{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:10:19Z","timestamp":1791227419341,"version":"4.1.0"},"reference-count":53,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Current menopause assessment instruments primarily evaluate vasomotor, somatic, and urogenital symptoms, with limited attention to oral, sensory, and integrated psychological domains. Evidence that oral tissues are estrogen-responsive suggests that oral symptoms may represent an important but underrecognized component of menopausal burden. This study aimed to develop and provide initial psychometric validation of the Multidimensional Menopausal Burden Questionnaire (MMBQ-44), a 44-item instrument integrating systemic, oral, and psychological symptoms. Methods: A cross-sectional validation study was conducted in 308 women aged 45\u201365 years (perimenopausal n = 66, menopausal n = 40, postmenopausal n = 202). The MMBQ-44 combined items from the Menopause Rating Scale (MRS), Xerostomia Inventory (XI), Oral Health Impact Profile-14 (OHIP-14), and psychological measures derived from the PHQ-9, GAD-7, and HADS. Instrument development included expert review, cognitive interviewing, and field testing. Psychometric evaluation assessed item performance, internal consistency, factor structure, discriminant validity, and known-groups validity. Exploratory factor analysis used principal axis factoring with promax rotation, with factor retention determined by parallel analysis. Results: Internal consistency was good to excellent across domains (Cronbach\u2019s \u03b1: 0.813\u20130.941; McDonald\u2019s \u03c9: 0.864\u20130.953). All corrected item\u2013total correlations exceeded 0.30. The questionnaire showed strong factorability (KMO = 0.931; Bartlett\u2019s \u03c72 = 9006.2, p &lt; 0.001). Parallel analysis identified four factors explaining 48.6% of total variance. Psychological and OHIP domains emerged clearly, whereas several MRS and XI items cross-loaded onto related factors. Most HTMT ratios were below 0.85, supporting discriminant validity. Floor effects were observed for OHIP (37.0%) and XI (23.4%). Known-groups validity was modest, with OHIP scores differing significantly across menopausal stages. Conclusions: The MMBQ-44 demonstrates strong reliability and acceptable construct validity as an integrative screening instrument for menopausal burden. Further confirmatory studies and refinement of oral symptom items are warranted.<\/jats:p>","DOI":"10.3390\/diagnostics16162574","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T15:48:36Z","timestamp":1786722516000},"page":"2574","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Development and Initial Psychometric Validation of the Multidimensional Menopausal Burden Questionnaire (MMBQ-44) in a Sample of Romanian Women"],"prefix":"10.3390","volume":"16","author":[{"given":"Ana-Cristiane","family":"Dragomir","sequence":"first","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Discipline of Biochemistry, Department of Biochemistry and Pharmacology, Faculty of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3331-9010","authenticated-orcid":false,"given":"Alina Ramona","family":"Buzatu","sequence":"additional","affiliation":[{"name":"Discipline of Biochemistry, Department of Biochemistry and Pharmacology, Faculty of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3182-1683","authenticated-orcid":false,"given":"Ruxandra-Cristina","family":"Marin","sequence":"additional","affiliation":[{"name":"Discipline of Pharmacology, Clinical Pharmacology and Pharmacotherapy, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410087 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radu Dumitru","family":"Moleriu","sequence":"additional","affiliation":[{"name":"Department III, Functional Science, Discipline of Medical Informatics and Biostatistics, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0497-0405","authenticated-orcid":false,"given":"C\u0103lin","family":"Muntean","sequence":"additional","affiliation":[{"name":"Department III, Functional Science, Discipline of Medical Informatics and Biostatistics, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teodora","family":"Piro\u0219","sequence":"additional","affiliation":[{"name":"Department III, Functional Science, Discipline of Medical Informatics and Biostatistics, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7337-7868","authenticated-orcid":false,"given":"Iulia Najette","family":"Crintea","sequence":"additional","affiliation":[{"name":"Department of Surgery I, Faculty of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania"},{"name":"Emergency Department, Emergency Clinical Municipal Hospital Timisoara, 300079 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreea Anda","family":"Alexa","sequence":"additional","affiliation":[{"name":"Discipline of Biochemistry, Department of Biochemistry and Pharmacology, Faculty of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3875-8143","authenticated-orcid":false,"given":"Anca","family":"Marcu","sequence":"additional","affiliation":[{"name":"Discipline of Biochemistry, Department of Biochemistry and Pharmacology, Faculty of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marilena","family":"Dinu\u021bi","sequence":"additional","affiliation":[{"name":"Discipline of Biochemistry, Department of Biochemistry and Pharmacology, Faculty of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"ref_1","unstructured":"Peacock, K., Carlson, K., and Ketvertis, K.M. 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