It is common to mistake perimenopause for menopause and vice versa. Labs can be misleading. Doctors can be misleading in your concerns about whether you are in perimenopause vs. menopause. Even symptoms can be misleading. In this article, I am going to explain the differences between perimenopause and menopause. As well as information to help you determine which hormone phase you are in at the moment.
Both perimenopause and menopause can start between 35 to 50years old. As the word states, perimenopause starts before menopause. While that might seem obvious, sometimes it is hard to differentiate between them. I have had many patients tell me they are in menopause but are really in perimenopause. You might be asking, ‘why is it a big deal to know the difference?’. That can come down to the treatment. Treating a woman for menopausal symptoms when she is in perimenopause can not only be ineffective. But can make the symptoms worse as well as new symptoms.
Perimenopause usually starts in the mid-’40s, but I have seen it as early as the early ’30s. The average age of menopause is 51 years old, but I have often seen it occur in the mid-’40s. So while it seems that perimenopause and menopause can overlap, there are distinctions in the symptoms.
Some distinctions between perimenopause and menopause: I will try to be as comprehensive as possible. Here are the most common differences in symptomatology between perimenopause and menopause.
In perimenopause, if you still have your uterus, then you will be having a period. The periods can change from your “normal.” But you will still be having a regular period. What you might notice are periods might be heavier, longer, more spotting, more cramping. Often this can lead to low-iron/anemia.
This is the time that women find out that they have fibroid(s). Fibroids are benign growths in the uterus and during perimenopause can become “active,” causing cramping, heavier periods and more spotting. This is usually the time women will get a hysterectomy. The periods are so “off” that most doctors only recommend a hysterectomy. Now that might correct the period “issues.” But it does nothing for the other symptoms.
In menopause, the periods become less frequent. Might miss one or many months at a time. The period that you do have can come at any time. They might be light one month and then four months later a heavy, painful period.
In menopause, you will have lots of hot flashes and night sweats. But the distinction here is, in perimenopause you don’t have daytime hot flashes. But you will have night sweats, really bad night sweats. The night sweats in perimenopause usually happen anywhere from 7 to 10 days before your period. But once you get your period, the night sweats go away.
In perimenopause, you are much more irritable than in menopause. That is one of the most common complaints in perimenopause. Short-fuse, low tolerance, very little patience for even minor offenses. The impatience and overwhelmed wound up feeling is not seen as much in menopause as it is in perimenopause.
In menopause, vaginal dryness and pain with intercourse is very common. But in both perimenopause and menopause, the sex drive can dive as well. But you do not see the vaginal dryness or pain with intercourse in perimenopause.
It is common in both perimenopause and menopause to gain weight.
Perimenopause cannot stay asleep
What happens if you have had a hysterectomy and still have your ovaries and really cannot determine if you are in peri or menopause?
Labs can be very helpful in determining your hormonal status. But there is a lot of issues with interpreting the lab results. I have had many patients that have claimed that their doctor told them they were in menopause based on their labs, but they were not.
For example, a patient I recently saw, Kim told me that her doctor said she was in menopause 5 years ago. But she had regular periods, and on her labs, there was estrogen present in her blood without taking it as a medication. She felt tired, forgetful, super irritable, terrible periods, and could not sleep through an entire night. Not to mention Kim went from a size 7 to 12 without much change in her diet and exercise routine. After speaking with Kim and looking over her lab work, she was definitely not in menopause.
Kim was dealing with symptoms of perimenopause. But the lab work can be misleading on how you interpret it. While her doctor tried to treat her for menopause with estrogen. Kim took estrogen and immediately gained 10 lbs and started bleeding nonstop. This is because the treatment for menopause to 180degree different from perimenopause.
Perimenopause has many symptoms. You do not need to “just deal with it,” “wait it out for menopause” or take medications that are ineffective and habit forming. Be sure to check out our website because we have a perimenopause course to help you navigate through perimenopause with effective options to help with your symptoms.
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In this episode, we discuss the best way to reduce triglycerides. Sasha, a podcast listener, asked us how to lower her triglycerides. We then go into depth about triglycerides, how to lower them, and why they could be high in the first place.
