Slym Wellness Perimenopause & Menopause Symptom Questionnaire
Rate how much each symptom is bothering you today. Choices: Not at all (0), A little bit (1), Quite a bit (2), Extremely (3). Your total score shows severity and suggested next steps.
Total
Category
Highest Symptoms
Why Understanding Your Hormonal Health Matters at Slym Wellness Clinic
Perimenopause and menopause can affect sleep, mood, cognition, metabolism, pelvic health, and intimacy. A quick snapshot of your symptoms helps our providers decide whether to:
Order targeted labs and review medications and risk factors
Personalize nutrition, sleep, and stress strategies with our dietician, Julia Leone, RDN
Discuss evidence-based therapies to reduce symptoms and protect long-term health
We don’t chase numbers — we help you feel and function better.
Understand Your Symptoms
IMPORTANT DISCLAIMER: This questionnaire is for educational purposes only and does not diagnose any condition. A licensed Slym Wellness provider must review your health history and, if appropriate, labs before making recommendations.
The checklist covers 16 common symptoms with four choices each — Not at all, A little bit, Quite a bit, Extremely — so you can see your overall pattern and where support could help most.
Rate each item based on how much it’s bothering you today. Scores are summed for a total from 0 to 48.
Your result shows Mild (0–16), Moderate (17–32), or Severe (33–48) to guide your next steps.
You’ll also see your top three symptoms to focus your plan.
Mild: You’re experiencing some change. We’ll plan proactive routines for sleep, mood, and metabolism, and set a follow-up if symptoms progress.
Moderate: Symptoms are affecting daily life. We’ll combine lifestyle, nutrition, and clinical support to reduce severity and restore quality of life.
Severe: Symptoms are significantly disruptive. A provider evaluation is recommended to consider comprehensive options.
Next best step:
Book a Women’s Hormone Consultation →
Explore Slym Wellness Women’s Health Programs →
Take Action with Slym Wellness Clinic
Perimenopause and menopause don’t have to mean feeling unlike yourself. At Slym Wellness Clinic, we take a comprehensive, inside-out approach — blending clinical expertise with personalized care to restore balance, energy, and confidence.
Our providers specialize in:
Hormone Optimization: Bioidentical therapies customized to your unique levels and symptoms.
Nutrition & Metabolic Support: Dietician-led plans that fuel energy, muscle, and mood stability.
Symptom Relief: Strategies to ease hot flashes, brain fog, and sleep disturbances.
Preventive Health: Protecting bone, heart, and cognitive function during hormonal transition.
Whether your symptoms are mild or severe, we’ll create a plan that works with your lifestyle — not against it.
Frequently Asked Questions (FAQ)
A: This self-assessment, adapted from the Greene Climacteric Scale, helps you measure how often and how strongly you experience symptoms of perimenopause or menopause. It’s not a diagnostic tool, but it’s a helpful way to start understanding how hormonal changes may be affecting your mood, energy, sleep, and overall well-being.
A: The tool covers 16 of the most common symptoms associated with hormonal transition, including hot flashes, night sweats, brain fog, sleep disruption, mood changes, anxiety, vaginal dryness, fatigue, weight gain, and irregular periods. You’ll rate each symptom from “Not at all” to “Extremely” to reflect how much it’s impacting you.
A: Each symptom is scored from 0 to 3, giving a total possible score of 48. Your total falls into one of three categories:
Mild (0–16): Minimal symptoms or infrequent discomfort.
Moderate (17–32): Noticeable symptoms that affect your day-to-day comfort or focus.
Severe (33–48): Frequent or intense symptoms that significantly impact your quality of life.
If your score is moderate or severe, it’s a good idea to speak with a Slym Wellness provider about next steps.
A: No. This is a screening and educational tool, not a diagnostic exam. While it can help identify patterns, only a licensed Slym Wellness provider can interpret your symptoms in the context of lab results, history, and lifestyle factors to create a personalized plan.ent
A: Absolutely. Nutrition, hydration, movement, and stress management all influence how your body metabolizes hormones. Our on-staff dietician, Julia Leone, RDN, provides individualized nutrition guidance that supports hormonal balance, energy, and long-term health — for both patients and non-patients.
A: No. Slym Wellness Clinic offers functional nutrition and hormone optimization services for both patients and non-patients. Whether you’re interested in hormone therapy, nutrition counseling, or natural approaches to symptom relief, our team can help you find the right fit.
A: Once you review your results, schedule a consultation with one of our providers to discuss your symptoms and explore treatment options. Depending on your goals, your care plan may include bioidentical hormone therapy, targeted peptides, or dietician-led lifestyle support designed to restore balance and improve your quality of life.
Important Medical Disclosure
Medical Disclaimer
This questionnaire is provided by Slym Wellness Clinic for educational use only. It does not diagnose, treat, cure, or prevent disease. Results are estimates based on your self-ratings and may not reflect your medical needs. Always consult a qualified healthcare provider before starting or changing any medical, nutritional, or supplement regimen. Completing this questionnaire does not establish a patient-provider relationship.