Are You Perimenopausal Or Pregnant? Here's How To Find Out

We’ve dealt with it nearly our whole lives, but our reproductive system can still be, in a word, confusing. Our reproductive hormones fluctuate by nature and can leave us feeling foggy, emotional, or even in pain depending on where we are in our cycles.

And what’s worse: sometimes it can be hard to tell what’s really going on in our own bodies when there are changes, because there are so many different possibilities.

Take perimenopause and pregnancy, for example. Both of these are major changes that can be considered complete opposites to each other, and yet they share very similar symptoms early on.

This can make it really difficult to figure out what’s going on when you start experiencing symptoms, especially if you’re trying for a baby.

So let’s break it down: is it perimenopause, or is it pregnancy?

Why Perimenopause and Pregnancy Have Such Similar Symptoms

Just like many topics in women’s health, the reason that pregnancy and perimenopause are so similar boils down to the hormones.

Here’s what’s going on in your reproductive cycle normally: your body releases a series of hormones throughout the month in the hopes of getting pregnant and supporting a baby. In particular:

  • Estrogen helps eggs to mature in the ovaries, then triggers their release into your fallopian tubes to be fertilized. It also signals your body to start building its uterine lining to support a fetus.
  • Your progesterone continues the process of building and managing your uterine lining, making it a nice environment for a baby to grow.

If the released egg is not fertilized, both estrogen and progesterone levels start to decline, which eventually triggers the start of your period and the shedding of your uterine lining since your body no longer needs it to support a growing baby.

But both perimenopause and pregnancy are interruptions of your regular menstrual cycle. This means that they both affect estrogen and progesterone, but in opposite directions:

  • In perimenopause, your estrogen and progesterone start to decrease until, eventually, you no longer have a menstrual cycle and can’t get pregnant anymore
  • In pregnancy, your estrogen and progesterone levels start to rise to support a growing fetus

And it’s this change in hormone levels that can be the cause of all those symptoms.

Ideally, your body wants your hormones to be at a balanced level. When they’re imbalanced, whether higher or lower than normal, it can set off a slew of side effects that can leave you feeling distinctly “off.” So even though the same hormones are being affected in different ways, they can still trigger a lot of the same symptoms including:

  • Irregular periods/spotting
  • Weight gain
  • Mood swings
  • Sleeping problems

So it can be really confusing to figure out whether you’re experiencing perimenopause or pregnancy, especially early on.

You also can’t rule anything out based on age. Most women begin experiencing perimenopausal symptoms in their 40s or early 50s. Perimenopause is a sign that your reproductive system is starting to produce less estrogen and progesterone, but as long as you’re still having a period, you can still get pregnant. On the flip side, some women also experience early menopause as young as in their thirties.

Luckily, both perimenopause and pregnancy have unique symptoms which can help you narrow down what’s really happening in your reproductive system.

Unique Symptoms of Early Perimenopause

You officially reach menopause when you haven’t had a period for a full twelve months, but the period leading up to it is called “perimenopause.” During perimenopause, your body produces less and less estrogen and progesterone, so that your menstrual cycle becomes irregular.

This decrease can also cause symptoms unique to perimenopause, like:

  • Vaginal dryness
  • Decreasing fertility
  • Bone loss
  • Decreased sex drive

Unique Symptoms Of Early Pregnancy

On the other hand, when you’re pregnant, your body starts producing more estrogen and progesterone to support the baby growing inside of you.

This sudden surge of hormones early on during pregnancy leads to unique symptoms including:

  • Nausea/morning sickness
  • Increased need to urinate
  • Swollen breasts

Perimenopause or Pregnant?

The differences between perimenopause and pregnancy can be subtle. When you find yourself questioning if it’s perimenopause vs. pregnancy, here’s a quick test:

  • If you are experiencing a decreased sex drive, vaginal dryness, and are losing bone mass, you may be perimenopausal.
  • If you are experiencing nausea, have to run to the bathroom more often, and your breasts are swollen and tender, you might be pregnant.

However, these aren’t hard-and-fast rules. Everyone experiences both perimenopause and pregnancy differently, so what’s true for your friends may not be true for you, and you can’t make a judgment based on the symptoms alone.

The easiest way to know whether it’s perimenopause or pregnancy would be to take a pregnancy test. These tests usually measure your level of human chorionic gonadotropin (HCG), a hormone that is produced at higher levels when you are pregnant. Even though perimenopause comes with its own share of hormone fluctuations, this increase is much more pronounced in pregnancy.

An ultrasound by your physician will also confirm whether or not you are pregnant.


Even though perimenopause and pregnancy yield such different results, they usually feel pretty similar at their beginning stages. The best way to know for sure is to get a pregnancy test or an ultrasound to confirm or deny what’s going on in your reproductive system.