Literature review of instruments to assess health-related quality of life during and after menopause YF. Zo¨llner 1 , C. Acquadro 2 & M. Schaefer 3 1 Solvay Pharmaceuticals, Hannover, Germany; 2 Mapi Research Institute, Lyon, France(E-mail: cacquadro@ mapi.fr); 3 Charite´ Hospital, Humboldt University, Berlin, Germany Accepted in revised form 15 June 2004 Abstract Background and objectives: Menopause is a physiological event occurring in women at about the age of 50. It signals the end of the reproductive years and is associated with signs of estrogen deficiency having a considerable impact on women’s health-related quality of life (HRQoL). The most common form of treatment is hormone replacement therapy (HRT). Studies have shown negative events can arise from long- term use of HRT. The aim of this review is to determine if there are any HRQoL instruments that address the impact of menopausal symptoms including positive and negative effects of HRT. Methods: The fol- lowing eight instruments were identified: Greene Climacteric Scale, Women’s Health Questionnaire (WHQ), Qualifemme, Menopause-Specific QOL Questionnaire (MENQOL), Menopausal Symptoms List (MSL), Menopause Rating Scale (MRS), Menopausal Quality of Life Scale (MQOL), and the Utian Quality of Life Scale (UQOL). Results: All instruments reviewed proved to be reasonably structured and have their place in applied research. None were found that addressed all aspects of the impact of HRT on HRQoL. Conclusion: In order to capture the possible short-term side effects of HRT on HRQoL, it is necessary to modify one or more of the existing instruments or develop a new instrument applicable in many different countries and languages. Key words: Health-related Quality of Life, Menopause, Questionnaires, Review Introduction The menopause is a normal physiological process that all women reaching a certain age will undergo. In spite of this fact, the word ‘menopause’ has come to have several meanings associated with it. From a clinical standpoint, it is defined as the permanent cessation of menstruation due to loss of ovarian follicular function [1]. In most developed countries, this event occurs around the age of 50 [2]. It is associated with a reduction in the normal estrogen levels. In popular literature and women’s magazines, the term ‘menopause’ is applied to the entire climacteric, including the peri- and post-menopausal phase. From a sociological standpoint, the menopause can be seen as a natural transition encompassing not only the bio- logical changes but also the social and cultural changes associated with the natural ageing pro- cess, including how a woman views herself and how she is viewed by society [3]. Despite the diverse, often complicated inter- pretations of menopause, one biological fact re- mains: symptoms will occur as a result of the sudden drop in hormone levels. These symptoms can be divided into three major categories: Vasomotor, Atrophic, and Psychological/Sexual [4–6]. Vasomotor symptoms include hot flushes and night sweats. These symptoms can be severe enough to cause distress, fatigue and insomnia. Atrophic symptoms include uro-genital com- plaints, changes in skin appearance, and aching Qual Life Res (2005) 14: 309–327 Ó Springer 2005