Annals of PIMS-Editorial Board

Objective: To determine the value of Menopause Rating Scale (MRS) in assessing Post- menopausal women.
Study Design: Cross sectional study
Place and Duration: The study was undertaken at MCH Centre Unit II, Pakistan Institute of Medical Sciences, Islamabad from 1^st to 29^th February 2008.
Materials and Methods: The study subjects were women beyond 45 years of age with amenorrhea of more than one year duration. A Menopause Rating Scale (MRS) chart was filled for each woman. The main outcome measures were MRS score and the time taken to administer it. The secondary outcome measures were the mean age at menopause, educational status, HRT use and time elapsed since menopause.
Results: Fifty women fulfilling the study criteria were interviewed. The mean age of these women was 56 years. The mean age at menopause was 48.5 years and all were multiparous. 18% of women were uneducated, 75% had passed intermediate (grade 12) and seven percent had professional degrees. The average duration for disappearance of postmenopausal symptoms was 4.5 years. 70% of women were still symptomatic while the rest were symptom free. Hormone replacement was ever taken by 8%. The Menopause Rating Scale ranged from 9-21 score with a mean of 12. The most commonly reported symptoms were hot flushes (90%) and sleep disturbances (89%) followed by palpitations (42%). Sexual problems (18%) and bladder symptoms (12%) were reported least frequently. The time to administer MRS ranged from 3-7 min with a mean of 4.8min.
Conclusion: Menopause rating scale was easily and rapidly administered comprehensive tool for assessing symptoms of climacteric women.
Key Words: Menopause, Climacteric, Menopause rating scale.

Introduction

The menopause is a physiologic event, a transition in life that occurs in all women who reach midlife. The frequency of ovulation decreases by the age of 40 years and reproductive function ceases within the following 15 years.¹ The menopausal woman has profound reduction in ovarian sex steroid production. Estrogen deficiency is associated with symptoms like hot flushes, night sweats, insomnia and vaginal dryness. Many other symptoms and conditions like restless legs, muscle and joint pains, palpitations, forgetfulness, depressed mood, osteoporosis and dyslipidemia are associated with menopause although these may not all be directly related to estrogen lack.

According to Massachusetts Women’s Health Study, cessation of menses is perceived by most women to have no negative impact on their subsequent physical and mental health.²

With the exception of women experiencing surgical menopause, majority of these women felt happy and healthy and did not seek contact with health care providers. Among Muslim women in Pakistan the added advantage of uninterrupted prayers and fasting in addition to fertility cessation leads to welcoming of this transition.³

Menopause has also been looked on as a signal occurring at the right time of life when preventive health care is crucial. The primary aim of health promotion is improvement of quality of life (QOL). Assessment of QOL at menopause has been largely inadequate⁴. Despite evidence of psychosocial distress, the level of development and evaluation of QOL is poor in the gynecology outpatient clinics.

By definition scales are instruments that measure a continuum of phenomena using ordinal scaling. Among the various commonly used scales to assess menopause, the final Menopause Rating Scale (MRS) comprises of 11 symptoms each rated on a five point scale of severity.⁵ This scale has been validated in eight languages⁶and the construct validity of this score has been demonstrated in HRT clinical trial as well.⁷ A study was therefore undertaken at MCH Centre to determine the value of Menopause Rating Scale in assessing the quality of life in postmenopausal women.