The Menopause Symptom Index (MENSI)

The Menopause Symptom Index (MENSI)
The questions should be asked, “In the last month did you experience . . . ?” Indicate the response by circling the response: 0 = No, 1 = Occasionally, 2= Yes, on a regular basis. The reply to the second part of the questions, “Is it a real problem for you?” should be indicated by circling Y for Yes or N for No.
In the last month, did you experience...	No	Occasionally	Yes	Is it a real problem for you?
1. Hot or warm flashes?	0	1	2	Y	N
2. Palpitations?	0	1	2	Y	N
3. Headaches?	0	1	2	Y	N
4. Sleep disturbance?	0	1	2	Y	N
5. Chest pressure or pain?	0	1	2	Y	N
6. Shortness of breath?	0	1	2	Y	N
7. Numbness?	0	1	2	Y	N
8. Weakness or fatigue?	0	1	2	Y	N
9. Pain in bone joints?	0	1	2	Y	N
10. Memory loss?	0	1	2	Y	N
11. Anxiety?	0	1	2	Y	N
12. Depression?	0	1	2	Y	N
13. Fear of going out of the home?	0	1	2	Y	N
14. Loss of urinary control?	0	1	2	Y	N
15. Vaginal dryness?	0	1	2	Y	N
16. Loss of sexual desire?	0	1	2	Y	N
17. Pain with intercourse?	0	1	2	Y	N
18. Disrupted function: Home?	0	1	2	Y	N
19. Disrupted function: Work?	0	1	2	Y	N
20. Other symptons:	0	1	2	Y	N
MENSI SCORE (0-38):	Number of Yes Answers:
The Menopause Symptom Index can be used to assess a woman’s symptoms and the degree to which they affect her quality of life (QOL). A total score of 12 or more from the first three columns indicates that clinical intervention should be strongly considered; the clinician should look at the total number of “yes” answers on the right side to gauge how treatment will affect patient’s perception of her QOL.

__________________________

Suzanne Trupin, MD, FACOG

Women's Health Practice

2125 South Neil Street, Champaign, IL 61820

PHONE (217)356-3736
FAX (217) 356-5849