• Menopause Symptoms Questionnaire

  • What day are you filling this out?
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  • Heart beating quickly or strongly
  • Feeling tense of nervous
  • Difficulty in sleeping
  • Memory problems
  • Attacks of anxiety, panic
  • Difficulty in concentrating
  • Feeling tired or lacking in energy
  • Loss of interest in most things
  • Feeling unhappy or depressed
  • Crying spells
  • Irritability
  • Feeling dizzy or faint
  • Pressure or tightness in head
  • Tinnitus (ringing or buzzing in the ear)
  • Headaches
  • Muscle and joint pains
  • Pins and needles in any part of the body
  • Breathing difficulties
  • Hot flushes
  • Sweating at night
  • Loss of interest in sex
  • Urinary symptoms
  • Symptoms due to vaginal dryness
  • According to several menopause societies, a score of 15 or over usually indicates estrogen deficiency that is intrusive enough to require treatment, but this is only a guide. Women are very variable in their tolerance of discomfort, often tolerating quite severe symptoms before they will even consider taking hormone therapy. Scores of 20-50 are common in symptomatic women, and with adequate treatment tailored to each person. The score will reduce to 10 or under in 3-6 months. Please repeat this questionnaire in 3 months and then at 6 months time if/when you do begin hormone therapy.

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