BioTE Female Symptom Survey

Within the past 2 weeks, please indicate your level of the following symptoms:*

	Never	Mild	Moderate	Severe	Very Severe
1. Hot flashes
2. Sweating (night sweats or increased episodes of sweating)
3. Sleep problems (difficulty falling asleep, sleeping through the night or waking up too early)
4. Depressive mood (feeling down, sad, on the verge of tears, lack of drive) Irritability (mood swings, feeling aggressive, angers easily)
5. Anxiety (inner restlessness, feeling panicky, feeling nervous, inner tension)
6. Physical exhaustion (general decrease in muscle strength or endurance, decrease in work performance, fatigue, lack of energy, stamina or motivation)
7. Sexual problems (change in sexual desire, sexual activity, orgasm and/or satisfaction)
8. Bladder problems (difficulty in urinating, increased need to urinate, incontinence)
9. Vaginal symptoms (sensation of dryness or burning in vagina, difficulty with sexual intercourse)
10. Joint and muscular symptoms (joint pain or swelling, muscle weakness, poor recovery after exercise)
11. Difficulties with memory
12. Problems with thinking, concentrating or reasoning
13. Difficulty learning new things
14. Trouble thinking of the right word to describe persons, places or things when speaking
15. Increase in frequency or intensity of headaches or migraines
16. Hair loss, thinning or change in texture of hair
17. Feel cold all the time or have cold hands or feet
18. Weight gain or difficulty losing weight despite diet and exercise
19. Dry or wrinkled skin