Am I in perimenopause?

No questionnaire can answer that, including this one. The Menopause Rating Scale measures how heavy your symptom burden is right now, across 11 items scored 0 to 4. It does not establish menopausal stage, it does not measure any hormone, and a low score does not rule perimenopause out. Stage is established clinically, mainly from your cycle history and your age, by a clinician who can also rule out the conditions that mimic these symptoms.

What is the Menopause Rating Scale?

The MRS is a published 11-item questionnaire that scores menopausal symptom severity from 0 (none) to 4 (extremely severe) on each item, across three subscales: somato-vegetative, psychological and urogenital. Total scores run 0 to 44. It has been validated in multiple languages and is used as an outcome measure in hormone-therapy trials, which is why we implemented it rather than writing our own quiz.

What is a high score on the Menopause Rating Scale?

In the MRS validation study the total score bands are 0 to 4 for no or little symptoms, 5 to 8 mild, 9 to 15 moderate, and 16 and above severe. The subscales carry their own bands, so a total in the mild band can still sit beside a severe urogenital subscale, where a score of 4 and above counts as severe. That split is the reason to read the subscales and not only the total.

Validated instrument · Menopause Rating Scale

Menopause symptom checker

This is the Menopause Rating Scale, a published instrument with a validation history and printed cut-offs. 11 items, each scored 0 to 4, summed into three subscales and a total out of 44. The severity bands come from the MRS validation study published in Health and Quality of Life Outcomes in 2004, and the paper is linked at the bottom of this page. The item wording below is the published English form, quoted rather than rewritten, because a rewritten item is a different questionnaire wearing a validated instrument's name.

It measures symptom burden. It is not a diagnosis, it is not a hormone test, and it cannot tell you whether you are in perimenopause. What it gives you is a number a clinician will recognise, split three ways so a single bad subscale does not disappear into a comfortable-looking total. Nothing you enter leaves this browser tab, and there is no email gate.

Which of these apply to you at this time?

0 of 11 answered

One box per symptom. For symptoms that do not apply, mark None. The response anchors below are the form's own: none, mild, moderate, severe, extremely severe, scored 0 to 4.

Your score

Answer the eleven items above and the subscale scores, the total and the published severity bands appear here. The bands table below is the same one either way, so you can read the cut-offs before you start.

The published severity bands

These cut-offs are not ours. They are the table printed in the MRS validation study, reproduced here so you can check our arithmetic against the source. The three subscales carry different maxima and different bands, which is why a total in the mild band can sit beside a severe urogenital subscale. A urogenital score of 4 and above is severe on this instrument.

Scale	Max	No or little	Mild	Moderate	Severe
Somato-vegetative	16	0 to 2	3 to 4	5 to 7	8 and above
Psychological	16	0 to 1	2 to 3	4 to 6	7 and above
Urogenital	12	0	1	2 to 3	4 and above
Total MRS score	44	0 to 4	5 to 8	9 to 15	16 and above

One disagreement in the literature, recorded rather than smoothed over: some later papers using the MRS place the total-score severe threshold at 17 and above instead of 16 and above. We publish the 2004 validation study's table because that is the source we read directly, and a total of exactly 16 is the only score where the two disagree.

What this score is, and what it is not

It is a symptom-burden measure. The MRS asks how badly eleven named symptoms are affecting you right now and adds the answers up. That is the entire mechanism.
It is not a diagnosis. No score on this scale establishes perimenopause, menopause or anything else. Menopausal stage is a clinical judgement made mainly from cycle history and age.
It is not a hormone test. Nothing here measures estradiol, FSH or anything else in your blood. A blood panel is a different instrument answering a different question, and in perimenopause a single FSH reading is famously unreliable because the levels swing.
It does not identify a cause.Thyroid disease, anaemia, depression, sleep apnoea and several medications produce high scores on these same eleven items. Ruling those out is a clinician's job and it is the main reason to take a score to one rather than act on it alone.
It is a snapshot. Perimenopausal symptom burden fluctuates. One administration is one week of your life. Two administrations six weeks apart are worth considerably more.

What we cover on each of these

These are the pages on this site that map to each subscale. They are references, not recommendations, and none of them replaces the conversation.

Somato-vegetative

Hot flashes, sleep, heart discomfort, joint pain

This is the cluster systemic estrogen is licensed for. The FDA-approved products, their labelled strengths and the starting dose each label states are on our HRT dosage chart. The route question (pill against patch against gel) changes one measured risk, and the mechanism is on the estradiol page. Patches are on the ASHP shortage list, so if that is the form you want, check who can ship an alternative on the patch tracker.

Psychological

Mood, irritability, anxiety, exhaustion

The hardest cluster to attribute, and the one most often dismissed. Our perimenopause hub covers what is known about the hormonal contribution and where the evidence stops, and the black-box warning guide covers what actually changed in the FDA labelling in 2025 and 2026, which is the question most readers in this cluster are really asking before they raise it with a doctor.

Urogenital

Vaginal dryness, bladder symptoms, sexual problems

The cluster with the cheapest evidence-backed route, and the one systemic therapy is not always needed for. Local vaginal estradiol is dosed in micrograms rather than milligrams and is considered separately from systemic therapy: the labelled products and their strengths are on the dosage chart, and which providers publish a price for a vaginal product is in our verified price table.

If the next question is who to see and what it costs, the rankings score all 13 menopause platforms we track on verified prices and a Transparency Grade, the cost calculator returns a first-year total rather than a monthly sticker, and the match quiz is the shortest route to a shortlist.

Sources

MRS questionnaire, published English form
Item wording and the 0 to 4 response anchors, read 2026-08-15
Heinemann K et al, The Menopause Rating Scale (MRS) scale: a methodological review, Health and Quality of Life Outcomes 2004;2:45
Subscale membership and per-subscale maximum scores
Heinemann LAJ et al, The Menopause Rating Scale (MRS) as outcome measure for hormone treatment? A validation study, Health and Quality of Life Outcomes 2004;2:67
The severity bands used on this page, total and per subscale

The Menopause Rating Scale was developed by the Berlin Center for Epidemiology and Health Research and published in the peer-reviewed literature cited above. We reproduce the published English item wording and cite it. We hold no rights in the instrument and we claim none.

Back to all tools.

This is general information, not medical advice. The Menopause Rating Scale records symptom severity. It does not diagnose any condition, it does not measure any hormone, and it is no substitute for assessment by a licensed clinician who can rule out the other conditions that produce these same symptoms. HRT Picks is not a medical provider and has no role in your care. Reviewed by Iacob Pastina.