Open Access Open Badges Review

The Menopause Rating Scale (MRS) scale: A methodological review

Klaas Heinemann1*, Alexander Ruebig2, Peter Potthoff3, Hermann PG Schneider4, Frank Strelow5, Lothar AJ Heinemann1 and Do Minh Thai1

Author Affiliations

1 Center for Epidemiology & Health Research Berlin, Invalidenstr. 115, 10115 Berlin, Germany

2 Berlex Canada Inc., 334 Avenue Avro, Pointe-Claire (Québec) H9R 5W5, Canada

3 TNS Healthcare(Germany), Landsberger Str. 338, D-80687 Munich, Germany

4 University Muenster, Dept. Obstetrics and Gynecology, Von-Esmarch-Strasse 56, 48149 Muenster, Germany

5 Schering Deutschland GmbH, Max-Dorn-Str. 10, 10589 Berlin, Germany

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Health and Quality of Life Outcomes 2004, 2:45  doi:10.1186/1477-7525-2-45

Published: 2 September 2004



This paper compiles data from different sources to get a first comprehensive picture of psychometric and other methodological characteristics of the Menopause Rating Scale (MRS) scale. The scale was designed and standardized as a self-administered scale to (a) to assess symptoms/complaints of aging women under different conditions, (b) to evaluate the severity of symptoms over time, and (c) to measure changes pre- and postmenopause replacement therapy. The scale became widespread used (available in 10 languages).


A large multinational survey (9 countries in 4 continents) from 2001/ 2002 is the basis for in depth analyses on reliability and validity of the MRS. Additional small convenience samples were used to get first impressions about test-retest reliability. The data were centrally analyzed. Data from a postmarketing HRT study were used to estimate discriminative validity.


Reliability measures (consistency and test-retest stability) were found to be good across countries, although the sample size for test-retest reliability was small.

Validity: The internal structure of the MRS across countries was astonishingly similar to conclude that the scale really measures the same phenomenon in symptomatic women. The sub-scores and total score correlations were high (0.7–0.9) but lower among the sub-scales (0.5–0.7). This however suggests that the subscales are not fully independent.

Norm values from different populations were presented showing that a direct comparison between Europe and North America is possible, but caution recommended with comparisons of data from Latin America and Indonesia. But this will not affect intra-individual comparisons within clinical trials.

The comparison with the Kupperman Index showed sufficiently good correlations, illustrating an adept criterion-oriented validity. The same is true for the comparison with the generic quality-of-life scale SF-36 where also a sufficiently close association has been shown.


The currently available methodological evidence points towards a high quality of the MRS scale to measure and to compare HRQoL of aging women in different regions and over time, it suggests a high reliability and high validity as far as the process of construct validation could be completed yet.

MRS; Health Related Quality of Life; Questionnaires; Reliability; Validity