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Psychometric properties of a menopausal symptom list

Freeman, Ellen W. PhD1,2; Sammel, Mary D. ScD3; Liu, Li MD, MS4; Martin, Paula MS4


Objective To determine psychometric properties of a brief menopause symptom list and its sensitivity to menopausal status in a population-based cohort of late reproductive-age women.

Design A 12-item menopause symptom list (MSL) administered in a cohort of African American and Caucasian women aged 38 to 52 years (N = 350) was psychometrically evaluated. Menopausal status of the cohort was determined by menstrual cycle dates obtained in interviews and participants' daily symptom records. Results of factor analysis were applied to longitudinal assessments of the cohort over a 3-year period. Convergent validity with other standard measures of mood, stress, health, and quality of life was determined.

Results Internal consistency was found for the MSL items. Item total correlations are reported. Factor analysis identified three dimensions (psychological, somatic, and vasomotor). Multivariate analysis of cohort data over a 3-year interval showed that the menopausal symptoms increased over time (P = 0.0004) and that the identified factors were differentially associated with menopausal status. Psychological symptoms increased in the premenopausal and early transition groups but decreased in the late menopausal-postmenopausal groups (P = 0.0046 for the interaction). Vasomotor symptoms increased in both the early transition and late menopausal-postmenopausal groups (P = 0.0309 and P = 0.0543, respectively). Psychological symptoms (factor 1) had high correlations with other standard symptom measures (Center for Epidemiologic Studies-Depression Scale, r = 0.59; Zung Anxiety Scale, r = 0.65), whereas factors 2 and 3 did not, suggesting that the somatic and vasomotor symptoms were not associated with mood or health problems.

Conclusions The MSL provides a brief questionnaire with acceptable psychometric properties for assessing three dimensions of menopause-related symptoms and demonstrated sensitivity to menopausal status in a population-based cohort.

From the Departments of 1Obstetrics/Gynecology and 2Psychiatry, the 3Center for Clinical Epidemiology and Biostatistics, and the 4Center for Research in Reproduction and Women's Health, University of Pennsylvania, Philadelphia, PA.

Received March 24, 2002; revised and accepted October 9, 2002.

This study was supported by grant RO1-AG-12745 from the National Institutes of Health.

Address reprint requests to Ellen W. Freeman, PhD, Department of Ob/Gyn, 3701 Market Street, Suite 820, Philadelphia, PA 19104-5509, USA. E-mail:

©2003The North American Menopause Society