Menopause or Pregnancy? How to Tell What’s Happening

When you reach a certain age (usually your late 30s and throughout your 40s), you’ll begin to contemplate “the change” or perimenopause. This is when your body gradually winds down its reproductive years and prepares to enter menopause. 

Menopause is the end of that transition—when you’ve gone 12 months without a period and are no longer ovulating or capable of reproducing. Therefore, strictly speaking, it’s not possible to become pregnant when you’re menopausal.

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 things begin to level out, and those erratic hormonal fluctuations (and their associated symptoms) ease.

All this said, sometimes in everyday conversation, menopause and perimenopause are lumped together and both stages are labeled simply “menopause.” This can lead to some confusion about these stages and what’s possible. To make it clear:

• Perimenopause: The stage in a woman's life leading up to menopause when the menstrual cycle gradually winds down. While ovulation is still happening (and therefore pregnancy is still possible), women are generally less fertile during perimenopause and cycles are more erratic. However, missed periods can cause confusion about the possibility of pregnancy. If you do not wish to become pregnant, birth control is recommended.
• Menopause: The moment when you’ve gone 12 full months without a period and are therefore considered to be no longer fertile or ovulating. Pregnancy is no longer possible and birth control is not required (though contraceptives are still recommended for the prevention of STIs).

Symptoms of Perimenopause vs Pregnancy Symptoms

There are many common symptoms between perimenopause and pregnancy. 

Changes in your cycle can indicate various events, including pregnancy, perimenopause or others 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 (which you should do), you can buy an at-home pregnancy test from any pharmacist. If you’re on the fence about 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 information about prenatal care, nutrition, and overall health during pregnancy. 

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 Include Weight Gain , Mood Swings and Missed Periods

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
• Hot flashes and night sweats
• Incontinence
• 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 (i.e. not common with perimenopause.) These pregnancy symptoms include:

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 unusual combinations of foods.

Increased Urination

It is considered normal to pee more frequently during a healthy pregnancy. This is due to the hormonal changes in the body in early pregnancy (later, it can be caused by the pressure of your uterus upon 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 emotional reactions (mood 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 (aka hot flushes) 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 is quite long. The good news is not all perimenopausal women experience these symptoms. And they may be less intense for some. The list includes:

• Nausea: Fluctuating estrogen levels can result in feelings of nausea.
• Weight gain: Sudden changes in weight or digestion can also point to perimenopause.
• Vaginal dryness: Vaginal or endometrial atrophy occurs in some women after menopause. The body produces less estrogen after menopause, 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, general 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 or having sudden flashes of rage.
• 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 or vaginal infections. Loss of tissue strength may contribute to urinary incontinence.
• 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 and muscle 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 stress, lack of sleep, and certain foods or drinks, 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.

The symptoms of perimenopause are numerous. But they can also be easily confused with other things going on in our bodies. This means it can be difficult to say decisively if one is experiencing perimenopause or something else. And the situation can be even more confusing if you’re typically prone to an irregular menstrual cycle. It might be hard to spot the differences.

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

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.