Age Group? Under 40 40-45 46-50 51-55 Over 55 None Have you experienced any changes in your menstrual cycle recently? No Yes, irregular periods Yes, periods have stopped None Do you experience hot flashes or night sweats? No Occasionally Frequently None Have you noticed changes in your mood or increased irritability? No Yes, but it’s mild Yes, and it’s significant None Do you have trouble sleeping or experience insomnia? No Occasionally Frequently None Do you experience headaches along with dizziness? No Occasionally Frequently None Have you had any sudden changes in weight (gain or loss)? No Yes, slight changes Yes, significant changes None Do you experience joint pain or stiffness? No Occasionally Frequently None Have you experienced any changes in your libido (sex drive)? No Yes, decreased Yes, increased None Do you feel dizzy or lightheaded when you stand up quickly? No Occasionally Frequently None 1 out of 2 Name Email Phone Time's up
