Menopause Hormone Therapy Questionnaire

  • Are you experiencing recurring bladder infections?

  • Do you suffer from disruptive hot flashes (intense and sudden waves of heat accompanied by excessive sweating?

  • Are you experiencing uncharacteristic mood changes (e.g. sadness, irritability, etc.)?

  • Are you experiencing night sweats, sleep disturbances or difficulty sleeping?

  • Do you suffer from vaginal dryness or painful intercourse?

  • Do you have a loss of interest in sexual activities (libido, desire)?

  • Has your complexion gone through noticeable changes (i.e. drier than usual, unwanted facial hair, acne).

  • Do you feel bloated or have gained weight?

  • Have your periods become irregular (i.e. skipped periods, heavier flow, etc.)?

  • Do you have difficulty concentrating or remembering things?

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