How often did you feel a sudden wave of heat this past week?

None

1–2 times

3-5 Times

Every day

In the past week, on how many nights did you wake up sweaty or find damp sheets?

None

1–2 nights

3 - 4 nights

5+ Nights

Over the last 6 months, which best describes your periods?

They still come like clockwork

They arrive closer together than before

They skip months or come late

I haven’t had a period for more than 12 months

When you wake up in the morning, you feel…

Refreshed and ready to go

Okay, but I could use another hour

Exhausted—as if I never slept

How often do you swing from calm to irritable (or teary)?

Never

Rarely

A few days a week

Most days lately