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Create Your Personalized Symptoms Map

This questionnaire is designed to complement your AI analysis by giving you a clear picture of your symptoms. Answer each question to build a complete symptoms map that you can share with your healthcare provider. This tool will help you monitor changes, track improvements, and have more informed discussions about your health.

  1    Answer all questions – For a clear view of your experience.

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  2    Pick one answer – The closest match to how you feel.

Hot Flashes
None
Mild
Moderate
Severe
Light-Headed Feelings
None
Mild
Moderate
Severe
Headaches or Migraines
None
Mild
Moderate
Severe
Irritability
None
Mild
Moderate
Severe
Depression
None
Mild
Moderate
Severe
Unloved Feelings
None
Mild
Moderate
Severe
Anxiety
None
Mild
Moderate
Severe
Mood Changes
None
Mild
Moderate
Severe
Difficulty Falling or Staying Asleep
None
Mild
Moderate
Severe
Night Sweats
None
Mild
Moderate
Severe
Shorter Menstrual Cycles (Up to 25 Days)
None
Mild
Moderate
Severe
Breast Soreness or Swelling
None
Mild
Moderate
Severe
Weight Gain Without Lifestyle Changes
None
Mild
Moderate
Severe
Unusual Tiredness
None
Mild
Moderate
Severe
Backache
None
Mild
Moderate
Severe
Joint Pain
None
Mild
Moderate
Severe
Muscle Pain
None
Mild
Moderate
Severe
New Facial Hair
None
Mild
Moderate
Severe
Dry Skin
None
Mild
Moderate
Severe
Crawling Feelings Under the Skin
None
Mild
Moderate
Severe
Low libido
None
Mild
Moderate
Severe
Vaginal dryness
None
Mild
Moderate
Severe
Uncomfortable Intercourse
None
Mild
Moderate
Severe
Urinary Frequency
None
Mild
Moderate
Severe
Heavy/Longer Flow
None
Mild
Moderate
Severe
Night Sweats
None
Mild
Moderate
Severe
Breast Soreness or Swelling
None
Mild
Moderate
Severe
Weight Gain Without Lifestyle Changes
None
Mild
Moderate
Severe
Increased Cramps
None
Mild
Moderate
Severe
Heart Palpitations
None
Mild
Moderate
Severe
Brain Fog or Difficulty Concentrating
None
Mild
Moderate
Severe
Dry or Itchy Eyes
None
Mild
Moderate
Severe
Increased Appetite or Food Cravings
None
Mild
Moderate
Severe
Changes in Body Odor
None
Mild
Moderate
Severe
Frequent Infections (such as UTIs)
None
Mild
Moderate
Severe
Gum Problems (Sensitivity, Inflammation, or Disease)
None
Mild
Moderate
Severe
Dry Mouth (Xerostomia)
None
Mild
Moderate
Severe
Increased Tooth Sensitivity
None
Mild
Moderate
Severe
Burning Mouth Syndrome (BMS)
None
Mild
Moderate
Severe
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