This assessment will highlight the health issues and treatment options for YOUR stage of peri/ menopause. Answer all questions for an accurate and informative result, which we’ll email to you afterwards.

Name
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What is your age?
Have you had a hysterectomy? (Your uterus removed)
Have you had your ovaries removed or had treatment that stopped them from working eg. chemotherapy?
When was your last menstrual period?
Was it more than 10 years ago?
Have you ever had breast cancer?
Do you have osteoporosis?
-Poor dietary calcium intake? eg. dairy food
-A history of bone fracture from quite a small impact?
-Several years or more without periods?
-Used steroid medications for more than 3 months?
-Rheumatoid arthritis
-Thyroid or parathyroid disorders?
-Coeliac or malabsorption disease?
-A strong family history of osteoporosis?
-Low body weight? eg. BMI less than 20
Do you have any of these osteoporosis risk factors?
Hot flushes and/or night sweats
Mood changes, eg. new or worsening anxiety, depression and/or irritability
Sleep disturbance
Vaginal dryness and/or pain
Urinary frequency, urgency or UTIs
-More than 10kg overweight, or waist measurement over 80cm?
-Smoker?
-High blood pressure, or medication for high blood pressure?
-High cholesterol, or medication for high cholesterol?
-Diabetes?
-Family history of heart disease, strokes or diabetes
Do you have any of these heart disease risk factors?
-Breast pain, lumps or discharge?
-Strong family history of breast, ovarian or bowel cancer?
-Heavy or unusual vaginal bleeding?
-New vaginal bleeding after more than 12months of no periods?
-Unusual vaginal discharge?
-Pelvic or vaginal pain?
Do you have any of the following breast or vaginal issues:
-Uncontrolled high blood pressure? (above 140/90)
-A condition which makes your blood clot too much?
-A history of blood clots or stroke?
-Heart disease or angina?
-Migraine headaches?
-A diagnosis of heart disease?
-Lupus (SLE)?
-Liver problems?
Do you have any of these conditions?
Thank you for using WellFemme’s Menopause Assessment Tool. After submitting your answers you will receive an on-screen and emailed report.