Menopause symptoms checklist

Published on Feb 28, 2020
Medically reviewed by Charanjeet Singh, MBBS
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Many women experience physical and emotional changes that affect their daily life during menopause. Simply answer the questions, print out the checklist and take it to your doctor to discuss.

This tool is not intended to result in a diagnosis or a treatment recommendation. Please use it to have a more meaningful discussion with your doctor. We do not store or collect the information filled out below.

Have you experienced the following symptoms?

       Yes       No
  1. Hot flushes
  2. Night sweats
  3. Difficulty sleeping
  4. Feeling anxious or nervous
  5. Feeling depressed, down or blue
  6. Experiencing poor memory
  7. Aching in muscles and joints
  8. Feeling a lack of energy
  9. Changes in appearance texture or tone of your skin
  10. Crawling feelings over the skin
  11. Weight gain
  12. Frequent urination
  13. Changes in your sexual desire
  14. Vaginal dryness during intercourse
  15. Avoiding intimacy

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February 2020


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