What is the difference between perimenopause and menopause?

Menopause is your last period. You only know this afterwards, once you have gone twelve months without a period.3,5 Perimenopause is the time before that, when your cycle changes and symptoms such as hot flushes can start. It lasts until a year after your last period.

How do I know if I am perimenopausal?

Usually from your symptoms and your cycle. In women over 45, the guidelines say no blood test is needed.3,4,5 If you use hormonal contraception, the NHG says it can mask the symptoms.5 If you are unsure, talk it through with your GP or a care provider.

What do we really know about perimenopause?

Medically reviewed by

Dr. William Declerck

Physician

Updated 2 November 2026

Portrait of a woman with short brown hair and a gold necklace looking into the camera

Signs & symptoms Finding your way in care

You lose a word halfway through a sentence. Your heart suddenly races. Few women think of perimenopause when that happens: 33 to 45% see concentration or memory problems as a possible sign, 28 to 38% heart palpitations.

For this perimenopause survey, the research agency iVOX asked 3,500 women in Belgium, the Netherlands and Luxembourg in August 2026 what they know about menopause and where they get their information. The survey was commissioned by Uma.¹ Below you can read what came out of it, country by country.

How much do women know about menopause? On average, 5 out of 10

On a short test about menopause, three in ten women in Belgium and the Netherlands score less than 5 out of 10.

The women were given eight statements, for example about the difference between perimenopause and menopause and how long the menopause transition lasts. For each statement they chose true, false or no idea. iVOX turned that into a score out of ten.

On average, Belgium scores 5.2, the Netherlands 5.3 and Luxembourg 5.7. In Luxembourg, 19% stay below 5. According to iVOX, Luxembourg scores significantly better than the other two countries. Between Belgium and the Netherlands, the difference is not significant.

Three panels showing the average knowledge score out of ten by country: Belgium 5.2, with 30% low, 50% average and 20% high knowledge; Netherlands 5.3, with 30% low, 50% average and 20% high knowledge; Luxembourg 5.7, with 19% low, 57% average and 23% high knowledge. Luxembourg scores significantly higher than Belgium and the Netherlands. — Average knowledge score on eight statements about menopause, by country. In Belgium and the Netherlands, three in ten women score less than 5 out of 10 (iVOX, August 2026).

When does perimenopause start?

16% of Belgian women don't know at what age the first symptoms usually start. In the Netherlands it is 10%, in Luxembourg 8%. Women who do give an age say 46.7 on average in Belgium and 45.6 in the Netherlands and Luxembourg. The difference is small, but significant according to iVOX.

Most women do know it can also start before 40: 67% in Belgium, 76% in the Netherlands and 77% in Luxembourg mark that statement as true. Our perimenopause page explains the age perimenopause usually starts and how long it can last.

A normal blood test. What then?

One in four Belgian women think a normal blood test rules out perimenopause. Half don't know.

For the statement 'A normal blood test rules out perimenopause', 25% in Belgium chose 'true'. In Luxembourg it was 22%, in the Netherlands 14%. And 49% in Belgium, 56% in the Netherlands and 41% in Luxembourg answered 'no idea'.

Nearly everyone knows hot flushes. Far fewer know the other signs.

With concentration problems, heart palpitations or anxiety, fewer than half of women think of perimenopause.

The women were given a list of symptoms and marked which ones they think can be a sign of perimenopause. They could choose more than one.

Hot flushes top the list in every country: 77% in Belgium, 81% in the Netherlands, 85% in Luxembourg. Concentration or memory problems are marked by 33% in Belgium, 43% in the Netherlands and 45% in Luxembourg. Heart palpitations, anxiety and joint pain don't go above 40% anywhere. Read more on the pages about concentration problems and brain fog in perimenopause, heart palpitations in perimenopause and anxiety.

