The terms premenstrual syndrome and perimenopause mean two entirely different biological processes in a woman’s body. Both can wreak havoc on the daily routine of a woman and unfortunately both can occur at the same time. Premenstrual syndrome, or PMS as it’s commonly called, is a condition which causes the bloating, headaches, breast tenderness, weight gain, fatigue and irritability because of the sensitivity that a woman experiences due to the changing hormone levels during the menstrual cycle.
PMS is experienced only during childbearing years because it requires the changing hormone levels due to menstruation. While scientists are unsure of the exact cause they do have some clue as to the nature and can identify the symptoms. Unfortunately, because they are unable to identify an exact cause they also have difficulty with an exact test specifically identifies the condition.
Perimenopause is that time during a woman’s life where her body is getting ready for menopause, or the cessation of menses. According to Steadman’s medical dictionary, menopause is the permanent cessation of menses. Therefore this condition can only be diagnosed in retrospect when 12 consecutive menstrual periods have been missed. Although this diagnostic criteria is pretty cut and dried, it doesn’t help the woman who is in the process of perimenopause and menopause.
Specifically, perimenopause is that time period when a woman’s hormones are decreasing in strength and number, but she continues to have irregular menstrual periods. This is a transitional period from normal menstruation to no periods at all and can take up to 10 years. During these transitional years a woman can experience a combination of PMS and menopausal symptoms at the same time. Women who have never experienced PMS can suddenly be hit with a full set of symptoms they’ve never suffered before.
It is important to differentiate the symptoms between PMS and perimenopause because the treatments are different. While PMS doesn’t have a definitive test, doctors are able to test hormone levels to determine if a woman is experiencing the process of perimenopause.
The start of diagnosis will be a history of a woman’s family. Doctors can find clues in the experiences of the mother and sister of the patient. By determining the ages of menopause and the history of PMS in family members doctors can help to plot the probability of the future of their patient.
Factors that will influence the age at which you experience perimenopause or if you experience PMS, will be if your mother did or at what age she did; if you smoke, pregnancies, birth control pills, age of first menses and if you breast fed may all have some bearing on the severity of PMS or when you experience perimenopause.
Some of the symptoms of depression are found in both diagnoses of premenstrual syndrome and perimenopause. While depression is not caused by menopause it can be exacerbated by the hormonal fluctuations brought on by menopause. Depression and PMS can occur together and it’s not uncommon for depression or anxiety to worsen during the week before your period.
After reviewing your medical history and family history, as well as doing a physical exam, your physician will probably ask you to keep a historical calendar for two to three months in order to document both physical symptoms and emotional symptoms you may be experiencing. Women who experience menopause before the age of 40 are relatively rare however, perimenopause can begin before the age of 40 because it is a process that can take up to 10 years.
Until you have achieved a menopause, that is no periods for 12 months, you can continue to get pregnant and should practice appropriate birth control. By becoming more familiar with your symptoms and the time of the month in which they occur you and your gynecologist can design a treatment plan to address the symptoms of pre-menopause, perimenopause, premenstrual syndrome or menopause depending upon what you experience.
Dr Oz: Conquering Perimenopause
Wexner Medical Center: Perimenopause
Christiane Northrup: Premenstrual Syndrome