Cheryl Bryan RNI always have normal and regular cycles but occasionally I have bad PMS. During my PMS I would feel irritable, bloated, gained weight and have difficulty sleeping. Lately my PMS has gotten worst and I started having more symptoms including irregular cycles. Some of my girlfriends told me I could be in perimenopause while others think it is just bad PMS. The symptoms of PMS and perimenopause are so similar. How would I be able to distinguish the two?

What is PMS?

This is biological changes in the body where there are fluctuations of hormones during the menstrual cycle. PMS usually starts at mid cycle and ends before the menstrual flow.

What is Perimenopause?

This is the insidious decline of hormones which results in various biological changes in the body. The changes are often unnoticed and closely resemble other mild disorders. For some women, hormone decline starts in the mid 30’s and is considered the beginning of the perimenopausal phase. Some women start in their 40’s. When a woman reaches in her 50’s the level of hormone decline is great and the symptoms of menopause are very noticeable and bothersome. The symptoms of perimenopause do not stop like PMS do; they continue and increase in intensity with progressive hormone decline.


This is the cessation of menstruation for 12 months and a landmark of cessation of fertility. The information below will help you recognize the symptoms of PMS and perimenopause and guide you on how to get help.

PMS Symptoms

  • Feeling bloated
  • Weight gain
  • Irritability
  • Fatigue
  • Frequent headaches
  • Decreased sex drive
  • Difficulty sleeping at nights
  • Depression
  • Moody


Perimenopause Symptoms

  • Weight gain
  • Difficulty sleeping at nights
  • Mood swings
  • Decreased sex drive
  • Vaginal dryness
  • Increase sweating at nights
  • Fatigue
  • Irritability
  • Headaches
  • Depression
  • Hot flashes
  • Irregular periods
  • Decrease in breast tissue
  • Thin skin and hair loss

Testing for Menopause

A diagnosis of menopause is based on the clinical symptoms. However, there are hormone testings that are available which can reveal the levels of specific hormones. These can provide more concise information which can help to differentiate PMS from preimenopause. Other disease conditions cannot be ruled out by these tests.

FSH Test

– Follicle Stimulating Hormone stimulates the growth of ovarian follicles which promote the release of estrogen from the ovaries. During the perimenopause phase, there is reduced secretion of estrogen by the ovaries but the FSH levels remain elevated in an effort to continue stimulating ovarian estrogen release. Be mindful that an elevated FSH does not confirm menopause because there are various disorders that can cause this elevation.

Estrogen Test

– The levels of estrogen decrease in menopause. Also, estrogen levels fluctuate during different phases of the menstrual cycle, therefore a conclusive diagnosis cannot be made.

You can discuss with your physician to have these tests done or they can be performed at home with the use of Hormone Test Kits that are available from various online sources. These are FSH and Estrogen Test Kits. The tests can be done with saliva or a drop of blood as per kit instructions. There are also various walk-in labs where the tests can be done for under $100 without a referral from a physician.

How To Combat Menopause

The use of Hormone Replacement Therapy (HRT) has been beneficial to women and it alleviates the undesirable symptoms of menopause. A combination of estrogen and progesterone is used in HRT.

The Benefits of HRT

  • Alleviate vaginal atrophy and dryness which can greatly improve sexuality.
  • Prevent osteoporosis
  • Decrease the incidence of colorectal cancer
  • Delay changes in breast tissue
  • Alleviate mood swings.
  • Stop hot flashes and night sweats
  • Improve psychological wellbeing
  • Rejuvenate the skin and promote hair growth

When To Start Taking HRT

HRT is best initiated as soon as the symptoms of perimenopause are identified and before the cessation of menstruation. However, if you have stopped menstruating you still receive the benefits of HRT.


Products That Are Helpful in Treating Menopause Symptoms

Estriol-This is a vaginal cream that alleviates vaginal dryness. It is available in most pharmacies and online stores for under $10.00.

Soybeans-This helps to lower cholesterol which improves the function of the heart. It also maintains vaginal health by reducing the thinning process that occurs with decreased estrogen in menopause.

Omega 3– Alleviates psychological symptoms such as depression and mood swings.

You don’t have to face menopause alone. You can have an ageless experience while going through menopause. As an expert with The Ageless Society, I am available to answer any questions or concerns about menopause.

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