Perimenopause Self-Check for ADHD Mums

⚠️ Important to know

This isn’t a diagnosis tool. It’s just a way to track what’s happening in your body (and brain) so you can spot patterns, talk to your doctor, and maybe stop blaming yourself for things that aren’t your fault. Rate symptoms below from 0–4. Quick taps, no essays.
🔥 Hot flushes*

0 = Not an issue1 = Noticeable but fine2 = Messy and frustrating4 = Taking over my life
🌙 Night sweats*

0 = Not an issue1 = Noticeable but fine2 = Messy and frustrating4 = Taking over my life
😴 Sleep dramas*

0 = Not an issue1 = Noticeable but fine2 = Messy and frustrating4 = Taking over my life
😭 Crying easily*

0 = Not an issue1 = Noticeable but fine2 = Messy and frustrating4 = Taking over my life
😵 Feeling overwhelmed : *

0 = Not an issue1 = Noticeable but fine2 = Messy and frustrating4 = Taking over my life
🙃 Loss of joy in things you used to like *

0 = Not an issue1 = Noticeable but fine2 = Messy and frustrating4 = Taking over my life
😡 Irritability*

0 = Not an issue1 = Noticeable but fine2 = Messy and frustrating4 = Taking over my life
😰 Anxiety / racing heart / panic feelings*

0 = Not an issue1 = Noticeable but fine2 = Messy and frustrating4 = Taking over my life
🧠 Brain fog*

0 = Not an issue1 = Noticeable but fine2 = Messy and frustrating4 = Taking over my life
🎯 Concentration fails *

0 = Not an issue1 = Noticeable but fine2 = Messy and frustrating4 = Taking over my life
🪫 Fatigue*

0 = Not an issue1 = Noticeable but fine2 = Messy and frustrating4 = Taking over my life
🎧 Dizziness / tingling / ringing in ears*

0 = Not an issue1 = Noticeable but fine2 = Messy and frustrating4 = Taking over my life
💥 Headaches / migraines*

0 = Not an issue1 = Noticeable but fine2 = Messy and frustrating4 = Taking over my life
🦴 Achy joints / stiff muscles*

0 = Not an issue1 = Noticeable but fine2 = Messy and frustrating4 = Taking over my life
🧖 Skin or hair changes (dryness, thinning, new chin hair)*

0 = Not an issue1 = Noticeable but fine2 = Messy and frustrating4 = Taking over my life
🚽 Peeing all the time / leaks / UTIs*

0 = Not an issue1 = Noticeable but fine2 = Messy and frustrating4 = Taking over my life
🌵 Vaginal dryness / discomfort with sex/ UTIs*

0 = Not an issue1 = Noticeable but fine2 = Messy and frustrating4 = Taking over my life
💔 Libido gone AWOL*

0 = Not an issue1 = Noticeable but fine2 = Messy and frustrating4 = Taking over my life
🫠 Bloating / sluggish digestion*

0 = Not an issue1 = Noticeable but fine2 = Messy and frustrating4 = Taking over my life
⚖️ Weight gain that won’t shift*

0 = Not an issue1 = Noticeable but fine2 = Messy and frustrating4 = Taking over my life
Life Impact Check: 🏠 Home life (cooking, cleaning, kids)*

0 = Not an issue1 = Noticeable but fine2 = Messy and frustrating4 = Taking over my life
Life Impact Check: 👩‍👧 Parenting (patience, energy, showing up)*

0 = Not an issue1 = Noticeable but fine2 = Messy and frustrating4 = Taking over my life
Life Impact Check: ❤️ Relationships (connection vs. constant snapping)*

0 = Not an issue1 = Noticeable but fine2 = Messy and frustrating4 = Taking over my life
Life Impact Check: 💼 Work / study (emails, meetings, focus)*

0 = Not an issue1 = Noticeable but fine2 = Messy and frustrating4 = Taking over my life
Results
Name

First NameLast Name
Email*
The results will be emailed out to you
Should be Empty: