Somato-vegetative
Items 1, 2, 3 and 11. Range 0 to 16.
- Hot flushes and sweating
- Heart complaints, including racing or skipping
- Sleep problems
- Joint and muscular discomfort
Reference
The Menopause Rating Scale
Eleven questions, three domains, a number between 0 and 44. It has been validated across nine countries and translated into ten languages, and almost nobody explains what your number actually means. This page does, and it will interpret your score in the browser without sending it anywhere.
Interpret your score
Add up each domain on your completed questionnaire and enter the three subtotals. You get every band, the arithmetic checked, and a comparison against published reference values for US women aged 40 to 70. It runs on your device: no account, no upload, nothing stored.
Total score
0of 44
None or little
The average for US women aged 40 to 70 is 9.1.
| Domain | Score | Band | US average |
|---|---|---|---|
| Somato-vegetative | 0 / 16 | None or little | 3.8 |
| Psychological | 0 / 16 | None or little | 3.4 |
| Urogenital | 0 / 12 | None or little | 2.0 |
The bands and reference values on this page come from the international MRS review by Heinemann and colleagues (2004). Severity bands are population categories, not clinical thresholds: no MRS score means you do or do not need treatment.
What the scale actually measures
The MRS asks about 11 complaints. Each one is rated from 0, meaning no complaints, up to 4, meaning very severe. A factor analysis of the original 1996 standardization sample sorted those 11 into three groups that explained roughly 59 percent of the variance, and a nine-country survey six years later found close to the same structure. Those three groups are the domains, and they are scored separately because they behave differently.
Psychological
Items 4, 5, 6 and 7. Range 0 to 16.
- Depressive mood
- Irritability
- Anxiety
- Physical and mental exhaustion, including memory and concentration
Urogenital
Items 8, 9 and 10. Range 0 to 12.
- Sexual complaints
- Bladder complaints
- Vaginal dryness
Two items sit less neatly than the rest. Joint and muscle pain loaded onto both the somatic and urogenital domains in the US sample, and sleep problems loaded onto both the somatic and psychological domains in Latin America. The domains correlate with each other at 0.4 to 0.7, so they are related, not independent. In practice that means a high psychological score alongside heavy flushing is an ordinary result rather than a contradictory one, even though the two are often treated as separate problems.
The severity bands
Four categories, defined for the total and separately for each domain. They come from the original German standardization and held up across Europe and North America, where the distribution of severity turned out to be almost identical.
| Band | Total0 to 44 | Psychological0 to 16 | Somato-vegetative0 to 16 | Urogenital0 to 12 |
|---|---|---|---|---|
| None or little | 0 to 4 | 0 to 1 | 0 to 2 | 0 |
| Mild | 5 to 8 | 2 to 3 | 3 to 4 | 1 |
| Moderate | 9 to 16 | 4 to 6 | 5 to 8 | 2 to 3 |
| Severe | 17 and above | 7 and above | 9 and above | 4 and above |
Notice how low the urogenital thresholds are. A single point puts you in mild and four points puts you in severe, because the domain has only three items and about a third of US women score zero on all of them. A urogenital score that looks small next to a total of 44 is still worth raising, because it sits on a scale where small numbers are not mild.
How your score compares
A large survey run across nine countries between 2001 and 2002 collected MRS scores from about 9,900 women aged 40 to 70, including roughly 1,400 in the United States. Those are the published reference values.
| Region | Total | Psychological | Somato-vegetative | Urogenital |
|---|---|---|---|---|
| United States | 9.1 | 3.4 | 3.8 | 2.0 |
| Europe | 8.8 | 3.4 | 3.6 | 1.9 |
| Latin America | 10.4 | 4.9 | 4.1 | 1.4 |
| Asia (Indonesia) | 7.2 | 2.9 | 3.3 | 1.0 |
Mean scores. Europe and the United States did not differ significantly, so the two can be compared directly. Latin American and Asian values differed enough that the authors advised against comparing across those regions.
Roughly a quarter of US women aged 40 to 70 land in the severe band, and a little over a quarter in none or little. If your total is 17 or higher, that puts you in the same band as roughly one in four women your age, which is a reason to raise it with a clinician rather than a reason to assume it is unusual.
