PMS or menopause? How to identify the difference (and why it matters)

Many women struggle to differentiate between PMS and menopause—and that’s entirely understandable. The hormonal symptoms often overlap: bloating, mood swings, fatigue, or difficulty sleeping. However, the underlying causes and progression are distinct. It’s crucial to understand the difference, as recognising what’s happening in your body enables you to provide the right support and helps you feel your best.

Menopause is not an abrupt change but a gradual process that can span several years.

Constant bloating, that rollercoaster of emotions. Then it got worse. I thought: could I be entering menopause? – Nadia (47)

PMS and menopause: what’s the difference?

PMS, or premenstrual syndrome, occurs in the second half of your cycle, after ovulation. Symptoms include mood swings, headaches, cravings, and restlessness. These symptoms typically subside once your period begins. The hormonal changes linked to PMS are temporary and cyclical.

Menopause, particularly perimenopause, is a more prolonged process. It marks your body’s transition out of its fertile years, accompanied by hormonal fluctuations that are no longer predictable. Symptoms such as mood swings, bloating, tender breasts, and difficulty sleeping—similar to PMS—can occur at any time of the month and vary in intensity.  

The overlap: symptoms that appear similar

It can be challenging to determine whether your symptoms are related to PMS or menopause. Both involve hormonal changes, which can make it confusing—especially if your body starts behaving differently than it used to.

Do you recognise one or more of these symptoms?

• Irritability and mood swings
• Fatigue and low energy
• Tender breasts
• Sleep disturbances
• Increased cravings for sweet or salty foods
• Feelings of anxiety or depression
• Brain fog (difficulty concentrating or thinking clearly)

If so, it’s essential to examine the pattern and context in which these symptoms arise.

What many women don’t realise: both PMS and menopause symptoms are caused by an imbalance between oestrogen and progesterone. However, with PMS, this imbalance is temporary, while in menopause, it is structural and progressive.  

This is why it’s important to consider not only the type of symptoms but also the pattern in which they occur.

The differences between PMS and menopause

• Timing of symptoms
  With PMS, symptoms only occur in the second half of your cycle. With menopause, symptoms can appear throughout the month.
• Menstrual pattern
  With PMS, your menstrual cycle usually remains regular. During menopause, your cycle becomes irregular: shorter or longer cycles, or occasionally missed periods.
• Specific symptoms
  Hot flushes, night sweats, and vaginal dryness are typical menopause symptoms—they rarely occur with PMS.
• Hormone levels
  With PMS, your hormone levels are generally normal. During menopause, FSH levels may be elevated, which can be determined through a blood test. 
• Symptom progression
  PMS symptoms often disappear after your period. Menopause symptoms can persist, even after menopause. 
• Sensitivity to stress
  During menopause, your sensitivity to stress often increases, whereas it usually remains stable with PMS. 
• Duration of symptoms
  PMS does not lead to long-term symptoms. In menopause, some symptoms—such as sleep disturbances or mood swings—can last for an extended period.

Did you know?

Women who have experienced PMS are more likely to have intense menopause symptoms. Hormonal sensitivity appears to play a role—your brain reacts more strongly to fluctuations in oestrogen and progesterone.

What if your symptoms change?

Do you notice that:

• Your emotions are more unpredictable than usual?
• Your cycle is becoming less regular?
• You suddenly experience hot flushes, night sweats, or dryness?
• You’re finding it harder to cope with stress?
• Symptoms that were once temporary are now lingering?   

It could be that your PMS is transitioning into perimenopause. If you’re around or over 40, this is the time to pay attention to your body’s signals. It’s not your imagination—your body is indicating that something is changing. You may be entering a new hormonal phase of life.

What can you do?

Find recognition and support

More women are opening up about this transitional phase. Reading, listening, and talking can reassure you that you’re not alone. Our blogs offer relatable stories and trustworthy information to support you on your journey.

Keep a symptom diary

Track your symptoms, when they occur, and how long they last. This can help you (and your doctor or healthcare provider) identify whether your symptoms are hormonally driven and if a pattern is emerging.

Get your hormones tested

A blood test can provide insight into your FSH levels—a hormone that rises as you approach menopause. Keep in mind that a single test is only a snapshot. Multiple tests offer a more accurate picture of your hormonal phase. For an easy first step, consider the Silex Menopause Self-Test, which allows you to measure your FSH levels at home with two tests for a clearer understanding.  

Explore your options

Lifestyle changes, nutrition, supplements, and possibly hormone therapy can provide relief. What works for one person may not work for another—it’s about finding what suits your unique body and circumstances.

Reduce stress and support your nervous system

During menopause, your body becomes more reactive to stress.

Rest, breathing exercises, physical activity, and quality sleep are key to restoring balance. 

You know your body best

Whether you feel that PMS symptoms are intensifying or suspect that menopause has begun, your intuition is often correct. You know when something is changing in your body — even if others don’t immediately notice. Trust your instincts, seek support, and remain curious about what your body needs.  

I thought it was just PMS again, but it felt different. Now I know I’m in menopause, and that knowledge has helped me make better choices. – Sarah (45)

Discover what can help you

Every body and every menopause experience is unique. What works for one person may not necessarily work for another. Fortunately, there are various ways to ease your symptoms. Consider lifestyle and dietary adjustments, natural supplements, or—if necessary—medication under a doctor’s guidance.

See what you can do

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