Quality of life (QOL) is difficult to define, and difficult to measure, in virtually any disease state or medical condition, but particularly one in which the symptoms or effects of the condition can vary so widely, as is the case with menopause. But, do the presently available QOL indices really provide physicians or research investigators with a clear picture of what a menopausal woman is experiencing, or how she really feels? The answer, according to one of the founding presidents of the North American Menopause Society (NAMS), is no. At the annual meeting of the NAMS, held in New Orleans in October, Dr Wulf Utian, professor emeritus of reproductive biology and obstetrics and gynaecology at Case Western Reserve University school of medicine, Cleveland, US, unveiled what he hopes will become the first in a new generation of QOL indices.