The 16-item Peri-SS captures symptoms that existing scales leave out, including weight changes, hair loss and digestive issues, and powers the Peri Score in the Flo app
A new study published in Menopause, the official journal of The Menopause Society, has confirmed the reliability of the Perimenopause Symptom Scale (Peri-SS), a 16-item questionnaire developed by scientists at Flo Health in collaboration with clinicians from Mayo Clinic. The scale gives women a more accurate way to measure their individual experience of perimenopause and can be used in clinical research or built into digital platforms to track symptoms that fluctuate over time.
The study, "Validation of the Perimenopause Symptom Scale (Peri-SS) for Digital Self-Assessment: Psychometric Evaluation Among U.S. Women Aged 35 to 59 years," surveyed 1,255 U.S.-based women aged 35 to 59.
Filling a gap in perimenopause measurement
Perimenopause is the time leading up to menopause, when fluctuating hormone levels can bring symptoms such as mood and memory changes, hot flashes, sleep disruption and low sex drive. Until now, few tools have measured perimenopause symptom burden specifically. The widely used Menopause Rating Scale (MRS), for example, was developed using postmenopausal populations and omits symptoms many perimenopausal women experience, including weight changes, hair loss and digestive issues.
The Peri-SS addresses those gaps. It asks women to rate the severity of 16 symptoms over the past 30 days, a window designed to capture symptoms that come and go while staying recent enough for women to recall them reliably. The symptoms span four domains:
- Sexual: vaginal dryness, painful sex and low sex drive
- Physical: digestive issues, hair changes, skin changes, joint and muscle pain, bladder problems and weight changes
- Psychological: anxiety, sleep difficulties, physical and mental exhaustion, feeling down or sad, and irritability
- Vasomotor: hot flashes and night sweats
How the scale performed
Respondents completed the Peri-SS alongside two established questionnaires, the MRS and the EuroQol 5-Dimension, 5-Level questionnaire (EQ-5D-5L), so researchers could compare how each captured symptoms. The researchers concluded that the Peri-SS met key standards for evaluating psychometric scales and may do a better job of capturing the earlier, fluctuating symptoms typical of perimenopause, while remaining simple and user-friendly.
"We are only now beginning to understand the ways perimenopause can impact a woman's life, and the validation of the Peri-SS gives us a powerful, research-backed tool to more effectively assess symptom severity," said Dr. Liudmila Zhaunova, Director of Science at Flo Health and one of the lead authors on the paper. "This is a vital step to help women better understand what is happening in their bodies, recognize patterns in their symptoms, and feel more empowered to seek support and care."
The Peri-SS is the basis for the Peri Score, a feature in the Flo app that evaluates users based on the symptoms they are experiencing and helps them understand the real-life impact of those symptoms.
About Flo Health
Flo is the #1 Health and Fitness app worldwide and the #1 OB-GYN-recommended platform for period and cycle tracking. In 2024, Flo became the first European femtech unicorn following an investment from General Atlantic, and it now supports 80 million monthly active users (MAUs) worldwide. Powered by a network of more than 100 medical experts, Flo guides women through every stage of their health journey, from menstruation to conception, pregnancy and menopause, with cycle and ovulation tracking, personalized health insights, daily educational content and a private community for users to share questions or concerns. Through its Pass it on Project, Flo has donated more than 29 million Flo Premium subscriptions to women in need, with the aim of reaching up to one billion. A leader in privacy and security, Flo's Anonymous Mode feature was recognized as one of TIME's Best Inventions 2023 and was named a finalist for Fast Company's 2023 World Changing Ideas Awards.
For more information, please visit flo.health.
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Contacts:
Samantha Wannemacher
Flo Health
s_wannemacher@flo.health
Sunshine Sachs Morgan Lylis
flo@ssmandl.com