Accuracy of Patient Self-Reported Menopause Stage: A Cross-Sectional Study

To evaluate the accuracy of patient self-reported menopause stage among midlife US women.

This cross-sectional analysis included women 40 to 65 years of age who presented to women's health clinics at one of three Mayo Clinic sites from December 2016 to September 2019. Patients self-reported their menopause stage (pre-, peri-, postmenopausal, or unsure) while clinician-determined stage (pre-, peri-, postmenopausal, or unknown) was assessed by menopause-trained specialists using a standardized form. Only women with both self- and clinician-reported menopause stages were included.

A total of 3411 women (mean age 53.5±6.2 years) were included with the majority being White (91.1%), educated (67.2%, at least some college education) and married/partnered (84.1%). Overall, 323 (9.5%), 640 (18.8%), 1182 (34.7%), and 1266 (37.1%) women self-reported being pre-, peri, postmenopausal, or unsure, respectively. Patient-reported and clinician-determined menopause stages aligned in only 56.6% of cases (n=1930, kappa=0.38). Notably, more than one-third of women (n=1266, 37.1%) reported being unsure of their menopause stage, whereas just 389 (11.4%) were classified as unknown by their clinicians. Of those who self-reported being unsure of their stage, 958 (75.7%) were classified as postmenopausal by clinicians. In a subset of women from 45 to 55 years of age (n=1786), the agreement was 56.8% (n=1015, kappa=0.40), with the highest concordance observed in the postmenopausal stage (41.0%).

These findings highlight significant discrepancies between patient-reported and clinician-determined menopause stages, underscoring a lack of awareness among women regarding their menopause stage. This gap may result in missed opportunities for timely and appropriate interventions for care.