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Are my symptoms PMS or Perimenopausal? Dr Marilyn Glenville answers

Article by Dr Marilyn Glenville

perimenopause symptoms image

Anna: I’ve been experiencing mood swings, food cravings, bloating, lack of concentration and weight gain. How can I tell if it’s menopause already or just PMS?


For many women the most difficult part of this stage is the differentiation between PMS symptoms and perimenopausal symptoms. The symptoms might seem identical but it is the timing that is important.

PMS/Perimenopause symptoms can include:

food cravings

water retention

weight gain

aches and pains


lack of sex drive

changes in sleep patterns


breast discomfort



crying spells

anxiety and tension


low self-esteem

lack of concentration


mood swings




Up to 150 symptoms can be related to PMS so it can’t be differentiated by symptoms. Whether your symptoms are PMS or perimenopause is dependant on when they occur. Normally for PMS your symptoms would occur after ovulation (approximately the middle of your monthly cycle) and then stop as the period arrives. The difficulty at the perimenopause is that your periods may be irregular or you could be having a gap with no periods for a couple of months, so you can’t tell when the middle of the month is.

Keep a diary of your symptoms

The best way to deal with this is to keep a diary or chart of your symptoms and note the day on which they occur. Then when your period arrives you can look back at the diary. If your symptoms were mainly only there in the two weeks or so leading up to the period they are premenstrual symptoms. And there will be certain periods of time when you have no symptoms at all and have good energy levels and steady moods. If there is no pattern to when the symptoms come and they seem to be there all the time, then these are perimenopausal symptoms.


There is always the possibility of having a combination of both PMS and perimenopausal symptoms. Were this to happen, what you would see in your diary are certain blocks of time when symptoms seem to be more extreme and magnified. You may be having underlying perimenopausal symptoms and then for a couple of weeks, before a period comes, suffer from PMS.


You may also have noticed from the box above that there is no mention of hot flushes or night sweats. These are very definitely perimenopausal symptoms that would occur randomly and are not linked to your cycle.


It is important to know whether you are experiencing PMS, perimenopausal or even a combination of both symptoms to help tailor the best supplements and herbs for yourself. Be aware that if you are taking HRT, it has been found that HRT can cause symptoms that are identical to PMS, caused by the progestogen part of the HRT, which could make your symptoms worse.



Dr Marilyn Glenville

Dr Marilyn Glenville PhD is the UK’s leading nutritionist specialising in women’s health. Dr Glenville is the Former President of the Food and Health Forum at the Royal Society of Medicine. She is the author of eight internationally best selling books including ‘Natural Solutions to the Menopause’, ‘Healthy eating for the Menopause’, ‘Osteoporosis – how to prevent, reverse and treat it’ and ‘Fat around the Middle’. Dr Glenville runs clinics in London, Tunbridge Wells and Ireland. For more in depth information look on Marilyn’s website www.marilynglenville.com. If you are interested in a consultation you can contact Dr Glenville’s clinic on 0870 5329244 or by email: health@marilynglenville.com. For good quality supplements and herbs during the menopause go to www.naturalhealthpractice.com

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