# Menopause symptom score: Greene subscales · Unpaused

> Source: https://unpaused.cc/articles/menopause-symptom-score-the-greene-climacteric-scale-scored-with-your-subscales

Symptoms

## Menopause symptom score

Rate each of 21 symptoms from not at all to extremely, and see an overall score plus four group scores you can compare later.

By Ines Kovac. Published 21 October 2026\. 8 minute read.

By the day of the appointment, the last few weeks often blur into a vague "I have not been myself." The Greene Climacteric Scale turns that into 21 ratings, each from 0 to 3, a total, and group scores for psychological symptoms, somatic symptoms, vasomotor symptoms and sexual interest. Anxiety and low mood sit inside the psychological group. You can compare today's figures with a later set, including one you complete after treatment.

[Patient.info](https://patient.info/womens-health/greene-menopause-scale) says there is no single score that confirms menopause, rules it out, or automatically indicates that treatment is needed. The figures are general information you can show a clinician.

[Score the 21 symptoms](#score)

### What this scale measures

Greene's 1998 paper in [Maturitas](https://www.maturitas.org/article/S0378-5122%2898%2900025-5/abstract) looked at seven factor-analytic studies of climacteric symptoms and described a standard measure of the core symptoms. [RWS](https://lifesciences.rws.com/greeneclimactericscale/instrument-information), which licenses the questionnaire, describes 21 items with four answers on each one. [PhenX](https://www.phenxtoolkit.org/protocols/view/880401) calls it a brief, validated, self-administered scale that is easy to use and score.

[Menopause Matters](https://www.menopausematters.co.uk/greenescore.php) reprints the questions with permission from Dr Greene. The same instrument is on the RWS site linked above. The NHS and NICE use symptoms and age for this diagnosis. This questionnaire is a research measure you can take to your appointment.

The [menopause symptom checklist for your GP](/articles/menopause-symptom-checklist-to-print-and-take-to-your-gp) follows NHS symptom groups. You mark how often each one happens and how much it bothers you from 1 to 10\. That sheet has no published total. The list here is the fixed research set, and the points add up. A menopause symptom quiz is often a short untitled list. The menopause rating scale is a separate questionnaire, with 11 items. An [NCBI Books appendix](https://www.ncbi.nlm.nih.gov/books/NBK447620/) lists both, and it says this scale has 21 questions.

The form asks how bothered you are right now, which you can answer while your periods are still changing. The [stage checker](/articles/perimenopause-or-menopause-a-stage-checker-from-your-age-and-your-last-period) uses your age and the date of your last period, which is a different question from how strong the symptoms feel.

### How the points add up

Each symptom uses four answers, from the [RWS scoring page](https://lifesciences.rws.com/greeneclimactericscale/instrument-information/instrument-scoring): Not at all is 0, A little is 1, Quite a bit is 2, Extremely is 3\. RWS reports that patients typically finish in about five minutes. PhenX records the sums like this:

* Psychological, the first 11 symptoms
* Anxiety, the first 6 of those
* Depressed mood, symptoms 7 to 11
* Somatic, symptoms 12 to 18
* Vasomotor, symptoms 19 and 20
* Sexuality, symptom 21

Anxiety and depressed mood are part of the psychological score. The total counts each symptom once. The highest possible scores are 33 for the psychological group, 18 for anxiety, 15 for depressed mood, 21 for somatic symptoms, 6 for vasomotor symptoms and 3 for sexuality. Because each of the 21 symptoms scores up to 3, the highest total is 63\. The same NCBI appendix says to add all 21 questions for a quality-of-life score, and a higher score means a worse quality of life. These sources do not name a total at which HRT should start.

Take four example ratings, with every other symptom at 0\. Hot flushes at Quite a bit (2). Sweating at night at Extremely (3). Difficulty in sleeping at Quite a bit (2). Irritability at A little (1).

The anxiety score uses only the sleep rating, which is 2\. The depressed-mood score uses only the irritability rating, which is 1\. Psychological is 3, somatic is 0, vasomotor is 5 and sexuality is 0\. The total comes to 8.

### Score your symptoms

[RWS](https://lifesciences.rws.com/greeneclimactericscale/faqs) says the UK English scale was validated on paper, and has not been adapted for a tablet, a handheld, the web or an automated phone line. The same FAQ says academic researchers can use the scale at no charge. Commercial pharmaceutical use requires email permission and a per-patient fee. The form below follows the published wording so the group scores can be added in the browser. The paper questionnaire remains the version RWS validated.

Please indicate the extent to which you are bothered at the moment by any of these symptoms. That is the PhenX introduction. The first six add up as anxiety. The next five add up as depressed mood.

Psychological 

1\. Heart beating quickly or strongly 

Not at all A little Quite a bit Extremely 

2\. Feeling tense or nervous 

Not at all A little Quite a bit Extremely 

3\. Difficulty in sleeping 

Not at all A little Quite a bit Extremely 

4\. Excitable 

Not at all A little Quite a bit Extremely 

5\. Attacks of panic 

Not at all A little Quite a bit Extremely 

6\. Difficulty in concentrating 

Not at all A little Quite a bit Extremely 

7\. Feeling tired or lacking in energy 

Not at all A little Quite a bit Extremely 

8\. Loss of interest in most things 

Not at all A little Quite a bit Extremely 

9\. Feeling unhappy or depressed 

Not at all A little Quite a bit Extremely 

10\. Crying spells 

Not at all A little Quite a bit Extremely 

11\. Irritability 

Not at all A little Quite a bit Extremely 

Somatic 

12\. Feeling dizzy or faint 

Not at all A little Quite a bit Extremely 

13\. Pressure or tightness in head or body 

Not at all A little Quite a bit Extremely 

14\. Parts of body feel numb or tingling 

Not at all A little Quite a bit Extremely 

15\. Headaches 

Not at all A little Quite a bit Extremely 

16\. Muscle and joint pains 

Not at all A little Quite a bit Extremely 

17\. Loss of feeling in hands or feet 

Not at all A little Quite a bit Extremely 

18\. Breathing difficulties 

Not at all A little Quite a bit Extremely 

Vasomotor 

19\. Hot flushes 

Not at all A little Quite a bit Extremely 

20\. Sweating at night 

Not at all A little Quite a bit Extremely 

Sexual interest 

21\. Loss of interest in sex 

Not at all A little Quite a bit Extremely 

Optional note for the appointment, up to 500 characters. If you type one, it is stored with the scores. See my scores 

