MEASURING THE IMPACT OF MENOPAUSAL SYMPTOMS ON QUALITY-OF-LIFE

Objective-To examine the impact of menopausal symptoms on the overall quality of life of women. Design-Data collection with a questionnaire administered by an interviewer, incorporating two different quality of life measurement techniques (time trade off and rating scale). Settin g-Specialist menopause clinic and two general practices in Oxford. Sub jects-63 women aged 45-60 years recruited opportunistically during a c linic or appointment with a general practitioner; no exclusion criteri a. Results-Subjects gave very low quality of life ratings for health s tates with menopausal symptoms. The time trade off method of measuring preferences for these health states (on a scale from 0 to 1, where pr eference for full health is given as 1) yielded utility values of 0.64 for severe menopausal symptoms and 0.85 for mild symptoms. The rating scale measurement technique yielded even lower values: utilities of 0 .30 and 0.65 were obtained for severe and mild symptoms respectively. Kappa scores indicated that the two methods produced results that were poorly related but not contradictory. Comparison of quality of life r atings before and after treatment with hormone replacement therapy sho wed significant improvements: with the rating scale measurement techni que mean increases in utility values after the relief of severe and mi ld menopausal symptoms were 0.56 and 0.18 respectively. Conclusions-Qu ality of life may be severely compromised in women with menopausal sym ptoms, and perceived improvements in quality of life in users of hormo ne replacement therapy seem to be substantial. This emphasises the nee d to include quality of life measurements when assessing outcomes of h ormone replacement therapy. Several limitations may exist with widely applied measurement techniques, calling for the development of appropr iate and well validated instruments for measuring quality of life asso ciated with reduced health states.