6.1 - KIDNEY AND BLADDER
Never
Occasionally
Moderately / Often
Frequently / Daily
1) Fluid retention throughout body
4) Excessive urination during night
5) Burning with urination
8) Bloody, cloudy or darkened urine, or strong-smelling urine
12) Severe one-sided lower back or groin pain associated with restlessness
13) History of kidney stones
6.3 - PMS SYMPTOMS
Never
Occasionally
Moderately / Often
Frequently / Daily
16) Breast tenderness, swelling or lumps
17) Feeling depressed, teary, or sensitive
18) Feeling anxious, irritable, or easily angered
19) Diarrhoea or constipation
20) Headaches or migraines
21) Food cravings or binge eating
23) Fluid retention or weight gain
25) Feeling aggressive, or feeling suicidal
6.4 - MENSTURAL CYCLE
Never
Occasionally
Moderately / Often
Frequently / Daily
26) Irregular intervals between periods
27) Long period cycles, greater than 32 days
28) Short period cycles, less than 24 days
29) Vaginal bleeding between periods
30) Painful periods – lower abdomen or back
31) Pain with periods is worsening
32) Painful intercourse during menstruation
33) Pelvic and/or rectal pressure around menstruation
34) Constipation or diarrhoea with menstruation
35) Nausea and/or vomiting with menstruation
37) Heavy blood flow, or flooding
38) Passage of large or profuse blood clots
39) Prolonged duration of bleeding
41) Absence of menstrual flow for more than 5 months
6.5 - SYMPTOMS OF MENOPAUSE
Never
Occasionally
Moderately / Often
Frequently / Daily
42) Irregular menstrual cycle and/or changes in menstrual flow (heavier or lighter)
43) Dry skin, hair or vagina
45) Mood swings, irritability, depression, nervousness, anxiety
48) Headaches or dizziness
51) Difficulty concentrating, poor memory, or confusion
52) Thinning of armpit and pubic hair, or increased hair growth on upper lip
53) Breasts reducing in size and starting to sag
6.6 – FEMALE REPRODUCTIVE ISSUES
Never
Occasionally
Moderately / Often
Frequently / Daily
54) Swelling under armpit
55) Vaginal dryness or pain
57) Milk production (not nursing), or engorged breasts
60) Acne and/or oily skin
66) Vaginal discharge: excessive, smelly, or coloured
67) Burning or itching of external genitalia
68) Vaginal bleeding after intercourse, or between periods
69) Lower abdominal or back pain
70) Lower abdominal or back painBreast lumps, or a change in breast size or shape
71) Nipple discharge, or change in appearance of nipple