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Do I Have PMS or Perimenopause?

PMS or Perimenopause
Jun 26 2023

Do I Have PMS or Perimenopause?

Is it PMS or Perimenopause?

When you aren’t feeling your best, it can be challenging to determine exactly what is causing the symptoms, and if you are in the 40-50-year-old age range, you might wonder if your symptoms could be the start of menopause. Many different things can cause mood changes. The symptoms you experience during PMS can be very similar to those that occur during perimenopause. Let’s tease out the differences and determine when it might be time to see your healthcare provider.

What is PMS?

PMS, or premenstrual syndrome, refers to a group of physical and emotional symptoms that often start a week or two before the onset of your period. The symptoms usually go away once your period starts. PMS is related to hormonal changes during the menstrual cycle, and some women are affected more than others.


Symptoms of PMS that you might experience include both physical and emotional symptoms.


Physical symptoms may include:


  • Breast swelling and tenderness
  • Acne
  • Bloating and weight gain
  • Headaches
  • Joint aches and pains
  • Constipation or diarrhea
  • Food cravings


Emotional symptoms may include:


  • Mood changes
  • Irritability
  • Depression
  • Anxiety
  • Trouble sleeping or sleeping too much
  • Lack of concentration and difficulty remembering things
  • Decreased sex drive

What is Perimenopause?

Perimenopause is the time when your body begins to make the natural transition to menopause. Once in menopause, you’ll stop having your period. Perimenopause can last for several years before periods finally stop. Once you’ve gone a full 12 months without having a period, you are considered to be in menopause.


In perimenopause, the ovaries begin to produce fewer hormones, and your periods may become irregular. Perimenopause can start as early as in your 30s or as late as mid-50s. The most significant change during perimenopause is a decline in estrogen levels. This decline changes the balance of progesterone and estrogen in your body, which can lead to unpleasant symptoms.


Symptoms of perimenopause include:


  • Irregular periods
  • Periods that might be heavier or lighter than usual
  • Hot flashes
  • Vaginal dryness
  • Urinating more frequently
  • Insomnia
  • Mood changes
  • Irritability
  • Depression

Which is it, Perimenopause or PMS?

Because several of the symptoms of PMS and perimenopause are the same, you might have trouble determining which is causing problems.


During perimenopause, the symptoms are unrelated to your periods, while PMS symptoms tend to occur before your period and stop once you start your period. Perimenopause symptoms do not follow this pattern.


While there is no test to determine PMS, your healthcare provider can discuss your symptoms and their relation to your period to decide if you have PMS.


Perimenopause can be determined based on the symptoms you experience, and a blood test called FSH (follicle-stimulating hormone) can be measured to confirm when menopause has started. Blood tests that show declining hormone levels can also support a diagnosis of perimenopause and help guide treatment options.

Do I Need Treatment?

When symptoms become bothersome enough to interfere with your enjoyment of life, it’s time to talk to your healthcare provider. Both PMS and perimenopause can be treated.


You should contact your healthcare provider right away if you have the following:


  • Periods with lots of blood clots
  • Frequent spotting between periods
  • Bleeding after having sex
  • Emotional symptoms that are interfering with your ability to function

Treating PMS

Mild PMS can often be managed with things like:


  • Over-the-counter pain relievers like ibuprofen or naproxen to decrease cramps, headache, and breast tenderness
  • Regular exercise
  • Getting enough sleep
  • Health diet
  • Avoid salt, caffeine, sugar, and alcohol in the two weeks before your period


You might need further treatment when symptoms cannot be managed with general care. Sometimes hormonal birth control is used to manage physical symptoms, but it might worsen emotional symptoms. Your healthcare provider will work closely with you to monitor how you respond to medications and if changes are needed.


Antidepressants and therapy may be prescribed to help with emotional symptoms. Stress management techniques like meditation can also help if you experience emotional symptoms.


Diuretics or “water pills” might help with bloating and breast tenderness. Some medications are only taken during the time of your cycle when you are having symptoms and not continuously.

Treating perimenopause

Mild perimenopause symptoms can be helped by:


  • Eating a healthy diet
  • Regular exercise
  • Improving sleep
  • Limiting alcohol and caffeine
  • Quit smoking
  • Weight loss


It’s time to see your healthcare provider when symptoms are more severe. Hormone imbalances can be determined through lab testing and treated with hormone therapy. At Vitality Aesthetics and Regenerative Medicine, we specialize in a personalized approach to managing hormonal imbalances that often includes treatment with bio-identical hormone therapy.


The bottom line is no matter what is causing your symptoms, we can help! With many treatment options available, it won’t be long until you feel back to normal and enjoy your life. If you’d like to discuss PMS, perimenopause, or other symptoms of hormonal imbalance, contact us at Vitality Aesthetics and Regenerative Medicine today.