Bar chart showing, for each symptom, the share of women who marked it as a possible sign of perimenopause, by country: Hot flushes: Belgium 77%, Netherlands 81%, Luxembourg 85%; Mood swings or low mood: Belgium 68%, Netherlands 75%, Luxembourg 82%; Sleep problems: Belgium 56%, Netherlands 64%, Luxembourg 77%; Change in sex drive: Belgium 57%, Netherlands 65%, Luxembourg 74%; Vaginal dryness: Belgium 64%, Netherlands 61%, Luxembourg 68%; Concentration or memory problems: Belgium 33%, Netherlands 43%, Luxembourg 45%; Heart palpitations: Belgium 28%, Netherlands 37%, Luxembourg 38%; Bladder problems or needing to pass urine more often: Belgium 27%, Netherlands 33%, Luxembourg 39%; Feelings of anxiety: Belgium 27%, Netherlands 32%, Luxembourg 40%; Dry skin or dry eyes: Belgium 26%, Netherlands 28%, Luxembourg 38%; Joint pain: Belgium 25%, Netherlands 28%, Luxembourg 34%. — Which symptoms women recognise as a possible sign of perimenopause, by country. 77 to 85% recognise hot flushes, 33 to 45% concentration or memory problems (iVOX, August 2026).

Belgian women mark almost every sign least often, women in Luxembourg most often. But women in Luxembourg also more often ticked symptoms that no guideline in this article links to menopause, such as swelling in one leg: 20%, compared with 10% in Belgium and 9% in the Netherlands. This survey cannot tell whether some women simply tick boxes more readily.

Women aged 35 to 54 make the link most often

Among women aged 35 to 54, 48% in Belgium, 56% in the Netherlands and 65% in Luxembourg see concentration or memory problems as a possible sign. Among younger and older women it is 22 to 38%. The difference is significant in every country.

First they thought it was stress

Some women only realised later that their symptoms were linked to menopause. About one in eight first thought of stress or a busy life (12 to 14%). Just as many thought it was simply part of getting older. These figures cover all the women, including those who had no symptoms yet.

Among women who think they are perimenopausal now, it is one in three: 30% in Belgium, 33% in the Netherlands and 35% in Luxembourg first thought of stress. These are smaller groups, of 115 to 185 women per country.

Perimenopause or burnout? That doubt comes up too: 5 to 8% first thought of burnout or depression. Further down, a Belgian woman describes how for a long time she thought she was heading for burnout.

Portrait of a woman with long light-brown hair looking seriously into the camera — Image from the Faces of menopause campaign.

Three in ten had little or no information

In Belgium and the Netherlands, three in ten women say they had little or no information about menopause. In Luxembourg it is one in ten.

So where do women get their information? In Luxembourg, the GP or gynaecologist is the main source for 55% of women. In Belgium it is 40%, in the Netherlands 22%. Dutch women rely more on friends or family (22%) and on Google or online articles (21%). In every country, social media is the main source for about one in twenty women.

Bar chart showing the main source of information about menopause, one answer per woman, by country: My GP or gynaecologist: Belgium 40%, Netherlands 22%, Luxembourg 55%; Friends or family: Belgium 14%, Netherlands 22%, Luxembourg 16%; Online articles or Google: Belgium 9%, Netherlands 21%, Luxembourg 11%; Social media (e.g. TikTok, Instagram): Belgium 4%, Netherlands 4%, Luxembourg 5%; Podcasts or books: Belgium 3%, Netherlands 1%, Luxembourg 3%; Nowhere: little or no information: Belgium 30%, Netherlands 31%, Luxembourg 11%. — Main source of information about menopause, by country. In Belgium and the Netherlands, three in ten women say they have had little or no information (iVOX, August 2026).

Women in Luxembourg more often name their doctor and also score better on the knowledge test. This survey cannot say whether one explains the other.

Looking for reliable information about menopause? Uma's knowledge centre explains it by symptom and by theme.

At home, menopause often went unspoken. Less so for younger women.

Half of Belgian women grew up in a family where menopause was not talked about. Younger women heard about it at home more often.

In the Netherlands, 40% say it was not talked about at home, in Luxembourg 31%.

The gap between generations is large. In Belgium, 35% of women aged 34 or under say it was talked about openly at home. Among women aged 55 and over it is 15%. In the Netherlands it is 47% compared with 22%, in Luxembourg 57% compared with 31%.

Three bar charts, one per country, showing the share of women who say menopause was talked about openly at home when they were growing up, by age group: Belgium: Up to 34 35%, 35 to 54 22%, 55 and over 15%; Netherlands: Up to 34 47%, 35 to 54 34%, 55 and over 22%; Luxembourg: Up to 34 57%, 35 to 54 43%, 55 and over 31%. In every country, younger women talked openly significantly more often. — Menopause talked about openly at home, by age group and country. The younger the women, the more often they say it was talked about openly at home (iVOX, August 2026).

