When a woman enters menopause, there are three stages. These phases consist of perimenopause, menopause, and post-menopause. Perimenopause is the earliest phase to present, often showing up as many as eight-to-ten years prior to actual menopause. Perimenopause, however, is the first sign of a hormonal imbalance and can often have similar effects on the body. Perimenopause can present with several symptoms, including: • Tenderness of breasts • Weight gain • Retaining water • Unstable moods or increased PMS symptoms • Decreased thyroid function (caused by increased production of thyroid binding globulin) • Irregular periods • Discomfort or pain during sex • Hair loss or hair thinning • Fibrocystic breast symptoms Approximately one year after their last menstrual cycle, women then begin to experience full menopause. Menopause occurs when the woman’s body stops producing enough estrogen for the ovaries to function properly. The symptoms of menopause are similar, albeit often more intense or frequent than those of perimenopause. Additional symptoms of menopause include symptoms of arthritis, a higher number of fine lines or wrinkles, vaginal dryness, and urinary incontinence.