Am I in Perimenopause? Or is it PMS?
20 Sep 2017

Am I in Perimenopause? Or is it PMS?

As we come to the end of Menopause Awareness Month, I want to talk about a question that comes up often.

“Am I in perimenopause or is it just PMS?”

Perimenopause can be sneaky.

Signs of perimenopause can start as early as your mid-late 30’s. While you’re in the thick of raising kids (or considering having more), your ovaries may be looking toward retirement.

Maybe you’re having vague signs that something is changing such as insomnia, bloating, breast tenderness, anxiety, feeling tired all the time or wonky periods (heavier, irregular, twice a month).

Maybe you’ve been to your doctor to discuss these things and you’ve been dismissed as “too young” to be in perimenopause. You’re offered birth control pills, antidepressants or anti-anxiety meds and sent on your way.

Tweet: If you’re 38-42, and you’re experiencing these things, the likelihood is that you may be entering perimenopause. 

But deep down, you have a feeling this is not what you need.

If you’re 38-42, and you’re experiencing these things, the likelihood is that you may be entering perimenopause. These symptoms are caused by falling progesterone levels. And falling progesterone levels happen when you don’t ovulate every month. Estrogen begins to run the show and throws your hormone balance off. And if you’re stressed… cortisol joins the party and makes things even worse.

What Exactly IS Perimenopause?

Perimenopause is the stage in a woman’s life that leads up to menopause. It can last as long as 5-10 years. During this time, estrogen levels are rising and falling, progesterone is dropping like a rock, and testosterone may be increasing. (chin hairs anyone?). All of this can add up to a host of unpleasant symptoms!

PMS or Perimenopause?

So how can you tell if your bad mood is a by-product of PMS or if it’s actually one of the symptoms of perimenopause? Track the frequency of your mood swings, food cravings and other related symptoms. If they happen in the 2 weeks before your period and then go away, it’s probably PMS. But if you’re experiencing the symptoms all the time and they don’t go away when your period starts, it’s likely that you’ve entered perimenopause.

What’s a Girl to do?

Once you’re pretty sure that your symptoms are related to perimenopause and a hormone imbalance, it’s time to take action. Hoping it will all go away is not the best strategy! There’s no need to suffer for 5-10 years.

Lifestyle changes and supplements can help 80% of women… no hormones needed! It’s helpful to work with someone who is knowledgeable about interpreting test results and the options for management. Many physicians are not familiar with the use of BHRT and supplements to manage perimenopause. Your pharmacist, an herbalist or a naturopath can be an excellent resource for this kind of information.


It’s also very helpful to know which hormones are out of balance so you can target the specific problem. Testing can be done with saliva, blood or urine. Each method has its pluses and minuses. I use all three, depending on the client’s situation.

Your hormone levels may act up as early as 35 or as late as 50, but when they do, remember that perimenopause is an important, healthy and natural stage of your life as a woman. It is not a disease that needs a cure. And you’re not going crazy. In short, there is nothing “wrong” with you or your body!

Dr. Anna Garrett is a menopause expert and Doctor of Pharmacy. She helps women who are struggling with symptoms of perimenopause and menopause find natural hormone balancing solutions so they can rock their mojo through midlife and beyond. Her clients would tell you that her real gift is helping them reclaim parts of themselves they thought were gone forever.

Find out more about working with her at

Dr. Anna Garrett


  1. I started having heavy periods at 39 years old. Now I’m 40 years old and I haven’t had a period since August and it’s October 23rd already. I do not have any Symptoms at all. In fact I sleep better than ever and my energy is awesome!

    • Hi, sounds like you could be in perimenopause. It can start as early as mid-late 30’s..heavy periods followed by skipped cycles are a tip off. Educate yourself about other signs so you’ll know what to look for (if anything) as it progresses. If you’re feeling great, that’s awesome!

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