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A multidimensional, person-centered measure of menopausal symptom impact: Development and validation of the Menopause

Orsolya Kiss¹, Vincent Valton¹, Christine L Curry¹

¹Ouraring Inc., Science, San Francisco, CA, USA.

|October 7, 2026

Abstract

Objectives:

To develop and validate the Menopause Impact Scale (MIS), a brief, person-centered measure of menopause-related symptom impact that is psychometrically robust across reproductive stages and suitable for digital implementation.

Study Design:

Three sequential online studies with women aged 21-85 years in the United States (total N = 2915). Study 1 (n = 486) evaluated a 57-item pool using exploratory factor analysis (EFA) and reliability indices. Study 2 (n = 1429) used confirmatory factor analysis (CFA) and item reduction to derive a brief scale. Study 3 (n = 1000) cross-validated the final structure and examined convergent and divergent validity, age sensitivity, and menopause etiology differences.

Main Outcome Measures:

MIS total and subscale scores; structural fit indices; internal consistency; convergent validity with the Greene Climacteric Scale; divergent validity with the Copenhagen Burnout Inventory; age group and menopause etiology differences in symptom burden.

Results:

EFA supported a seven-factor solution (Kaiser-Meyer-Olkin measure of sampling adequacy [KMO] = 0.968; root-mean-square error of approximation [RMSEA] = 0.048; Cronbach's α = 0.974). A 22-item model showed excellent fit in Study 2 (comparative fit index [CFI] = 0.970; RMSEA = 0.047; α = 0.964) and was confirmed in Study 3 (CFI = 0.977; RMSEA = 0.041; α = 0.941), capturing cognitive, self-perception, sexual/vaginal, musculoskeletal, vasomotor, sleep, and urinary domains. Convergent validity with the Greene total score was strong (r = 0.76); divergent validity with burnout was moderate (r = 0.57). MIS scores peaked in midlife (45-55 years). After age adjustment, symptom burden was highest in primary ovarian insufficiency, with the largest differences in vasomotor and genitourinary domains.

Conclusions:

The MIS is a brief, multidimensional, impact-focused instrument with strong structural, convergent, and discriminant validity, supporting research, clinical, and digital applications.

Keywords:

Digital health Menopause Psychometrics Questionnaire Reproductive aging Symptom impact

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