Perimenopause and menopause: what is the difference?
Perimenopause is when your periods become irregular. Menopause is when you have not had a period for 12 months. The words are often used to mean the same thing, but they describe different stages.
Written by the HRTMe team at Forgeyard Digital. Medical facts from the NHS, last checked 6 November 2026.
Are perimenopause and menopause the same thing?
Not strictly, but they are often used to mean the same thing. Many women say "the menopause" to mean the whole time their periods are changing and their symptoms start, and that is how the word is used day to day. It is easy to see why: the symptoms can happen in both stages, and even the NHS covers them together, on one set of pages called Menopause and perimenopause.
Strictly, though, the two words describe different stages. The NHS puts it simply: perimenopause happens when your periods become irregular, and menopause is when your periods stop altogether.
What is perimenopause?
Perimenopause is the stage when your periods become irregular. The NHS says one of the first signs of perimenopause is usually a change to your periods: they may happen more often or less often, and bleeding may get heavier or lighter.
Symptoms such as hot flushes, low mood, sleep problems and memory problems can start during perimenopause, while you are still having periods. Perimenopause ends when you reach menopause.
What is menopause?
The NHS defines menopause as not having a period for 12 months, when you are not using hormonal contraception. It is caused by a fall in hormone levels and usually affects women between the ages of 45 and 55, but it can happen earlier.
The NHS says early menopause or premature ovarian insufficiency can happen before the age of 45. It can be caused by surgery to remove the ovaries (oophorectomy). Sometimes the reason is unknown.
What is postmenopause?
Postmenopause is the time after menopause: once you have not had a period for 12 months, the NHS calls it postmenopause. Some symptoms, such as joint pain and vaginal dryness, can continue after menopause.
What is the difference between perimenopause and menopause?
In perimenopause you still have periods, but they become irregular. Menopause is when you have not had a period for 12 months, and postmenopause is the time after that.
| Perimenopause | Menopause | Postmenopause | |
|---|---|---|---|
| What it means | Your periods become irregular | You have not had a period for 12 months | The time after menopause |
| Periods | Still happening, but may come more or less often, and be heavier or lighter | Stopped | Stopped. Any vaginal bleeding needs to be checked by a GP |
| Symptoms | Can start here | Can carry on | Some can continue, such as joint pain and vaginal dryness |
Can you get pregnant during perimenopause?
Yes. The NHS says it is possible to get pregnant during perimenopause, so you still need contraception: for 1 year after your final period if you are 50 or over, or for 2 years after your final period if you are aged 40 to 49.
How do you know which stage you are in?
The NHS says there is no routine test for perimenopause and menopause. A doctor may diagnose it based on your age and your symptoms.
Hormonal contraception can also make it harder to tell, because it can affect your periods. The progestogen-only pill, the hormonal coil (IUS), the contraceptive implant and the contraceptive injection can make periods irregular or stop them completely, and the combined pill causes monthly bleeds like a period for as long as you take it.
That is one reason a record of your periods and symptoms is useful to take to your GP.
When should you talk to a GP or pharmacist?
If you think you have symptoms of perimenopause or menopause and want to know your options, the NHS says to contact your GP. A pharmacist can help with questions about your medicines. This page is general information, not medical advice.
How can HRTMe help, whichever stage you are in?
Whichever stage you are in, HRTMe helps you log your symptoms, mood, energy and periods, and reminds you about your HRT if you add it. See the menopause symptoms HRTMe helps you track.
Sources
- NHS: What are menopause and perimenopause?
- NHS: Symptoms of menopause and perimenopause
- NHS: Menopause and perimenopause
NHS pages last reviewed 19 May 2026. Checked by us on 6 November 2026.