Pregnancy and menopause can have similar symptoms, so how can you know which one you’re going through? Here’s everything you need to know to tell the difference.
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Pregnancy and menopause can have similar symptoms, so how can you know which one you’re going through? Here’s everything you need to know to tell the difference.
If you’re both going through perimenopause and trying to get pregnant, irregular cycles and other symptoms can be especially confusing: is it pregnancy or menopause?
Especially when pregnancy and menopause have overlapping symptoms, it’s especially important to learn the key similarities and differences between the two.
Here’s what you need to know about symptoms and testing so you can figure out if it’s pregnancy or menopause.
Can you get pregnant during perimenopause?
First: is it even really possible that someone could be debating whether they’re going through pregnancy or menopause?
Yes! It’s possible to get pregnant during perimenopause, the time leading up to menopause. During perimenopause, your ovaries still release eggs, albeit irregularly. As long as you are still having periods, even if they are irregular, there is a chance of becoming pregnant.
>>RELATED: Perimenopause vs. Menopause: What’s the Difference?
While the chances are much lower because you’re releasing fewer eggs, usually estimated at around 5% per cycle if you’re over 40, you should use contraception if you wish to avoid pregnancy during this time.
What do pregnancy and menopause have in common?
Pregnancy and menopause are both phases that involve significant changes to your hormones. During pregnancy, for example, your progesterone increases to help ensure a healthy pregnancy. During menopause, your estrogen and progesterone have decreased from your pre-perimenopause levels.
All of these hormonal shifts can lead to various physical, emotional, and mental symptoms.
Missed periods
Missing a period is often considered a sign of pregnancy. When you’re pregnant, you don’t get a period because of the hormonal shifts happening in your body to support the pregnancy.
Irregular periods are often one of the first signs of perimenopause, or the transition to menopause. Shifts in estrogen and progesterone during perimenopause lead to irregular cycles, including longer or shorter cycles. Menopause marks the end of your period, so you’re not exactly “missing” a period, but rather marking the end of periods in your lifetime.
Fatigue
Feeling tired, restless, or unable to fall asleep is a common symptom of both pregnancy and menopause. In pregnancy, increases in your progesterone can contribute to fatigue.
Hormonal shifts are also to blame for fatigue in menopause, yet fatigue may also be a result of other menopause symptoms. For example, hot flashes and night sweats can make it hard to fall and stay asleep, contributing to overall fatigue.
Mood swings
Changes in estrogen and progesterone, which happen during both pregnancy and menopause, can lead to mood swings. During pregnancy, it’s more likely that your mood swings will manifest in feeling weepy, angry, or generally emotionally sensitive. During menopause, your mood swings may feel more like feelings of irritability or feeling low energy.
Weight changes
Weight gain is often a natural part of pregnancy as your stomach and baby grows. People at a normal weight before pregnancy tend to gain up to 25 to 35 pounds gradually while they’re pregnant.
Weight changes are common during menopause, too, and they may also be gradual. During menopause, hormonal shifts can affect your metabolism, making it harder to maintain your weight with the same eating and exercise habits.
Breast tenderness
Breast tenderness in pregnancy and menopause is a result of hormonal shifts, and both symptoms can cause general sensitivity and discomfort.
During pregnancy, your breasts may feel fuller and heavier. You may also see some visible changes to your areolas—becoming darker and larger—and to your nipples, which may be more prominent.
During menopause, your breasts will likely feel more achy.
Pregnancy vs. menopause symptoms
While some symptoms between pregnancy and menopause overlap, there are distinct differences between pregnancy and menopause symptoms that can help you differentiate between the two.
Pregnancy symptoms
Some symptoms that you may only experience during pregnancy include:
- Nausea and vomiting: Commonly known as morning sickness, these symptoms are prevalent in early pregnancy. Despite the name, you may not feel this way only in the morning.
- Frequent urination: Increased urination is a result of hormonal changes and the growing uterus pressing on the bladder.
- Food cravings or aversions: Sudden changes in appetite or specific food cravings.
Menopause symptoms
Some symptoms that are commonly associated with menopause, and not with pregnancy, include:
- Hot flashes: Sudden feelings of heat that can occur during the day or night.
- Night sweats: Hot flashes that happen during sleep, leading to excessive sweating.
- Vaginal dryness: Decreased estrogen levels can cause dryness and discomfort.
>>RELATED: What Is Vaginal Atrophy? Symptoms, Causes, and Treatment
How to know whether it’s pregnancy or menopause
Determining whether you are pregnant or entering menopause can be challenging due to the overlapping symptoms, but there are a few other ways to confirm what you’re experiencing.
Track your hormones
Tracking your hormones can give you a better sense of the patterns and changes in your specific hormone levels. For example, tracking your progesterone over time can show you whether an increase in progesterone may indicate a fluctuation (likely perimenopause or menopause) or sustained, high levels (likely indicating pregnancy).
Take a pregnancy test
If you suspect that you might be pregnant, taking a home pregnancy test can be an accurate way to figure out if you’re pregnant—as long as you ensure you’re taking the test at the right time.
While a pregnancy test may show up positive earlier than two weeks after ovulation, it’s recommended to wait a week after your missed period.
>>RELATED: You’ve Reached 14 DPO—Is It Time to Take a Pregnancy Test?
Pregnancy or menopause: the bottom line
Getting pregnant during perimenopause is less common, but still likely, which means it’s possible to wonder whether you’re going through pregnancy or menopause. While these two life stages have some similar symptoms—like missed periods, fatigue, and breast tenderness—they also have distinct ones that can help you tell the difference.
Of course, you don’t need to rely just on what you feel to figure out what’s happening in your body. The best ways to confirm whether it’s pregnancy or menopause is taking a closer look at what hormones are changing and taking a pregnancy test.
About the author
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- Noreika, D., Griškova-Bulanova, I., Alaburda, A., Baranauskas, M., & Grikšienė, R. (2014). Progesterone and mental rotation task: is there any effect?
- Taylor-Swanson, L., Wong, A. E., Pincus, D., Butner, J. E., Hahn-Holbrook, J., Koithan, M., Wann, K., & Woods, N. F. (2018). The dynamics of stress and fatigue across menopause: attractors, coupling, and resilience.
- Silver, Nazanin E. (2023). Mood Changes During Perimenopause Are Real. Here’s What to Know.
- Web M.D. (2024). Gain Weight Safely During Your Pregnancy.
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