Questionnaire

Learn more about how to make the most of menopause!

Menopause is a taboo for many women and therefore most women don’t know how to prepare for what’s coming. We help you prepare for this journey with this questionnaire by understanding your body better.

Are You in Perimenopause?

Let's talk about your overall health.

1Are you being treated for any disease or serious health condition?

2Have you been diagnosed with osteopenia or osteoporosis?

3Have you suffered from a hormonal imbalance in the past?

4Do you know much about thyroid condition, polycystic ovary syndrome (PCOS) and insulin resistance?

Let’s consider the level of stress in your life.

5Is work a source of stress for you?

6Do you skip meals frequently?

7Do you mostly eat out?

8Are your relationships (friends, family, partner, colleagues) a source of conflict or stress?

Let’s think about other demands on your body.

9Do you have caffeine or soft drinks more than once a day?

10Are you taking multiple prescriptions, or often use antibiotics?

11Do you have concerns about your family health history

12 Have you recently suffered a major emotional trauma such as divorce, separation, job loss, death of a loved one?

13Do you eat protein at every meal?

14 Do you eat fruits & vegetables every day?

15Do you eat breakfast every day?

16Are carbohydrates (count pasta too!) and/or sweets a big part of your diet?

17 Do you exercise four or more times a week?

18Do you get 7-8 hours of sleep per night?

19Do you practice some form of stress reduction such as meditation or yoga?

20Do you take high quality nutritional supplements, including omega-3?

21Are you on Hormone Replacement Therapy (HRT)?

22Have you had a hysterectomy?

23Are you taking some form of prescription birth control?

24What’s your age?

25Which stage of menopause do you consider you are?

Thank you for participating!

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