When you press See my scores, your 21 ratings, the totals, and any note you typed are sent to Unpaused anonymously, with no name or contact details. We keep them to see how symptom scores cluster. This is not medical care, and it does not go to your GP. Print or screenshot the result if you want a copy for the appointment.

### Taking the numbers to a GP

From age 45, [NICE quality statement 143](https://www.nice.org.uk/guidance/qs143/chapter/quality-statement-1-diagnosing-perimenopause-and-menopause) says perimenopause or menopause is diagnosed from symptoms alone, without a confirmatory laboratory test, when the symptoms fit. Bring the scores if they help you explain how you have been feeling. A clinician still makes the diagnosis at the appointment.

[Menopause Matters](https://www.menopausematters.co.uk/greenescore.php) uses the scale to assess changes in different symptoms, before and after menopause treatment. Fill in the same 21 items again before a review, and you have two totals to compare. For timings on flushes, sleep and mood after HRT starts, see [how long HRT takes to work](/articles/how-long-does-it-take-hormone-replacement-therapy-to-work).

If you are over 45 and thinking about HRT, the [NHS](https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/about-hormone-replacement-therapy-hrt/) suggests you note any recent changes to your periods before the appointment. Before that appointment, see [how to start HRT](/articles/how-to-start-hormone-replacement-therapy) for the questions worth taking in.

Day-by-day flushes and night sweats, with the triggers you suspect, belong in the [hot flush and night sweat diary](/articles/hot-flush-and-night-sweat-diary-log-episodes-and-triggers-for-your-gp). For tension, panic, low mood and irritability, see [HRT, anxiety and low mood in menopause](/articles/depression-and-hormone-replacement-therapy). Individual symptoms are gathered in [menopause symptoms](/topics/symptoms).

### Sources

* [Patient.info: Greene Menopause Scale](https://patient.info/womens-health/greene-menopause-scale)
* [Greene 1998, Maturitas](https://www.maturitas.org/article/S0378-5122%2898%2900025-5/abstract)
* [RWS: Greene Climacteric Scale instrument](https://lifesciences.rws.com/greeneclimactericscale/instrument-information)
* [RWS: scoring](https://lifesciences.rws.com/greeneclimactericscale/instrument-information/instrument-scoring)
* [RWS: frequently asked questions](https://lifesciences.rws.com/greeneclimactericscale/faqs)
* [PhenX protocol 880401](https://www.phenxtoolkit.org/protocols/view/880401)
* [NCBI Books appendix D, NBK447620](https://www.ncbi.nlm.nih.gov/books/NBK447620/)
* [Menopause Matters: Greene score](https://www.menopausematters.co.uk/greenescore.php)
* [NICE quality statement 143](https://www.nice.org.uk/guidance/qs143/chapter/quality-statement-1-diagnosing-perimenopause-and-menopause)
* [NHS: about hormone replacement therapy](https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/about-hormone-replacement-therapy-hrt/)
* [How we research and source health guides](/editorial-policy)
* [Privacy policy](/privacy)

### My take

I would complete the questionnaire on a quiet evening during the week of the appointment, and I would take the printout even if the overall score looks low. What helps is seeing which group changed: vasomotor, psychological, somatic, or sexual interest. Starting treatment is a decision for you and the clinician at the appointment. The figure 8 is the example from the four ratings above.

[Score the 21 symptoms](#score)

### Quick answers

Is this a menopause test? 

A test would give a yes or no on menopause. What you get here is a set of bother ratings and some sums. A GP or a menopause clinic still decides what the pattern means.

How is this different from the menopause rating scale? 

The menopause rating scale is the other questionnaire in the NCBI appendix, and it has 11 symptoms. The form here walks through Greene's longer list and adds the group sums.

Will my GP use this score? 

Offer the printout if you want the figures on the table at the appointment. Plenty of visits work from a conversation and the symptom checklist alone.

Are my answers private? 

Unpaused keeps the ratings and the optional note so editors can see which symptom groups readers are scoring. No name is attached. Your GP only sees what you print or photograph. The privacy policy sets out the rest.

Can I answer this during perimenopause? 

Yes. You answer from how the symptoms feel today, and periods can still be arriving. The stage checker reads age and the last period, which is a different question.

Written by

Ines Kovac

Menopause guides: symptoms, HRT, sleep and everyday changes

Ines Kovac writes the practical guides on Unpaused: perimenopause, symptoms, hormone therapy, sleep, hot flushes and weight. She builds each piece from NHS and NICE pages, The Menopause Society's position statements and the studies behind them, and links every claim a reader might want to check. She says plainly what the evidence supports and where it runs out, and she never tells a reader to start or stop a medicine. Corrections are added to the page that had the error.

[ikovac@unpaused.cc](mailto:ikovac@unpaused.cc)

Last checked 2026-10-21

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