Is it perimenopause or PMS?

Excellent question.

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The doctor is in Shilpa Amin MD, CAQ, FAAFP Q What are the early signs of perimenopause, and how can I tell the difference from premenstrual symptoms? A The telltale signs of perimenopause — the transitional time leading up to menopause — are hot flashes and irregular periods. However, it can be difficult to tell the difference between run-of-the-mill premenstrual syndrome (PMS) and signs of early perimenopause due to overlapping symptoms. Perimenopause typically starts in your late 30s to mid-40s. It's associated with drops and spikes in estrogen levels that occur more sporadically than premenopause cycles. This may cause your periods to be closer together, further apart, or both. Perimenopause period cycles can range from mild to severe, with common PMS symptoms such as changes in mood, emotional distress, anxiety, irritability, bloating, cramping, headaches, weight gain, constipation, diarrhea, joint aches, and breast tenderness. (Hormonal birth control can also mask perimenopause symptoms in some people.) Vasomotor symptoms — which include hot flashes and night sweats — are very common perimenopausal symptoms and typically not associated with PMS during premenopause. If you're in your late 30s, 40s, or 50s and you're experiencing vasomotor symptoms, that may be a good indication that perimenopause has begun. It's always a good idea to speak with a doctor about any new symptoms to rule out other conditions. Feel free to ask them about the various perimenopausal treatments and recommended lifestyle changes. Signs of perimenopause Did your PMS get worse during perimenopause? Or do you have any other questions for our menopause experts? Let us know at menopause@healthline.com and the answer may be featured in an upcoming edition! Therabody Smart Goggles 2 Save $30 on Therabody's Smart Goggles 2 until June 15! Shop now More resources for you 10 Foods High in Phytoestrogens These naturally occurring plant compounds may function in the same way as the human hormone estrogen. Read more > Late-Onset Menopause: What Is Causing Your Delay? Read more > Can Evening Primrose Oil Treat Menopause Symptoms? Read more > 5 Ways to Beat Menopause Fatigue Read more > Take the next steps in your wellness journey Find a menopause specialist near you Search by specialty, condition, procedures, and more to find top rated professionals in your area. Find care Don't break the bank on meds Find Rx savings with our prescription coupons — we beat competitor pricing 70% of the time. Save now HEALTHY TIP Download our free symptom tracker! Keeping a record of your menopause symptoms over time can help you and your doctor have a more informed conversation about your experience. Download More care for you Menopause Guide Embrace transition   Sleep + Relaxation Sleep tight, every night Shop products Get care Shipping info View in browser Unsubscribe Privacy policy We may feature your messages to our inbox within our content. Please do not provide any personal identifiable information. Replies may be edited for length and clarity. For more, see our Privacy Policy. Healthline, Optum Now, and their respective logo(s) are trademarks of RVO Health, LLC. All other trademarks are the property of their respective owners. © ‌2025‌ RVO Health, LLC. All Rights Reserved. ‌1101‌ Red Ventures Drive, Fort Mill, SC, ‌29707 ‌