What is the difference between perimenopause, menopause and premenopause?

Dr Alison Vickers, a Sydney GP with a special interest in the care of women during perimenopause and menopause, explains

The Short answer

Premenopause, perimenopause, menopause and postmenopausal are just terms to describe the different stages in a woman’s midlife. They are describing what is happening in the ovaries. The ovaries go from regularly producing an egg(premenopause) to being off and on and erratically producing an egg (perimenopause) to the last egg produced(menopause) and 12 months without producing an egg (postmenopausal).

While these are the correct medical terms, we do often lump perimenopause, menopause and postmenopausal all together and call it menopause.

I find it most helpful to make it a bit simpler and generally use the terms Perimenopause and Menopause in the following way:

Perimenopause – The transition phase in a woman’s life when the ovaries are on and off and erratically producing eggs and hormones. Hormone levels are up and down.

Menopause – The time in a woman’s life after the last egg is produced. Hormone levels stay low after this time.

The Long Answer

Hopefully, this hasn’t made things even more confusing! It is all just names we have made up, but it is tricky when we use the terms differently. It may make more sense if you read What is happening to my body during perimenopause and menopause?

What is the average age of menopause?

The average age of menopause in women in Australia is 51 years old. We say a woman has reached menopause when she has her very last period or her ovaries have produced an egg for the last time. This means no developing eggs produce estrogen, so estrogen levels are much lower.

How long does perimenopause last?

Perimenopause lasts, on average, 4-8 years. During perimenopause, the ovaries produce eggs erratically. This means estrogen levels are up and down, and symptoms are usually at their worst. For most women, perimenopause happens between the ages of 45-55. Because the ovaries are still producing eggs erratically, you still need to think about contraception during perimenopause.

What is early menopause?

If a woman has her last period between the ages of 40-45 this is called early menopause. If a woman has her last period before the age of 40 this is considered a medical condition called premature ovarian insufficiency (POI) and is very important to diagnose.

What is medical menopause?

Medical menopause is when menopause occurs early because of medical treatments like removal of the ovaries or chemotherapy stopping the ovaries from producing eggs. Often, there is no perimenopause transition, and symptoms can be particularly harsh.