• Green Climactic Scale Self-Assessment

    Please complete this self-assessment to help evaluate your climacteric symptoms. Your responses will be reviewed by a healthcare professional.

  • Over the past week, how much have you experienced the following symptoms? Please select the option that best describes your experience for each symptom.

    Rate each symptom from 0 (Not at all) to 3 (Extremely).
  • Heart discomfort (unusual awareness of heartbeat, heart skipping, heart racing, tightness)*
  • Irritability (feeling nervous or tense)*
  • Sleep problems (difficulty in falling or staying asleep)*
  • Memory Problems*
  • Attacks of anxiety or panic*
  • Difficulty concentrating*
  • Feeling tired of lack of 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/or joint pain*
  • Pins and needles in any part of the body*
  • Breathing difficulty*
  • Hot flashes*
  • Sweating at night*
  • Loss of interest in sex*
  • Urinary symptoms*
  • Symptoms due to vaginal dryness*
  • Should be Empty: