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Menopause Questionnaire
Progress: 
 
Thank you for completing this questionnaire - our aim is to make our information and support materials for women going through the menopause as relevant as possible to your current needs. We greatly appreciate your feedback. In recognition of your help and to maintain the anonymity of the responses, we will donate 50p to Leukaemia Care for each questionnaire returned.
 
1.
In what age group are you please?
Less than 45
45 - 50
51 - 55
Over 55
2.
What is your current menopausal status?
Not yet at the 'change'- no / minor symptoms GO TO Q13
Not yet at the 'change'- symptoms GO TO Q13
At the 'change' - symptoms
At the 'change' - no / minor symptoms
Through the 'change'- no / minor symptoms GO TO Q13
3.
How did you confirm that you were menopausal?
Own interpretation of symptoms
Home menopause test
Doctor consultation
Haven't confirmed
Other
4.
What symptoms are you experiencing? (tick all that apply)
Hot flushes
Night sweats
Mood swings
Anxiety
Depressive mood
Sleeplessness
Other - please state
No symptoms
5.
How are you currently managing your menopausal health?
Doing nothing
Using a natural approach
Using a conventional medical approach, eg HRT (Hormone Replacement Therapy)
Other
6.
In your view how trustworthy is the information on the menopause from each of the following?
 Very Somewhat Not   
Doctor   
Nurse   
Friend   
Magazine   
Internet   
Relative   
Retailer   
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