings. Be sure to talk to your doctor first to determine the best steps for you.