Is it Perimenopause, Menopause or Something Else?

How do you know if changes in your body are down to perimenopause, menopause or something else? We asked Doctor Barton for her expert insights on recognising the signs.

By Dr Fionnuala Barton
woman at laptop

Experiencing changes in your body can be unsettling, especially when they're unexpected, unpredictable, and out of your control, with unclear causes. It can be even more challenging when these changes and symptoms are diverse, gradual in onset, or fluctuate in severity and impact.

Menopause and perimenopause bring about changes to our bodies in all these ways and as a result, can be an unsettling and discombobulating time.

Understanding Menopause and Perimenopause

Menopause, marked by the cessation of menstruation, typically occurs between the age of 45-55. Symptoms manifest as a result of persistently low levels of three sex-hormones: oestrogen, progesterone and testosterone. These hormones exert powerful regulatory effect throughout the body. This means that when they become insufficient, you may feel the effects in many parts of your body. 

 “Perimenopause” is the ill-defined phase in the run up to menopause. During this time, ovarian reserves decline and sex-hormone levels reduce and fluctuate. As a result, women can begin to experience progressively worsening or erratically variable changes throughout the body. On average perimenopause lasts 2-8yrs but can start up to 10-15yrs before menopause so can show up from as early as our 30s.


Alongside changes to the menstrual cycle, there are over 60 well recognised symptoms of perimenopause and menopause.

The most common include:

  • night sweats
  • hot flushes
  • mood swings
  • insomnia
  • vaginal dryness
  • change in libido
  • weight gain
  • fatigue
  • brain fog
  • joint pain.

Less well known symptoms include:

  • hair changes
  • electric-shock sensations
  • changes to body odour
  • gum problems
  • digestive changes like bloating and wind
  • headaches or migraine
  • skin changes
  • changes to motivation, confidence and self-esteem 

What to Do If You're Experiencing Menopause or Perimenopause Symptoms

If you recognise these changes they may relate to perimenopause or menopause. But it is important to also consider and rule out some of the other causes. These can include: chronic stress and burnout, other medical conditions such as long-covid, thyroid disorders, anaemia, diabetes, raised blood pressure/cardiovascular disease, sleep apnoea, autoimmune or inflammatory disease. Nutritional deficiencies such as B12 (particularly with plant based diets), vitamin D or iron can also be a cause of some of these symptoms.

As such, it is important to seek proper medical evaluation.  Blood tests can help differentiate between menopause and other health issues. Discussing your medical history and symptoms in detail with your healthcare provider can offer valuable insights into the underlying cause and appropriate treatments.