Stages of Menopause The word menopause is used in popular culture to refer to the entire process of pre-menopause through post-menopause. Your doctor may be more precise and use one or more of the following terms: Pre-menopause Physical signs of menopause begin many years before your last menstrual period. Pre-menopause refers to a woman's reproductive or fertile life, from the first menstrual period to the last. It is frequently misused to describe the years immediately before menopause (perimenopause) or to describe premature menopause. Perimenopause Perimenopause refers to the years immediately before menopause. Most people refer to perimenopause when discussing menopause. While the average timeframe for perimenopause is about four years, it can last up to 10 years and still be considered normal. During this time, your ovaries gradually stop releasing eggs and producing estrogen and other hormones (progesterone, androgen, testosterone). In the years before your final period, hormone fluctuations occur and your periods become erratic. At times, estrogen levels may be higher, which may trigger symptoms similar to premenstrual syndrome (PMS). Both before and for a time after your last period, when estrogen levels decrease, you may experience symptoms like hot flashes, vaginal dryness, diminished concentration and mood swings. Menopause Technically, menopause refers to a specific event – the date of your last period. Menopause can be confirmed when you have missed your period for 12 consecutive months (in the absence of other obvious causes). Post-menopause Post-menopause begins after your final menstrual period and lasts for the rest of your life. While menopause symptoms taper off over a year or two, you are at increased risk for longer term health problems related to lower estrogen and progesterone levels. Two potential health concerns in post-menopausal women are osteoporosis and heart disease.