Sixteen studies were included in the review. These studies involved a total of 42,818 women, of whom 22,321 were premenopausal and 20,497 were perimenopausal.
Five studies were evidence level A, the other 11 were level B.
Hot flashes (n=5): the sensitivity ranged from 22 to 55% and the specificity from 83 to 91%. The positive LR ranged from 2.15 to 4.06 and the negative LR from 0.54 to 0.87.
Night sweats (n=3): the sensitivity ranged from 20 to 50% and the specificity from 74 to 87%. The pooled positive LR was 1.90 (95% CI: 1.63, 2.21) and the negative LR ranged from 0.67 to 0.92.
Vaginal dryness (n=3): the sensitivity ranged from 11 to 29% and the specificity from 80 to 97%. The positive LR ranged from 1.48 to 3.79 and the pooled negative LR was 0.92 (95% CI: 0.91, 0.04).
Incontinence (n=4): the sensitivity ranged from 16 to 39% and the specificity from 64 to 91%. The positive LR ranged from 1.09 to 1.66 and the pooled negative LR was 0.91 (95% CI: 0.89, 0.93).
Depressed mood (n=5): the sensitivity ranged from 9 to 47% and the specificity from 64 to 97%. The positive LR ranged from 1.30 to 3.14 and the negative LR from 0.82 to 0.94.
Insomnia (n=5): the sensitivity ranged from 21 to 53% and the specificity from 63 to 83%. The positive LR ranged from 0.98 to 2.06 and the negative LR from 0.79 to 1.0.
Nervous tension and/or irritability (n=3): the sensitivity ranged from 41 to 59% and the specificity from 51 to 68%. The pooled positive LR was 1.23 (95% CI: 1.12, 1.34) and the pooled negative LR was 0.83 (95% CI: 0.77, 0.90).
Self-rating (n=2): the sensitivity ranged from 77 to 94% and the specificity from 39 to 64%. The positive LR ranged from 1.53 to 2.13 and the negative LR from 0.18 to 0.36.
The following symptoms or tests were each assessed in one study: psychologic distress, sexual interest, current-smoking, FSH levels, inhibin A and B levels, and IR-INH levels. The positive LRs ranged from 1.31 to 3.06 and the negative LRs from 0.45 to 0.97.