This study aims to discuss a statistically reasonable inclusion of additional questions in the Menopause Rating Scale II (MRS II) for daily use in clinical practice. Retrospective data analysis was performed (cantonal ethics committee No. 2016-01179). The MRS II was extended with the parameters ‘changes in weight’, ‘headaches’, ‘skin changes’, ‘changes in hair growth’, ‘hair loss’, and whether therapy was desired. Data from 419 women seeking medical advice in our menopause center were collected between April 2009 and April 2017. Cronbach’s alpha was used to measure internal consistency of the extended questionnaire. For the conventional MRS II ( = 340 of 419, 81.1%), the internal consistency measured with Cronbach’s alpha increased from 0.805 to 0.820 considering ‘changes in weight’ ( = 237, 56.6%), to 0.815 considering ‘headaches’ ( = 247, 58.9%), and to 0.815 considering ‘skin changes’ ( = 236, 56.3%) if these additional parameters were added separately. Cronbach’s alpha increased from 0.805 to 0.835 ( = 224, 53.5%) if these parameters were added at once. Desire for therapy varied between 42.1% for ‘changes in hair growth’ ( = 38, 9.1%) and 60.6% for ‘hair loss’ ( = 33, 7.9%). We suggest including the items ‘changes in weight’, ‘headaches’, and ‘skin changes’ in the MRS II as our results show even higher internal consistency with these symptoms and as the wish for therapy was high.