self test

1	Do you experience hot flushes?	Yes	No

2	Do you experience night sweats ?	Yes	No

3	Do you feel depressed? Do you feel periods of hopelessness? Do you feel apathetic	Yes	No

4	Do you cry more easily, or more often ?	Yes	No

5	Do you experience difficulty falling to sleep, or difficulty staying asleep ?	Yes	No

6	Do you have trouble controlling your urine? Do you have to go more often ?	Yes	No

7	Do you have pain or burning when urinating ?	Yes	No

8	Do you spill urine when you cough or sneeze ?	Yes	No

9	Do you experience more aches and pain ?	Yes	No

10	Do you feel more fatigued ?	Yes	No

11	Are you more irritable ?	Yes	No

12	Do you have more nervous tension ?	Yes	No

13	Do you feel more anxious ?	Yes	No

14	Do you feel that your libido has lessened ?	Yes	No

15	Do you feel discomfort or pain during intercourse ?	Yes	No

16	Do you feel less pleased with sex ?	Yes	No

17	Do you feel less energetic ?	Yes	No

18	Do you feel more hostile, angry, agitated or aggressive ?	Yes	No

19	Have you noticed more wrinkles around your mouth and eyes ?/Is the skin tone on your arms, legs, or hands poor?/ Has the skin lost its firmness or fullness	Yes	No

20	Does it seem as though your breast are shrinking and sagging ?	Yes	No

21	Do you have thick, white or coloured vaginal discharge ?	Yes	No

22	Do you have heavy bleeding with your periods or pass many small clots or large ones which can leave you pale and very tired ?	Yes	No

23	Have you begun menstrual periods again after going without one for six months ?	Yes	No

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