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Menopause or Pregnancy

“Is this menopause or pregnancy?” has become a frequent question in recent years. More women have delayed childbearing than was common previously, perhaps giving birth to a first child later in life. Awareness of a woman’s “biological clock” reminds us at the same time that as she approaches 40, her fertile years may soon be coming to an end. It’s not unusual to hear the story of a woman who thought she was experiencing menopause, then learned instead she was pregnant. That’s why it’s important to be aware of the similarities and the differences in the symptoms of each.

If you are wondering “is this menopause or pregnancy?” – or if, at any age, you are facing concerns about a suspected or confirmed unplanned pregnancy – Avenue Women’s Center is here with assistance. Since 1981 we have served as a vital resource for women in Chicagoland who are confronting an unplanned pregnancy. We offer free, medical-grade pregnancy tests, no-obligation pregnancy options information, and other important services needed as you identify and determine your next steps. Contact us today for an appointment at one of our five DuPage County locations.

As we address “Is this menopause or pregnancy?” a good place to begin is “What exactly is menopause?”

Frequently, a woman will refer to being “in menopause” when actually she is not there yet. Rather, she is in the transition period leading up to menopause. This is called menopausal transition, or “perimenopause.” Menopause is the point at which a woman has not had a menstrual period—or spotting—for twelve consecutive months. When the transition is complete (twelve months with no period), a woman is “postmenopausal.” After that a woman can no longer become pregnant. The average age for menopause is 51 in the United States.

Perimenopause begins several years before a woman’s last period. Just as menstruation begins at different times and is experienced differently from one woman to the next, so there are many variations in perimenopause.

Often menopausal transition begins in her 40’s, but it may be as early as the 30’s for some women. It usually lasts 2 to 8 years; however, it could continue for as long as 14 years. It can be difficult for physicians to diagnose perimenopause or menopause. The actual time when a woman’s periods may stop altogether may not be accurately predicted.

Menopausal transition starts with fluctuations in the levels of hormones, estrogen and progesterone, produced by the ovaries. The menstrual cycle changes: sometimes it becomes longer, sometimes shorter. Flow may become heavier, or lighter. It’s not unusual at this time to miss periods. You may skip a couple of periods in a row; then they may start again for a few months. While perimenopausal, a woman can still become pregnant. If she does not want to become pregnant, she should continue using birth control at least a full twelve months after her last period.

Symptoms of Menopause and Pregnancy

A missed period might be a signal of the onset of perimenopause; at the same time, a missed period is often a first sign of pregnancy. For that reason, it makes sense to ask “Is this menopause or pregnancy?” To complicate matters further, there are other symptoms that pregnancy and menopause have in common. The following are examples of this:

  • Fatigue and problems sleeping – In pregnancy, rapidly elevating levels of progesterone can result in feeling tired or sleepy more than usual. In perimenopause, it may be more difficult to fall asleep or stay asleep, so the woman in this transition period may also feel tired.
  • Urination problems – There is an increase in blood during pregnancy, causing the kidneys to process more fluids. These end up in the bladder, resulting in increased urination. Loss of muscle tone during menopausal transition impacts bladder control, increasing the likelihood of urgency or incontinence.
  • Headaches – Changes in hormone levels may cause headaches. In pregnancy, it’s the increase of hormones; in perimenopause, it’s decreasing levels of estrogen.
  • Changes in mood – In pregnancy, it’s not uncommon for a woman to be unusually emotional and weepy. In menopausal transition, changes may result in moodiness, irritability, perhaps depression.
  • Weight gain – Ideally, weight gain in pregnancy is controlled and gradual. Perimenopausal weight gain is the result of slowed metabolism. Weight gain around the abdomen in perimenopause is a result of hormonal changes.

There are some changes that are unique to pregnancy:

  • Food sensitivity – Aversions or cravings
  • Nausea – With or without vomiting
  • Tender or swollen breasts

Unique symptoms of menopausal transition include:

  • Vaginal dryness
  • Loss of breast fullness
  • Cholesterol changes
  • Loss of bone mass

Diagnosing Menopause or Pregnancy

Most pregnancy tests work by measuring the level of human chorionic gonadotropin (hCG) in a woman’s system. The best-known type of hCG, often called the “pregnancy hormone,” is generated in the placenta in the first trimester of pregnancy. Early in pregnancy, the hCG levels increase very quickly, peaking, then leveling off at about 8 to 11 weeks.

Some hCG is produced even by women who are not pregnant. When transitioning into menopause, the levels may increase somewhat. Because of this, in rare instances a woman at this stage may have a false positive pregnancy test. With some pregnancy tests, an hCG level as low as 5mIU/mL (milli-international units per milliliter) may register as positive. In this way, some home pregnancy tests may not be 100% accurate.

According to the American Pregnancy Association (APA), it’s not until a result of 25mIU/mL or higher is recorded that it’s an “official” reading of pregnancy. For a result between 6 and 24 mIU/mL, it’s recommended the test be repeated to see if the levels rise. If, in subsequent tests, the level of hCG remains steady rather than increasing very rapidly as it does in early pregnancy, it’s more likely an indication of heading toward menopause than pregnancy. The mIU/mL level for most women after menopause is about 10.

With variables such as these, it’s understandable there can be uncertainty between menopause or pregnancy. Avenue Women’s Center offers free pregnancy tests that have a sensitivity level which measures positive at 25 mIU/mL or higher, producing an accurate result just ten days after the possible time of conception. If the question of “menopause or pregnancy” is on your mind -– or if you’re simply wondering, “Am I pregnant?”—please call, text, email or chat with us. That’s why we are here, and we look forward to serving you.


  • Healthline (2017, May). Are You Pregnant or Starting Menopause? Compare the Symptoms. Retrieved from:
  • Medical News Today. (2017, November). Is it menopause or pregnancy? Retrieved from:
  • (2017, August). Menopause and HCG. Retrieved from:
  • American College of Obstetricians and Gynecologists (ACOG). (2015, May). The Menopause Years, FAQ047. Retrieved from:
  • Mayo Clinic. (2017, August). Menopause. Retrieved from:
  • National Institute on Aging, National Institute of Health, US Dept. of Health and Human Services. (2017, August). Menopause, Understanding the Menopausal Transition. Retrieved from:
  • American Pregnancy Association (APA). (2017, August). Human Chorionic Gonadotropin (HCG): The Pregnancy Hormone. Retrieved from:

Reviewed by Patricia Kuenzi, APN-CNP, MSN, ANP, PNP.

The information provided here is general in nature.  It is not a substitute for a consultation with a medical professional. Before any medical procedure, it is imperative that you discuss your personal medical history, risks, and concerns with your doctor. If you have questions during or after a procedure, your doctor should be immediately contacted. Avenue Women’s Center is not an emergency center.  If you are experiencing severe symptoms, such as bleeding and/or pain, seek immediate medical attention.  Contact your physician, go to an emergency room, or call 911.