How to read a lipid panel
Supplements for lowering triglycerides
Lifestyle changes for lowering triglycerides
What do high triglycerides mean?
Building blocks for triglycerides
Improving metabolic health
Can menopause increase triglycerides?
High triglycerides and thyroid hormones
Sacha’s Question:”I know this isn’t a hormone question but was hoping you could give me some direction. I was wondering what is the best way to lower triglycerides? thank you for your help!”
If you have a question, please visit our website and click Ask the Doctor a question.
Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns youmay have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.
In this episode, we discuss a podcast listener’s question. ‘Alesha’ is concerned that she should not take estrogen replacement therapy because she has fibroids. This is a common concern. The idea that estrogen can cause or propagate fibroids has left many menopausal women without support for their symptoms. Just because women have or have had a history of fibroids does not mean they are not a candidate for estrogentherapy. In fact, women with fibroid can take estrogen hormone replacement therapy.
In this episode, we go into depth about taking estrogen with fibroids. And we break Alesha’s question into:
What are fibroids?
Fibroids and estrogen replacement therapy
Can I take estrogen if I have fibroids?
What is adenomyosis?
Estrogen’s role in fibroids
Difference between perimenopause and menopause
How menopause can affect prediabetes
Alesha’s Question:
“Is there any hope for someone with adenomyosis take estrogen? If so, when is the right time? I know adenomyosis is stimulated by estrogen. I even had 1 dr offer a hysterectomy so I could take estrogen without any issues ??!! I have a history of heavy periods have had many trans vag ultrasounds and biopsy’s over the years Uterus was enlarged, lining was wnl. Had a hysterscopy to remove some cysts they found 4 hrs ago. Last ultrasound showed probable adenomyosis.i am almost 57and I am in late perimenopause. Cycles have been erratic just went 6 months without a cycle then had a normal cycle…for years of perimenopause I had symptoms of high estrogen. Most of the time for the last year I had symptoms of low estrogen. Poor sleep waking up 4-5x night, dry skin, vaginal dryness, night sweats, brain fog, difficulty concentrating which makes my job very difficult. I have also developed mild sleep apnea(sleep lab) and after my last physical I am on the edge of pre diabetes. ( am normal weight, I walk daily and lift weights, eat high protein diet with lots of veggies and healthy fats.) I am currently taking a progesterone troche( 1/4 lozenge 50mg 2x day) and vaginal estrogen. I was taking an oral progesterone 300 mg thought it would help with sleep but didn’t. The progesterone has helped with GI issues, puffiness, bloating, cramping and anxiety.”
If you have a question, please visit our website and click Ask the Doctor a question.
Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.
In this episode, we talk about POI (primary/premature ovarian insufficiency) and earlymenopause. Samantha sent in a question about whether she is in menopause or hasPOI at the age of 36.We break Samantha’s question into:- What is POI (Premature/Primary ovarian insufficiency)?- Taking estradiol during perimenopause- Difference between perimenopause and menopause- What is an FSH?- Insulin resistance and perimenopauseSamantha’s Question:I am 36 and have been slowly noticing perimenopause/low estrogen symptoms for thepast year and a half. I went to an online provider and started HRT and haveexperienced so much relief! From mental symptoms to night sweats to dryness(everywhere) I have started to feel so much better being on estradiol and progesteronefor 3 months. I have been working with a functional nutritionist on my diet, walking daily,etc.i had gestational diabetes for all 3 pregnancies and also got my tubes removed lastyear. After I came off the birth control all of my symptoms started! I recently saw mynormal OBGYN so I could get my HRT through insurance and he agreed- but made itclear this isn’t menopause, could be POI, but seemed skeptical. I got bloodwork doneand my FSH has risen in the past few months from a 3.7 to an 8. But it’s still considerednormal. All of my thyroid and other bloodwork also comes back normal. Is POI apossible diagnosis? I feel crazy!!If you have a question, please visit our website and click Ask the Doctor a question.
