Symptom Checker - Wells Menopause Clinic

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Consultation Information
Menopause & HRT Information
Resources
Book a Consultation

Home
Consultation Information
Menopause & HRT Information
Resources
Book a Consultation

Individualised and evidence-based advice to support you through the menopause and beyond

Pre Consultation Symptom Checker

If you have booked a consultation and would like to fill in this online symptom checker it will email me your answers prior to our appointment.

Name

Date Of Birth

Email

Changes to periods/periods stopped

Yes No

Details

Daytime sweats/flushes

Yes No

Details

Night sweats/flushes

Yes No

Details

Poor sleep

Yes No

Details

Fatigue

Yes No

Details

Anxiety/panic attacks

Yes No

Details

Low mood/depression

Yes No

Details

Loss of joy/little interest in life

Yes No

Details

More emotional/tearful

Yes No

Details

Mood swings/irritability/PMT worse

Yes No

Details

Reduced motivation

Yes No

Details

Reduced confidence/low self-esteem

Yes No

Details

Brain fog

Yes No

Details

Poor memory/word finding problems

Yes No

Details

Reduced concentration

Yes No

Details

Increasing headaches/migraines

Yes No

Details

Heart palpitations/breathing difficulties

Yes No

Details

Feeling faint/dizzy

Yes No

Details

Muscle aching/joint pains

Yes No

Details

Weight gain around the middle

Yes No

Details

Thinning hair

Yes No

Details

Dry Eyes

Yes No

Details

Dry mouth/burning tongue/metallic taste

Yes No

Details

Dry/itchy/spotty skin

Yes No

Details

Restless legs

Yes No

Details

Tinitus

Yes No

Details

Urinary symptoms

Yes No

Details

Vaginal symptoms

Yes No

Details

Painful Sex

Yes No

Details

Loss of libido

Yes No

Details

Message

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If you have any queries before booking an appointment, please email

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Company number 12053266
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PLEASE NOTE THAT ALL MEDICAL INFORMATION GIVEN ON THIS WEBSITE IS AS ACCURATE AND COMPREHENSIVE AS POSSIBLE BUT IT IS ONLY GENERAL ADVICE AND SHOULD NOT BE USED AS A SUBSTITUTE FOR CONSULTING YOUR OWN DOCTOR FOR INDIVIDUAL ADVICE.