Menopause or Pregnancy? How to Tell What’s Happening

This article was medically reviewed by Dr. Navya Mysore and updated on June 18, 2024

When you reach a certain age (throughout your 40s), your body gradually winds down its reproductive years and prepares to enter perimenopause. 

Menopause is the end of that transition—when you’ve gone 12 months without a period and are no longer ovulating, which means you are no longer able to get pregnant.

However, during perimenopause, you are still ovulating, and you can become pregnant. And because ovulation starts to become more erratic (often resulting in missed periods or an irregular cycle), it is possible to confuse perimenopause and pregnancy—and it is possible to become pregnant when you are in perimenopause.

Menopause Versus Perimenopause: Can You Get Pregnant During These Stages?

The terms ‘perimenopause’ and ‘menopause’ have distinct medical meanings. Perimenopause means ‘around menopause’ and describes the years leading up to menopause. This is a time of transition. Fluctuating hormone levels lead to a wide array of symptoms, which can impact women with varying degrees of severity.

As previously mentioned, menopause is the end of that transition stage. By menopause, you are no longer ovulating and have gone a full 12 months without a period. While the symptoms of perimenopause can continue for some women even when they’re in menopause, generally, those erratic hormonal fluctuations and their associated symptoms ease.

Symptoms of Perimenopause vs Pregnancy Symptoms

There are many common symptoms between perimenopause and pregnancy. 

Changes in your menstrual cycle can happen for various reasons, including pregnancy, perimenopause, or other health issues. Therefore, it's always worth investigating if you miss a period.

In your 40s, missed periods may be due to perimenopause. So, how do you distinguish between pregnancy, perimenopause, or other conditions? 

The Easy Answer: Take a Pregnancy Test

Apart from seeing your doctor, you can buy an at-home pregnancy test at any pharmacy. If you’re not sure whether you’re pregnant or if there’s something else going on (e.g. perimenopause), a pregnancy test will help clear things up.

The Better Answer: See Your Doctor

If you suspect you could be pregnant, it’s always worth a trip to the doctor. A doctor can confirm your pregnancy through a blood test or urine test. If you are pregnant, they will also provide you with important prenatal care information.

Additionally, a doctor can check for any underlying health conditions that may affect your pregnancy and provide guidance on how to manage them. It's important to seek medical care early in pregnancy to ensure the best possible outcome for both you and your baby.

Symptoms Common to Both Pregnancy and Perimenopause

There’s a huge overlap between pregnancy symptoms and perimenopause or menopause symptoms. Symptoms that are common to both include:

• Missed (or late) menstrual periods
• Bloating
• Changes to libido
• Fatigue and poor sleep
• Headaches
• Mood changes
• Weight gain

Unique Pregnancy Symptoms

While the two are easily confused because they share such a long list of similar symptoms, there are also some symptoms that are considered unique to pregnancy:

Food and Taste Sensitivity

When you’re pregnant your taste buds can change. Foods that were previously your favorites might become repugnant to you. You might also find yourself craving unusual foods or an unusual combination of foods.

Increased Urination

It is normal to pee more frequently during a healthy pregnancy. This is due to the hormonal changes in the body in early pregnancy (later in pregnancy, it can be caused by the pressure of your uterus on your bladder.) When pregnant, your body also produces more fluid than at other times, which can also lead to frequent urination.

Nausea

So-called “morning sickness” can actually happen at any time of the day within 1 month of getting pregnant. It may or may not be accompanied by vomiting.

Swollen and Sensitive Breasts

Early in your pregnancy, hormonal changes can make your breasts more tender. They may even appear swollen. Breast tenderness usually subsides after a few weeks.

The Most Common Symptoms of Perimenopause

Fluctuating hormones can cause both physical and mental symptoms. There’s quite a range of symptoms perimenopausal women experience, and their severity and duration can vary wildly from person to person. Many women experience these more common menopause symptoms.

Missed or Irregular Periods

During perimenopause, you may notice changes to your menstrual cycles. Some of these changes can be extreme opposites of each other, from lighter periods to heavier periods. This is caused by the extreme fluctuation of your hormone levels. 

Hot Flashes / Night Sweats

Hot flashes are characterized by a sudden feeling of warmth or heat that spreads throughout the body, often accompanied by sweating, rapid heartbeat, and flushing of the skin.

Night sweats are episodes of excessive sweating during the night that can drench the bedding and clothing, leading to discomfort and interrupted sleep.

… And So Many Other Symptoms

There’s still a long list of other menopausal symptoms. 

The list includes:

• Nausea: Fluctuating estrogen levels can result in nausea.
• Weight gain: Sudden changes in weight can also point to perimenopause.
• Vaginal dryness: Vaginal atrophy occurs in some women after menopause. The body produces less estrogen, which can lead to the thinning, drying, and inflammation of the vaginal walls. 
• Changes in sexual desire or satisfaction: Some women report changes in sexual desire and arousal due to fluctuating hormones.
• Insomnia and sleep troubles: Apart from night sweats, sleep can become unpredictable during perimenopause and beyond.
• Mood swings & anxiety: Any fluctuation in hormones can have a knock-on effect on your mood. Many report feeling more anxious during this time.
• Bone loss: With declining estrogen levels, your bone density may decrease as you start to lose bone more quickly than you replace it. For some, this can lead to an increased risk of osteoporosis—a disease that causes fragile bones in women.
• Bladder problems: Low estrogen levels may also make you more vulnerable to urinary incontinence. (Pro-tip: Leakproof underwear can help with light bladder leaks.)
• Memory problems or difficulty concentrating: Memory problems or difficulty concentrating are common symptoms caused by hormonal changes. Other factors like stress, sleep disturbances, and mental health conditions can contribute to these symptoms. 
• Joint and muscle pain: Estrogen plays an important role in maintaining joint and bone health. As estrogen levels decline during perimenopause, women may experience a loss of bone density and joint cartilage, leading to joint pain
• Headaches or migraines: The exact cause of headaches during menopause is not fully understood, but hormonal changes are believed to play a role. Other factors, such as dehydration and lack of sleep, can also trigger headaches during menopause.
• Changes in skin and hair, such as dryness or thinning: As estrogen levels decline during menopause, collagen production decreases, and hair follicles may become less active, leading to thinner, less elastic skin and hair.

If you're experiencing symptoms that are interfering with your daily life, talk to your healthcare provider about your options for managing them. Most of these symptoms will subside in postmenopausal women.

Perimenopause symptoms are numerous. If you are unsure as to what is going on, please see your healthcare provider.

To help you navigate these uncertainties, we’ve devised a little quiz. Check it out here…

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We hope you found this post informative — but remember: we’re not doctors, and this post is not medical advice! While all posts are fact-checked and well-researched, we always recommend you chat with your doctor about any questions or concerns you might have regarding a medical condition. We’re here to support and educate, but never with the aim of disregarding professional medical advice you’ve been given. Phew, now that that’s out of the way, you can go on living unapologetically free.