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Do you feel like something isn't right?
(General health and wellbeing)
 
Not at all satisfied
 
Slightly satisfied
 
Moderately satisfied
 
Very satisfied
 
Completely satisfied
 
 
 
Have any joint pain and or muscular aches and pains?
 
Always
 
Most of the time
 
About half the time
 
Once in a while
 
Never
 
 
 
Have unexpected or sudden episodes of sweating or hot flashes when not doing anything?
 
Always
 
Most of the time
 
About half the time
 
Once in a while
 
Never
 
 
 
Have problems falling asleep, staying asleep, waking up feeling tired?
 
Always
 
Most of the time
 
About half the time
 
Once in a while
 
Never
 
 
 
Decrease in facial hair growth?
 
A very great deal
 
A great deal
 
Quite a bit
 
Moderately
 
Somewhat
 
A little bit
 
A tiny bit
 
About the same
 
 
 
Do people or situations easily upset you or has someone mentioned to you that you're moody?
 
Always
 
Most of the time
 
About half the time
 
Once in a while
 
Never
 
 
 
Decrease in sexual desire/libido?
 
Always
 
Most of the time
 
About half the time
 
Once in a while
 
Never
 
 
 
Feel physically exhausted, have less interest in leisure activities, feel like you are getting less done and or having to force yourself to undertake activities?
 
Always
 
Most of the time
 
About half the time
 
Once in a while
 
Never
 
 
 
Feel like you are not as strong as you use to be?
(Muscular weakness)
 
Always
 
Most of the time
 
About half the time
 
Once in a while
 
Never
 
 
 
Feeling down, sad, lack of drive, mood swings, verge of tears or feel that nothing is of any use?
 
Always
 
Most of the time
 
About half the time
 
Once in a while
 
Never
 
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