Menopause questionnaire
Menopause can present with a wide range of symptoms — from hot flushes and sleep disturbance to mood changes, joint pain, and vaginal discomfort.
This questionnaire helps us gain a clearer understanding of how you are feeling and the impact symptoms may be having on your daily life. Your responses allow our practitioners to assess symptom severity, monitor progress over time, and tailor treatment recommendations to your individual needs. Please complete the form as thoroughly as possible prior to your consultation.
Symptom Score (Modified Greene Scale)1
This symptom score can be used to document symptoms and monitor response to treatments. It should NOT be used to diagnose perimenopause or menopause. Perimenopause commences when menstrual cycle changes occur, with differences in length of consecutive cycles. Menstrual cycle changes cannot be used to diagnose perimenopause for people using hormonal contraception, or who have had an endometrial ablation or hysterectomy.
The severity of the problem is scored as follows:
Score: None =0; Mild =1; Moderate =2; Severe =3
Please note: Not all of the symptoms listed are necessarily oestrogen deficiency symptoms.
1 Greene JG. Constructing a standard climacteric standard. Maturitas 1998; 29:25-31. menopause.org.au
Note: Medical and scientific information provided and endorsed by the Australian Menopause Society might not be relevant to a particular person’s circumstances and should always be discussed with that person’s own healthcare provider. This Information Sheet may contain copyright or otherwise protected material. Reproduction of this Information Sheet by Australian Menopause Society Members and other health professionals for clinical practice is permissable. Any other use of this information (hardcopy and electronic versions) must be agreed to and approved by the Australian Menopause Society. ID:2025-02-20.
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