Perimenopause Symptom & Wellness Check-In

Could Perimenopause Be the Reason You Don’t Feel Like Yourself Anymore?

Perimenopause can affect much more than your menstrual cycle. Changes in hormones, metabolism, sleep, digestion, mood, energy, brain function, sexual health, stress response, and overall health can show up in ways you may not immediately connect to perimenopause.

Take this 2–3 minute quiz to see how strongly your current symptoms may be affecting your overall well-being and to better understand which areas of your health may need more attention.

For each question, choose the answer that best describes your experience right now.

1 = Not at all | 2 = Mildly | 3 = Moderately | 4 = Very | 5 = Extremely

3. How much are you experiencing heart palpitations, a racing heart, or episodes where your heartbeat feels irregular? *

20. How much have these changes affected your overall quality of life or your feeling of being “yourself”? *

Before we proceed with your submission, please enter your details below. This information will help us properly record and review your assessment.

Last Name *

First Name *

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