Keywords: menopause, GP

Background:

While qualitative studies show Bulgarian women often lack adequate support during menopause, structured symptom assessment tools are underused in practice. The Menopause Rating Scale (MRS), validated in Bulgarian, allows standardized evaluation of symptom severity and quality-of-life impact.

Research questions:

What is the symptom burden among Bulgarian women aged 40–60, as measured by the Menopause Rating Scale, and what are their care expectations from primary care?

Method:

A cross-sectional survey using the Bulgarian version of the MRS was conducted among 212 women aged 40–60 attending primary care. The MRS quantified somatic, psychological, and urogenital symptoms. Participants also answered open-ended questions regarding care expectations from their GPs. Quantitative data were analyzed descriptively; symptom severity scores were calculated according to MRS methodology.

Results:

Moderate-to-severe menopausal symptoms were reported by 58.4% of participants. The most prevalent complaints were hot flushes (71.2%), sleep disturbances (64.8%), joint pain (59.3%), and mood swings (53.1%). Urogenital symptoms were underreported but present in over 30%. Most women (72.6%) expressed dissatisfaction with available healthcare support. Open responses highlighted a desire for proactive communication, treatment discussions, and acknowledgment of symptoms by their GPs.

Conclusions:

The MRS demonstrates significant symptom burden among Bulgarian women in menopause. Despite this, perceived support from primary care remains limited. Incorporating structured symptom assessment and GP training could improve recognition and management of menopausal symptoms in Bulgaria.

Points for discussion:

How can symptom tools like the MRS be integrated into GP consultations?

Could standardized assessments improve patient-GP communication?

Should national screening protocols for menopausal symptoms be considered?