Close-up of a woman with curly blonde hair smiling into the camera — Image from the Faces of menopause campaign.

In their own words

'What would you have liked to know (earlier) about menopause?' This open question was answered by 1,284 women. Uma read every answer.⁷ Two wishes came up most often: a complete overview of the symptoms, and knowing when it starts.

“Around the age of 35 I went to my GP myself and asked whether the symptoms I had then could already have something to do with menopause. I was told I was really still too young for that, so I just carried on living with the symptoms. If I had known back then that it could be, I would probably have coped with it better.”

Respondent from the Netherlands

“That your head can feel like cotton wool and that you really lose yourself and don't recognise yourself”

Respondent from the Netherlands

“[…] People kept talking about 'menopause', I only got to know 'perimenopause' when I was in it myself. And for a long time I thought I was heading for burnout […]”

Respondent from Belgium

“That it can start very early and that you can get help you don't just have to sit it out. And that it isn't something that's all in your head”

Respondent from the Netherlands

Answers written in Dutch, translated here into English (our translation). The Dutch version of this article quotes them word for word, spelling included. The open answers do not give a representative picture: they come from the women who wanted to write something.

What can we learn from this?

Many women know the best-known symptom of menopause, but not the rest. If you don't know that concentration problems, heart palpitations or low mood can be part of it, you look for the cause elsewhere first. One in three women who think they are perimenopausal now first thought of stress.

Information often comes only once the symptoms are there, or not at all. In Belgium and the Netherlands, three in ten women say they had little or no information. If you know earlier what may come, you recognise it sooner. Many women wrote the same in the open question.

What you can do yourself:

Get to know the less familiar signs too. The pages under Signs & symptoms cover them one by one.
Keep track of your symptoms and take them to your doctor. With the symptom check you can map them in five minutes.
Were you told your blood results are normal, but you still recognise the symptoms? Ask what that result means for you.
Talk about it, with your mother, your daughter, your friends or your colleagues. Younger women already heard about it at home more often. You can keep that conversation going.

Take the symptom check Find a care provider

All about perimenopause

About the survey

iVOX ran this online survey from 14 to 30 August 2026, commissioned by Uma. 3,500 women took part: 1,000 in Belgium, 1,500 in the Netherlands and 1,000 in Luxembourg. According to iVOX, the samples are representative by age and education, and in Belgium also by language.

iVOX states a maximum margin of error of 3.02 percentage points for 1,000 respondents and 2.51 percentage points for 1,500 respondents. For subgroups, such as an age group, the uncertainty is greater. The base for each age group is given with the chart or in the text.

When we call a difference 'significant', we follow iVOX's testing: a z-test for percentages and a t-test for averages, at 95% confidence. We did no extra tests ourselves and calculated no weighted Benelux average. Each country is shown separately.

Percentages are rounded to whole numbers. You can find the exact values in the tables under each chart.

These are the statements as they appeared in the questionnaire. They are claims the participants had to judge. Uma deliberately gives no answer key here. For each statement they could choose true, false or no idea.

Perimenopause can start before the age of 40.
‘Perimenopause’ and ‘menopause’ mean the same thing.
A normal blood test rules out perimenopause.
On average, menopause happens at around 51.
Perimenopause can start years before your periods stop completely.
The menopause transition can last several years.
You are only in menopause once you have gone 12 months without a period.
Every woman has symptoms during the menopause transition.

iVOX reports a knowledge score out of ten and divides it into three groups: low knowledge (below 5/10), average knowledge (5 to 6.25/10) and high knowledge (7.5/10 or more). The table report does not describe the calculation, nor how 'no idea' is counted. We therefore make no statement about the formula.

The survey measures knowledge, recognition and what women report themselves. It makes no diagnoses and does not say how many women actually have a symptom.
For the question about signs, women chose from a list and could mark several symptoms. The list also included shortness of breath on light exertion, swelling in one leg, a skin rash, ringing in the ears, blood in the stool and a sore throat, as well as the option 'no idea' (12% in Belgium, 9% in the Netherlands, 5% in Luxembourg).
The question about symptoms that women only later linked to menopause also allowed several answers. Those percentages do not add up.
Differences between countries show what occurs together. They do not prove that, for example, a different information source explains the level of knowledge.
Not everyone answered the open question. The summary of those answers is Uma's own reading and does not come from iVOX.

