1. How old are you?
a) 35-40
b) 41-45
c) 46-50
d) 51-55
e) 56+

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2. How regular are your periods?
a) My periods are still regular, like clockwork.
b) My periods are getting a little unpredictable (earlier, later, or missed).
c) I’m noticing significant changes in the timing and flow—sometimes light, sometimes heavy.
d) I’ve skipped a few periods, and I’m not sure when my next one will come.
e) I haven’t had a period in a year or more.

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3. Have you experienced hot flashes or night sweats?
a) Nope, I’ve never experienced hot flashes or night sweats.
b) I get a little warm sometimes, but it’s not a big deal.
c) Hot flashes come and go, and they can be pretty intense, especially at night.
d) I’ve been waking up in a puddle of sweat more than I care to admit.
e) I’ve had no hot flashes for months now, so I think I’m through that stage!

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4. How would you describe your sleep patterns?
a) I sleep soundly and have no trouble falling asleep.
b) I wake up a little during the night but usually fall back asleep.
c) I often wake up multiple times throughout the night and struggle to get back to sleep.
d) Insomnia is becoming a regular issue for me. I’m exhausted during the day.
e) I haven’t slept well in months. My sleep quality is terrible!

 

5. Are you experiencing any changes in mood, such as irritability or anxiety?
a) I feel emotionally stable and happy most of the time.
b) I occasionally get more irritable or anxious, but it passes.
c) I’m feeling moody and sometimes a little anxious or emotional.
d) I have days when I feel extremely overwhelmed, stressed, or down.
e) I’m noticing mood swings or irritability almost every day, and it’s affecting my life.

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6. Do you find yourself forgetting things more often or having trouble concentrating?
a) No memory problems here—I’m as sharp as ever!
b) I sometimes forget things, but it’s nothing major.
c) I’m forgetting more things than I care to admit, and I have trouble focusing at times.
d) I can’t concentrate or remember things like I used to. My brain feels foggy!
e) I can’t recall the last time I felt mentally clear. I have trouble remembering even simple tasks.

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7. Have you noticed any changes in your body shape or weight?
a) My weight and body shape are pretty much the same.
b) I’ve noticed a slight change in my weight, but it’s manageable.
c) I’ve gained some weight around my midsection, and it’s harder to lose.
d) I feel like my metabolism has slowed down drastically, and my weight is creeping up.
e) My weight is fluctuating a lot, and I have more belly fat than I ever did before.

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8. How’s your energy level?
a) I’m energized and feel like I could take on anything!
b) I get tired at times, but I’m still managing to stay active and energetic.
c) I feel a little more tired than usual, but it’s nothing out of the ordinary.
d) I’m often tired and have less energy than I used to.
e) I’m exhausted most of the time and struggle to keep up with daily activities.

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9. Have you experienced vaginal dryness or discomfort during intimacy?
a) No changes here—everything is normal.
b) Occasionally, I feel a little dry, but it’s not uncomfortable.
c) I’ve noticed vaginal dryness, and it can be a bit uncomfortable during intimacy.
d) Intimacy has become more painful or uncomfortable due to dryness.
e) I’ve stopped having intimacy due to vaginal dryness or discomfort.

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10. Have you noticed any changes in your hair? (thinning, dryness, etc.)
a) My hair is as thick and shiny as ever.
b) I’ve noticed a little thinning or dryness, but it’s still manageable.
c) My hair seems to be thinning more than usual, and it feels drier.
d) My hair is thinning noticeably, and I’m starting to see more hair shedding.
e) My hair is thinning dramatically, and I’m concerned about it falling out.

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11. Are you experiencing any joint pain, stiffness, or muscle aches?
a) No pain or stiffness—everything feels great!
b) Occasionally, I feel a little stiffness in my joints, but it’s nothing serious.
c) I’ve noticed some joint pain or muscle aches, especially in the mornings.
d) My joints are stiff and achy almost every day, and I feel it in my muscles too.
e) I’m dealing with frequent joint pain, stiffness, and muscle discomfort that makes movement tough.

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12. How would you describe your emotional health?
a) I’m emotionally balanced and feel great overall.
b) I have some days of irritability or sadness, but they’re manageable.
c) I feel more anxious, emotional, or sad at times, and it’s hard to keep it together.
d) I’m experiencing frequent mood swings, stress, and emotional ups and downs.
e) I feel overwhelmed, sad, and frustrated most days.

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13. Are you ready to embrace menopause and all the changes that come with it?
a) Yes, I’m feeling confident and prepared for this transition.
b) I’m somewhat prepared, but I’d love more information and guidance.
c) I’m nervous about the changes, but I’m ready to learn.
d) I’m overwhelmed and definitely need more support and education.
e) I need a lot of help, and I’m looking for clear advice on how to manage all these changes.