International Journal of Clinical Obstetrics and Gynaecology · Sep 2026

A comparative study of menopausal symptoms in surgical and natural menopause: Using the menopause rating scale: A cross-sectional analysis

By Shamim I, Rahi S, Muzaffar U

Menopause is a physiological transition marked by the permanent cessation of ovarian follicular activity. Natural menopause typically evolves gradually over several years, whereas surgical menopause, precipitated by bilateral oophorectomy, produces an abrupt and profound fall in circulating estrogen. This sudden hormonal withdrawal is widely believed to generate a more intense and rapid-onset symptom profile than the gradual decline seen with natural menopause, although comparative data from North Indian populations remain limited. To compare the severity of menopausal symptoms between women with surgical and natural menopause using the Menopause Rating Scale (MRS), and to identify the domains of symptomatology most affected in each group. A comparative cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, Government Medical College (GMC), Jammu. Eighty postmenopausal women were enrolled and divided into two equal groups of 40: those with surgical menopause and those with natural menopause. Symptom severity was assessed using the validated MRS instrument across vasomotor, psychological, and urogenital domains. Data were analyzed using SPSS software; Student's t-test was applied for continuous variables and the Chi-square test for categorical variables, with p < 0.05 considered statistically significant. The mean age at menopause was significantly lower in the surgical group (43.0 years) compared with the natural group (48.67 years). Overall, mean age in the surgical menopause group was 46.2 ± 4.8 years versus 48.9 ± 5.1 years in the natural menopause group (p = 0.03). Vasomotor scores (8.4 ± 2.1 vs 4.6 ± 1.9), psychological scores (10.2 ± 2.8 vs 7.1 ± 2.3), and urogenital scores (9.0 ± 2.4 vs 6.7 ± 2.1) were all significantly higher in the surgical group (p < 0.01 for all domains). The total MRS score was markedly greater in the surgical group (27.6 ± 6.2) than in the natural group (18.4 ± 5.1; p < 0.001). Surgical menopause is associated with earlier onset and substantially greater overall symptom severity across all three MRS domains compared with natural menopause. These findings support the need for structured pre-operative counseling and individualized post-operative management for women undergoing bilateral oophorectomy.

doi.org/10.33545/gynae.2026.v10.i5d.2873Open accessPopulations