Frequently asked questions

The research agency iVOX, online, from 14 to 30 August 2026. The survey was commissioned by Uma. iVOX did the fieldwork and the analysis, and reports the figures and significant differences in a table report.

Participants judged eight statements as true, false or no idea. iVOX turned this into a score out of ten and divided it into three groups. The report does not describe the formula. You can find the statements under About the survey.

Menopause is your last period. You only know this afterwards, once you have gone twelve months without a period.³^,⁵ Perimenopause is the time before that, when your cycle changes and symptoms such as hot flushes can start. It lasts until a year after your last period.

Usually from your symptoms and your cycle. In women over 45, the guidelines say no blood test is needed.³^,⁴^,⁵ If you use hormonal contraception, the NHG says it can mask the symptoms.⁵ If you are unsure, talk it through with your GP or a care provider.

In women over 45, the guidelines say it isn't needed: your symptoms and your cycle are enough.³^,⁴^,⁵ In younger women, a test can play a role. The guidelines differ on exactly when. Our article Menopause guidelines compared sets them side by side.

None of the guidelines in this article discusses menopause tests from a pharmacy or chemist. The NHG-Standaard does write that levels of the hormone FSH can fluctuate widely during perimenopause, so a single measurement says little.⁵ Ask your GP or a care provider what a result means for you.

No. The symptom check based on the Greene Climacteric Scale maps your symptoms, so you can prepare for a conversation with a care provider. A diagnosis is made by a doctor.

Sources (7)

iVOX, Tabellenrapport Two is a Crowd – Uma Health, Perimenopauze (table report, in Dutch), project 20260024, fieldwork 14–30 August 2026. Sheets Resultaten Totaal, Resultaten België, Nederland and Luxemburg, and Open vraag per country.
iVOX, Bullets Two is a Crowd – Uma Health (in Dutch), comparison of Belgium, the Netherlands and Luxembourg, September 2026.
RIZIV-INAMI (2024). Consensusvergadering: Aanpak van menopauze, juryrapport, 30 mei 2024 (consensus meeting on the management of menopause, jury report; in Dutch). Jury conclusions, points 1.1.3.1 and 1.1.3.6 (p. 26), 1.2.3.1 and 1.2.3.2.1 (p. 30) and 1.3.3 (p. 36–37). riziv.fgov.be
NICE, Menopause: identification and management (NG23), published 2015, last updated 15 April 2026, recommendations 1.2.2 (p. 7–8), 1.3.1, 1.3.2, 1.3.4, 1.3.5 and 1.3.6 (p. 9–10) and 1.5.24 (p. 19). nice.org.uk
NHG, NHG-Standaard De overgang (M73) (Dutch GP guideline on menopause, in Dutch), version 3.0, June 2022, p. 5–6 and p. 8–10, and Detail no. 8 (p. 32) and no. 32 (p. 110) in the PDF version. richtlijnen.nhg.org
Belgian Menopause Society, Praktische richtlijnen voor de aanpak van de menopauze / Conseils pratiques pour la prise en charge de la ménopause (practical guidelines, Dutch and French editions), January 2026, p. 2, 4–5 and 7. Published by Gedeon Richter Benelux as responsible publisher. menopausesociety.be
Uma, own reading and coding of the 1,284 answers to the open question, September 2026.

This article is for information and does not replace medical advice.

For the press

All coverage of Uma is on our press page. For this survey: read the Dutch-language press release or the French-language press release. They also give contact details for interviews and images.

Share this article

Medically reviewed by

Dr. William Declerck

Physician

How long can you stay on HRT? Seven bodies, four positions: BCFI never past 65; NHG and NVOG/DMS under five years; NICE names no duration; BMS, RIZIV and IMS no fixed limit.

Research

Does this sound familiar?

Talk it through with a care provider on Uma who works with (peri)menopause every day. You leave with a clear explanation and concrete next steps. No account needed · booking takes under 2 minutes.

Book your consultation

Always be the first to know

Subscribe to our newsletter so we can keep you informed.

By signing up you agree to our Terms and conditions and Privacy policy.

What do we really know about perimenopause?