• Are you female?*
  YesNo
• What's your age?*
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• Your body

• Do you have periods?*
  YesNo
• Are your periods...
  RegularHeavyIrregularNormalPainful
• Why do you think your periods stopped?
  It stopped naturallyI’m using hormonal contraceptionOther
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• Are you on any hormonal medicine? (such as oral contraception, IUD, HRT)*
  YesNo
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• What’s your weight like?*
  Same as alwaysLost someGained some
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• Are you experiencing any changes in your skin?*
  No changesAcneMelasmaDrynessOilyItchyExcessive bodily hair growth
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• Have you noticed hair loss?*
  YesNo
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• How’s your tummy feeling?*
  DiarrhoeaFood intoleranceGas & BloatingNauseaFine
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• How’s your energy levels?*
  LowNormalHigh
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• How’s your sleep quality?*
  PoorAverageGreat
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• Are you trying to get pregnant?*
  YesNo
• How long have you been trying?
  Just startedOver 6 months
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• What’s your body temperature like?*
  I’m sensitive to coldI’m experiencing hot flashesI’m normal
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• Are you experiencing any pelvic or lower back pains?*
  YesNo
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• What’s peeing on your period like?
  PainfulNormal
• What’s peeing on your period like?
  Blood in my peeNormal
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• Are you experiencing any mood changes?
  DepressionPanicAnxietyIrritabilitySuicidalSuper positiveNo mood changes
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• Your mind

• Are you experiencing memory loss or brain fog?
  YesNo
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• What’s your overall quality of life?
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• You must be a female to continue this symptom check

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