• Perimenopause Symptom Checker

  • Date
     / /
  • Are you currently using HRT?*
  • Have you used HRT in the past?
  • What stage of the menopause transition are you currently in?

  • Green Climacteric Scale

    Rate how much each symptom bothers you on a daily basis.
  • 1. Heart beating quickly or strongly*
  • 2. Feeling tense or nervous*
  • 3. Difficulty sleeping*
  • 4. Excitable*
  • 5. Attacks of anxiety or panic*
  • 6. Difficulty concentrating*
  • 7. Feeling tired or lacking energy*
  • 8. Loss of interest in things*
  • 9. Feeling unhappy or depressed*
  • 10. Crying spells*
  • 11. Irritability*
  • 12. Feeling dizzy or faint*
  • 13. Pressure or tightness in head/ body*
  • 14. Part of body feel numb or tingling*
  • 15. Headaches*
  • 16. Muscle or joint pains*
  • 17. Loss of feeling in hands or feet*
  • 18. Breathing difficulties*
  • 19. Hot flushes*
  • 20. Night sweats*
  • 21. Loss of interest in sex*

  • Other Symptoms

  • Weight gain (esp around the middle)*
  • Brain Fog*
  • Memory problems/ Forgetfulness*
  • Loss of confidence/ self esteem*
  • Mood swings*
  • Uncontrollable rage/ anger*
  • Tinnitus / Ringing in ears*
  • Dry eyes/ ears*
  • Dry or itchy skin*
  • Restless legs*
  • Frequent Urinary Tract Infections (UTIs)*
  • Vaginal dryness, burning, itching or irritation*
  • Painful sexual intercourse*
  • Urinary incontinence*
  • Changes to menstrual cycle*
  • Heavy periods*
  • New or worsening allergies*
  • Digestives issues (bloating, gas, discomfort, constipation, diarrhoea, reflux, etc)*
  • Thinning hair*
  • How difficult have your symptoms made it for you to do your work, to take care of things at home and for your relationships with others?*

  • Devine Wellbeing is the data controller. We will process your responses and email only to create and send your report, unless you opt in to updates. We keep symptom responses for 12 months and email addresses while you’re subscribed or up to 24 months after your last interaction, then delete them. You can withdraw consent or exercise your rights at any time by emailing caroline@devinewellbeing.co.uk. We never sell your data.

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