Perimenopause Symptoms Quiz

Perimenopause Quiz

This is a simple quiz designed to help you understand what goes on in your body and to determine the likelihood of perimenopause based on your symptoms. It will help to guide you where to focus your efforts when it comes to dealing with the common symptoms of peri-post menopause. To complete the quiz, please rate the severity of your symptoms for each question (0=No symptoms to 5=Very Severe)
I have hot flushes (and/or night sweats)*

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I cannot get sufficient sleep (difficulty in sleeping)*

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I experience aching muscles and/or joints*

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I feel tired when I get up (feeling as if you lack energy)*

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I have the perception of feeling useless*

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I have noticed changes to my period flow or length*

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I feel anxious or nervous*

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I am afraid of performing physical activity/ exercise because my urine leaks*

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I have vaginal discomfort and dryness*

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I feel my heart beating quickly and experience heart palpitations*

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I have noticed skin dryness (changes in skin appearance, texture & tone)*

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Click any other symptoms you have:

Brain fogFatigueStressMood swingsRageLow sex driveHeadachesAnxietyItchy SkinRinging in earsIrregular cycleMemory LossLow MotivationDepressionDiscomfort during sexNone of theseAll of these (big hug!)
Since entering peri-menopause or menopause have you become uncomfortable with your weight?*

YesNo
Do you have a bone or joint problem that could be made worse by participating in exercise? *

YesNo
Do you have unexplained gut health or digestion issues (constipation, diarrhea, bloating, etc?*

YesNo
Do you become breathless with physical activity?*

YesNo
On a scale of 1-10, with 10 being the highest, how are these symptoms affecting your quality of life at home, work and relationships?
What stage of menopause are you in?
When was your last cycle?

0-1 month ago1-3 months ago3-6 months ago6-12 months ago>12 month ago
Anything else you would like to share with me?
Name

First NameLast Name
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Perimenopause Quiz