Pregnancy and menopause share a lot of similar symptoms. Telling the difference between pregnancy and menopause may be difficult. Understanding the symptoms of both will help you figure out what you’re experiencing.

There are many symptoms that may accompany pregnancy and menopause. Symptoms in one pregnancy may differ from another pregnancy, even in the same person.

Likewise, menopause symptoms differ from person to person, and they also can change over time. The following are some general symptoms that you may have in perimenopause and pregnancy.

SymptomSeen in perimenopauseSeen in pregnancy
a missed period✓✓
bloating and cramping✓✓
cholesterol changes✓
constipation✓
decreased libido✓✓
fatigue and sleep difficulties✓✓
food sensitivity✓
headaches✓✓
hot flashes and night sweats✓✓
incontinence✓✓
increased libido✓
increased urination✓
loss of bone mass✓
loss of fertility✓
mood changes✓✓
nausea✓
sensitive and swollen breasts✓
vaginal dryness✓
weight gain✓✓

Symptoms common in both pregnancy and menopause include:

  • Changes in menstrual cycle: A missed period is a tell-tale sign of pregnancy, while irregular periods may mean the onset of menopause.
  • Fatigue and sleep problems: Fatigue and problems with sleep can occur in pregnancy and during perimenopause. In pregnancy, fatigue is caused by soaring levels of progesterone, which may cause you to become sleepy. In perimenopause, you are more likely to have trouble sleeping and staying asleep, which can cause you to become more tired than usual.
  • Mood changes: Hormonal changes cause mood shifts in pregnancy and during perimenopause.
  • Headaches: Headaches appear in both perimenopause and pregnancy. In both cases, headaches are caused by changes in hormones.
  • Weight gain: Weight gain happens gradually during pregnancy. As your baby grows, so does your belly. During menopause, your metabolism slows down. Hormonal changes may also cause you to gain weight around your abdomen.
  • Problems with peeing: You may find that you are peeing more often during pregnancy. That’s because the increase in blood causes your kidneys to process more fluids, which end up in your bladder. During menopause, however, loss of tissue tone may cause you to lose control of your bladder. Incontinence can also happen during pregnancy.
  • Changes to sex drive: Hormonal changes can affect your sex drive both in menopause and pregnancy. You’re more likely to have a low sex drive during menopause. During pregnancy, your libido can increase or decrease.
  • Bloating and cramping: Your uterus may cramp early in pregnancy. Changes to hormones can also cause bloating. Bloating and cramping may also occur in perimenopause. In perimenopause, cramping may be a signal that you’re about to start your period.
  • Hot flashes and night sweats: Hot flashes and night sweats are commonly associated with menopause, but they may also be early signs of pregnancy. During a hot flash, you’ll feel a quick rush of heat that can cause you to sweat and your face to become red and flush. You may also sweat excessively during sleep, which can wake you up during the night and lead to fatigue.

Symptoms unique to pregnancy include:

  • Sensitive and swollen breasts: Your breasts may feel tender and sore at the beginning of pregnancy. As your body adjusts to the hormonal changes, the feeling of discomfort will ease.
  • Nausea with or without vomiting: Morning sickness is a common symptom people experience in the first trimester of pregnancy. Although it’s commonly referred to as morning sickness, the feeling of nausea can occur throughout the day. Some people may never feel nausea or the need to vomit during their pregnancy.
  • Constipation: Changes in your body during pregnancy will slow down your digestive tract. That can lead to constipation. Constipation can affect anyone, but it’s not specifically associated with menopause.
  • Food sensitivity: Your taste buds may change during pregnancy. You may stop eating your favorite foods or start to eat foods you haven’t had for years. You may also become sick after eating certain foods or smelling certain odors.

Symptoms unique to menopause include:

  • Loss of bone mass: Lower estrogen levels in perimenopause and menopause can cause a loss of bone density. That increases your risk for osteoporosis. Bone mass is not affected by pregnancy.
  • Decrease in fertility: Ovulation becomes irregular during perimenopause, which decreases your chances of becoming pregnant. You can still become pregnant if you’re still having periods, however.
  • Vaginal dryness: Your vagina may lose lubrication and elasticity because your estrogen levels are decreasing. This can make sex painful. It can also cause bleeding after sex.
  • Cholesterol changes and increased risk of heart disease: A loss of estrogen can cause an increase in LDL cholesterol, sometimes referred to as “bad” cholesterol. It can also lead to a decrease in HDL, or “good” cholesterol. This increases your risk of heart disease.

If you think you may be pregnant, take an at-home pregnancy test. Confirm the results with your doctor to make sure you did not receive a false positive or negative. If you are not pregnant, you should make an appointment with your doctor to figure out what may be causing your symptoms.

If it’s menopause, work with your doctor to develop a treatment plan for your symptoms. In some cases, you may be able to manage symptoms with lifestyle changes. If those don’t work, your doctor may recommend hormone therapy.