How much the numbers can be trusted
- Internal consistency. Cronbach's alpha for the total score sits between 0.83 and 0.88 across regions. The psychological domain is strongest at 0.79 to 0.90. The somatic and urogenital domains, with fewer items, run lower at roughly 0.6 to 0.7.
- Test-retest. Over two weeks, total score correlations ran 0.8 to 0.96 across Europe, the Americas and Asia. Domain scores were noisier, and the urogenital domain in Indonesia dropped to 0.5. Sample sizes for retest were small.
- Against the Kupperman Index. Pearson correlation 0.91. The two instruments are measuring the same thing, and the MRS is the one that was psychometrically standardised.
- Against the SF-36. The psychological domains correlate at 0.73 and the somatic at 0.48. Higher MRS scores track with lower general quality of life, which is the association the scale was built to capture.
The honest limitation, stated by the authors themselves: discriminative validity, meaning the scale's ability to track treatment effects and predict a clinician's own assessment, had not been fully analyzed. The MRS is well established as a measure of how bad things are and whether they are changing. It was never built to tell you why.
Getting the official questionnaire
The MRS is copyrighted, and this page deliberately does not reproduce it. It was developed by an interdisciplinary team of clinicians, epidemiologists and psychologists, and the copyright is held by ZEG Berlin, who distribute it to researchers on request. Their current terms: academic and research use is supported without a license, while commercial use and use in clinical trials require a licensing fee.
If you want to complete the MRS properly, ask your clinician, who can obtain it, or request it directly from ZEG Berlin. Validated translations exist in Brazilian Portuguese, English, French, German, Indonesian, Italian, Spanish, Mexican and Argentine Spanish, Swedish and Turkish.
Cite the scale as: Heinemann LAJ, Potthoff P, Schneider HPG. International versions of the Menopause Rating Scale (MRS). Health and Quality of Life Outcomes 2004;2:45. Copyright of the instrument is held by ZEG Berlin.
What the MRS will not tell you
It does not ask about your cycle. Not one item. That is not an oversight, it is the design: the scale was built to measure symptom burden and quality of life over time, in women who are already known to be menopausal or postmenopausal, and to show whether treatment moved the number.
So it cannot tell you where you are in the transition. Cycle length changes of seven days or more, skipped periods, the gap of 60 days that marks late perimenopause: none of that is in the instrument, and all of it is what actually distinguishes early perimenopause from late from postmenopause under STRAW+10, the staging system clinicians use.
Which is why a high MRS score and a shrug from your doctor can happen in the same appointment.
Our own check covers both. Sixteen questions, two minutes, scored in your browser like this page: a severity score across four domains, plus the cycle questions that place you in a stage, plus a summary written in the language a clinician recognizes.
Take the 2-minute checkFree, no email, no account. Screening, not diagnosis. 18+.
Common questions
What is a normal Menopause Rating Scale score?
There is no single normal score, but there are reference values. Among US women aged 40 to 70 the average total is 9.1 out of 44. About 28 in 100 score in the none-or-little band, 24 in mild, 26 in moderate, and 23 in severe. Europe is close enough to compare directly.
How do I calculate my MRS score?
Rate each of the 11 items from 0 to 4. Sum items 1, 2, 3 and 11 for the somato-vegetative domain, items 4 through 7 for the psychological domain, and items 8, 9 and 10 for the urogenital domain. Add the three domain scores together for your total. The interpreter above will check the arithmetic and give you every band.
What MRS score is considered severe?
A total of 17 or above. By domain: 7 or above for psychological, 9 or above for somato-vegetative, and 4 or above for urogenital. These are population categories rather than treatment thresholds.
Does the MRS diagnose menopause or perimenopause?
No. It measures symptom severity and quality of life, and it was designed to track change over time, including before and after treatment. It contains no questions about your cycle, so it cannot stage the transition and it cannot diagnose anything. Only a clinician who examines you can do that.
Is the Menopause Rating Scale free?
For academic and research use, ZEG Berlin supports it without a license. Commercial use and clinical trial use require a licensing fee paid to the copyright holder. Researchers request the questionnaire from ZEG Berlin directly.
MRS or Greene Climacteric Scale?
Both are validated symptom scales and they overlap heavily. The MRS has the larger multinational reference dataset, which is what makes it useful for comparing yourself to a population rather than only to your own earlier scores. Neither one stages the transition.