Disclaimer: All content in this blog, including text, images, audio, video, or other formats,was created for informational purposes only. This video, website, and blog aim topromote consumer/public understanding and general knowledge of various healthtopics. This content is not a substitute for professional medical advice, diagnosis, ortreatment. Please consult your healthcare provider with any questions or concerns youmay have regarding your condition before undertaking a new healthcare regimen.
Never disregard professional medical advice or delay seeking it because of somethingyou have read on this website. If your healthcare provider is not interested indiscussing your health concerns regarding this topic, then it is time to find a new doctor.
Can you be in both in perimenopause and menopause? Can you be menopausal andperimenopausal at the same time? The difference between perimenopause andmenopause is not a line in the sand. It is not like crossing through the Peace Arch fromBlaine Washington to the country of Canada. And at times, there is nothing peacefulabout perimenopause or menopause.There is a gray area where you are just moving out of perimenopause and intomenopause, where you are not quite in perimenopause but are not completely inmenopause. We delve deeper into the place that is between perimenopause andmenopause:- What is the difference between perimenopause and menopause?- Can you be both in perimenopause and menopause?- The difference between perimenopause and menopause- What it feels like to go from perimenopause to menopause- Can you take estrogen or biest when you are going from perimenopause tomenopause?- Is bleeding in menopause considered perimenopause?- Top symptoms of perimenopause- Top symptoms of menopause- Are you a candidate for estrogen replacement in perimenopause?If you have a question, please visit our website and click Ask the Doctor a question.Disclaimer: All content in this blog, including text, images, audio, video, or other formats,was created for informational purposes only. This video, website, and blog aim topromote consumer/public understanding and general knowledge of various healthtopics. This content is not a substitute for professional medical advice, diagnosis, ortreatment. Please consult your healthcare provider with any questions or concerns youmay have regarding your condition before undertaking a new healthcare regimen.Never disregard professional medical advice or delay seeking it because of somethingyou have read on this website. If your healthcare provider is not interested indiscussing your health concerns regarding this topic, then it is time to find a new doctor.
In this episode, we discuss a listener’s question about how to apply estriol to your face. ‘Connie’ is confused about whether she can use her Biest cream on her face. And she wanted to know the difference between estriol and Biest when it comes to treating menopausal symptoms.
We analyze Connie’s question into:
Applying estriol to the face
What is biest?
What is estriol?
What is the difference between estriol and biest?
Applying estriol vaginally
It is not a good idea to apply biest to vaginal tissues if you have a uterus
Connie’s Question:
“HI there, I loved your article on estriol for the face. I was prescribed an 80-20 bi-est cream for HRT. My question is, how is that different from a 0.3 estriol cream for the face like the kind My Alloy makes? Could I just use more of my Biest cream on my face? Would that be stronger than the My alloy 0.3 estriol cream? Lastly, the .3 estriol cream is not supposed to affect your overall hormone levels, but the Bi-est cream is supposed to affect your hormones and relieve symptoms of menopause. Why does one estriol work differently than the other? Thank you so much for any guidance you may be able to offer. It’s so hard figuring all of this out!”
If you have a question, please visit our website and click Ask the Doctor a question.
Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.
In this episode we talk about where to apply hormone creams. Sadie, our listener wants to know if she needs to rotate the application sites of her hormone cream.
In this episode we discuss:
Where to apply biest cream
What to apply testosterone cream for females
Places you should not apply your testosterone cream
Best absorption sites for hormone creams
Sadie’s Question:”I have been using hormones for a little over a year. I swear by them!! I have not rotated sites at all. I use testosterone/DHEA cream behind both of my knees and E3/E2 on both of my inner thighs every morning. I take a progesterone capsule at bedtime. My doctor and everything I read says to rotate sites. I found an article by Dr. Collins and now I found your article about not having to rotate sites, so I am going to keep doing what I have been. I put the cream on both of the backs of my legs and thighs. My question is should I alternate one back of knee and then the other and the same with the inner thighs or does it matter?
If you have a question, please visit our website and click Ask the Doctor a question.
Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.