MenoScale: a novel instrument to measure menopause-related symptoms and quality of life - overview and first insights

The average age of menopause (cessation of menstruation for minimum 12 months) is 51 years, accounting for over one-third of a woman’s lifespan (1, 2) . The transitional period known as perimenopause, characterised by menstrual irregularities due to female sex hormone deficiency, occurs from around 45 years. Menopausal changes significantly impact health, increasing prevalence of metabolic syndrome, cardiovascular risk factors, cognitive decline, and cause wide-ranging burdensome symptoms such as mood changes and sleep disturbances (1) . Considering the recognised influence of nutrition on these health variables, a specific, reliable tool to assess menopausal symptoms would enable further research into potential lifestyle interventions, such as diet, for effective symptom management. The Kupperman Index, Menopause Rating Scale, Menopause Specific Quality of Life questionnaire and the Greene Climacteric Scale are the most widely recognised instruments for assessing menopausal symptoms (3) . However, these scales were published between 1950 and 1996, when large-scale studies of menopausal experiences were lacking. This study examined menopause symptoms using the new MenoScale questionnaire, completed by peri- and postmenopausal women within two weeks of its launch on 4th September 2024, at https://zoe.com/menoscale. The MenoScale, developed with support from the British Menopause Society, considers 20 symptoms across four domains (vasomotor, sexual, psychological, somatic) and subjective impact on quality of life (QoL). The MenoScale score ranges from 0 to 100. It improves on existing tools by uniquely combining prevalence-informed symptoms, modern language, assessing QoL, and offering open online access. Descriptive statistical analysis was performed on the collected responses. The questionnaire was completed by 61,866 individuals. Average scores were 35.8 (95% CI 35.6, 36.0) for perimenopausal ( N = 21,695) and 35.2 (95% CI 35.0, 35.4) for postmenopausal ( N = 20,228) respondents. Nearly all (99.9%) peri- and post-menopausal women reported experiencing at least one symptom, with most reporting up to 10 symptoms (89.5% peri-, 87.0% postmenopausal). Furthermore, 8.6% of peri- and 9.5% of postmenopausal women reported all 20 symptoms. Most common symptoms for perimenopausal women were “tiredness and fatigue” (93.3%), “irritability” (88.4%), and “memory problems” (87.2%), and for postmenopausal women “tiredness and fatigue” (89.5%), “loss of interest in sex” (87.5%) and “sleep problems” (87.2%). As all stages of menopause involve various fluctuating symptoms and subjective experiences, reliable and accessible monitoring methods are essential for establishing dietary, lifestyle and pharmacological interventions that alleviate symptom burden. This open-access and online questionnaire allows real-time symptom monitoring and periodic reassessment to increase understanding of menopause, empowering women to track and manage their menopause experience, and facilitate data-backed conversations with healthcare providers. Investigations into the validity and reliability of the MenoScale in comparison to existing widely used tools is currently underway. Future research should include collecting dietary data alongside the MenoScale to investigate how adherence to dietary guidelines is related to menopausal symptom experiences.