OBJECTIVES: Menopausal symptoms can cause significant distress to women, yet little is known about the value women place on these symptoms.  METHODS: In April 2013, 3397 US women, ages 40 to 69, completed an online survey that included 30 paired comparisons. Specifically, respondents were shown two menopausal symptoms described using the Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) and asked, “Which do you prefer?” From their choices, we estimated a generalized linear model to assess values women place on symptom relief in terms of quality-adjusted life years (QALYs).  RESULTS: The majority of respondents (1753 of 3397; 52%) always preferred reduced lifespan (up to 90 days) instead of experiencing menopausal symptoms at their worst for 30 days. For a majority of the symptoms (248/263; 94%), including low-grade events, QALYs were significantly reduced (p-value<0.05). The value women placed on relief ranged widely by symptom domain: the relief of depression, problems with memory, headache, pain in abdomen, problems with anger, and vomiting were the most valuable. CONCLUSIONS:  Overall, the value women place on menopausal symptom relief is surprisingly high. As the first national study to directly ask women about their preferences and to estimate the value of menopausal symptom relief on a QALY scale, this work provides critical evidence for health outcomes research in mid-life women and can be applied in the evaluation of treatments that reduce or eliminate menopausal symptoms. This work also provides proof-of-concept for an approach to value PRO-CTCAE responses on a QALY scale.