Perimenopause vs Pregnancy Symptoms

Perimenopause and pregnancy share a lot of common symptoms. 

When you have a regular monthly cycle, changes can be disconcerting. And that’s not a bad thing - changes in your monthly menstrual cycle can indicate different events, from pregnancy to health concerns. So if you’ve missed a period, it’s always worth seeking to understand why.

As your years advance into your 40s, there’s a new possible explanation for missed periods: Perimenopause. So how can you tell whether you’re pregnant, experiencing perimenopause, or something else entirely? The easy (glib) answer is to wait. But assuming you want to know sooner than that, let’s take a closer look at the symptoms of each. 

Unique Symptoms of Pregnancy

Whether you’re trying to get pregnant or not, a missing or late period will elicit flurries of guesswork and emotion. However, pregnancy symptoms can easily be confused with menopause symptoms.

Symptoms Common to Both Pregnancy and Perimenopause

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

• Missed (or late) period
• 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.)

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.

Pro-Tip: Take a Pregnancy Test

Hopefully, it goes without saying, but there are tests for pregnancy. 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.

What Is Perimenopause?

Perimenopause means “around menopause.” The time before menopause is known as perimenopause and it can last anywhere between 1 and 10 years. 

According to the Mayo Clinic, “You may notice signs of progression toward menopause, such as menstrual irregularity, sometime in your 40s. But some women notice changes as early as their mid-30s.”

From a hormonal standpoint, perimenopause is characterized by irregular estrogen and progesterone levels. These changes to your hormone levels can cause many symptoms, which if severe, you might want to seek medical advice. Among those symptoms are changes to your menstrual period.

Perimenopause Symptoms

Let’s look in more detail at some of the major symptoms of perimenopause/the menopausal transition stage of a woman's life.

Changes to Your Period

During perimenopause, you may notice changes in 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. 

Some women may experience all of these changes, while others will just experience some. Below are some of the possibilities. If it reads like perimenopause is a bit of a rollercoaster ride, that’s not surprising—many women feel that way!

Less Frequent or Irregular Periods

Because you will start ovulating less as you approach menopause, your entire menstrual cycle may not run like clockwork anymore. This can mean less frequent periods, including skipped months. These infrequencies will increase as perimenopause progresses. This is part of the reason why doctors wait a full 12 months before confirming that you have passed into menopause.

Spotting or Lighter Periods

You might also experience very light menstrual periods or spotting between periods. Considering periods become irregular at this stage, it can be easy to mistake the stage you’re in for menopause. It’s worth tracking your periods and any irregular bleeding in a journal or app so you and your doctor can understand what stage you’re in.

Longer Periods or Heavy Bleeding

As periods become infrequent, sometimes the lining of the uterus has more time to become thicker. This means that when your uterus sheds its lining, there will be a longer and heavier period. If periods become excessively heavy, you may be at risk of anemia, or it might be a symptom of something else. So monitor your cycle and determine if you need to seek medical advice. 

Hot Flashes and Night Sweats

Hot flashes are commonly associated with menopause. According to the Mayo Clinic, “The cause of hot flashes isn't known, but it's likely related to several factors. These include changes in reproductive hormones and in your body's thermostat (hypothalamus), which becomes more sensitive to slight changes in body temperature.”

Night sweats are hot flashes that occur while sleeping. They can have the added complication of disrupting sleep and causing insomnia.

Mood Swings, Weight Gain and So Much More…

Sorry to be a bearer of potentially bad news, but the list of perimenopause symptoms is really long. The good news is not all perimenopausal women experience these symptoms. And they may be less intense for some. The list includes:

• 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.
• Weight gain: Sudden changes in weight or digestion can also point to perimenopause. If your diet, nutrition, and exercise levels are fairly stable and you find yourself experiencing weight gain, that may be a symptom of 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. During perimenopause this process can begin, resulting in dryness.
• Changes in sexual desire or satisfaction: Some women report changes in sexual desire and arousal due to fluctuating hormones.
• Sleep troubles: Apart from night sweats, general sleep can become unpredictable during perimenopause and beyond. It can also be hard to fall asleep, with some experiencing insomnia.
• 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 increase the 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.

Pro-Tip: Check Out Our Perimenopause Quiz

The symptoms of perimenopause may be numerous, but they can also be easily confused with other things going on in our bodies. In real-life situations where you’re juggling all the world throws at you, they can easily become confusing. Perimenopausal women may also wonder:

• Am I just stressed (work, world events, family life, etc.)
• Am I just run down?
• Maybe I’m coming down with the flu/cold/COVID?
• Maybe my body is just a little out of whack?
• Have I let my healthy habits slide a bit?
• Perhaps I’m just PMS-ing!
• Am I pregnant?

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…

Yes, You Can Become Pregnant During Perimenopause

Even as your menstrual cycle becomes less regular it is important to know that you’re still ovulating (even if it’s infrequent). As long as you’re ovulating and having periods, you can become pregnant. And no form of birth control is 100% effective.

If you want to avoid pregnancy, use birth control until you've entered menopause, i.e. you’ve had no periods for 12 months.

Hey, It’s Time for a Doctor’s Visit When…

If you experience any of the following, it’s worth scheduling a check-up with your doctor to discuss your cycle:

• Heavy periods with a lot of clotting (especially clots larger than a quarter)
• Spotting between periods accompanied by abdominal pain or cramping
• Pain or a burning sensation when peeing
• Unusual vaginal discharge and/or redness and itchiness

Even if you don’t have any of the above symptoms, always visit the doctor in the following situations:

• If you think you’re pregnant or are trying to get pregnant: You should always see a doctor as soon as you think you might be pregnant to be administered a pregnancy test.
• If you experience inconsistent spotting: If spotting seems to happen frequently and randomly, you should definitely look into it.
• Bleeding or spotting begins after unprotected sex: Unprotected sex can put you at risk for STIs and other infections so if you notice spotting after unprotected sex, it’s wise to visit a doctor.

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.