OBJECTIVES: An observational study was performed to determine the prevalence and economic burden for 3 stages of menopause: pre-menopause, perimenopause and post-menopause. METHODS: A prospective, primary care practice based, multicenter, observational study was conducted in Canada to determine the prevalence and burden for each stage of menopause as listed above. Women age 48-54 were asked to recall their expenses of the past 6 months for physician visits (general practitioners and specialists), hospital ward and emergency room (ER), pharmacotherapy and productivity loss (absenteeism, or missed work, and presenteeism or work with reduced productivity). Resource utilisation was costed as per standard costing sources in Canadian dollars (CAD$). Sample size calculations were done with a confidence level of 95% and power of 80%, allowing for 10% precision with 3% drop-out rate. Statistical analyses were performed on demographics, prevalence rates and the total costs for each stage and overall. Results were compared using Kriskal-Wallis tests with Dunn’s post-hoc procedure to identify differences. RESULTS: A total of 403 female subjects were recruited from 11 primary practices in 4 provinces, 60% of whom were employed and 63% had completed college; 22% were pre-menopausal, 33% were perimenopausal and 45% were post-menopausal.  The mean 6-month cost was $261 (SD=$586) for pre-menopause ($1.45/woman/day), $690 (SD=$2120) for perimenopause ($3.83/woman/day) and $403 (SD=$797) for post-menopause ($2.24/woman/day). Overall, the cost was $466 (SD=$1361)/woman ($2.59/woman/day), with productivity loss accounting for 40% of the total, physician visits for 21% and medications for 11.6%. Statistically significant differences were found between pre- and perimenopause (P=0.003) and between pre- and post-menopause (P=0.01). CONCLUSIONS: This observational study was based on data reported by women 48-54 years of age, presenting at primary care practices in Canada.  Perimenopause was the period with the highest burden. The major limitation was recall by subjects but the recall period was limited to a usually acceptable 6-month timeframe.