Fill this in by hand, or print it blank and complete it at the kitchen table — either way, bring it in.
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Free printable Doctor-visit toolkit
Menopause & perimenopause

Your Doctor-Visit Symptom Checklist

You get about ten minutes with your doctor, and it is easy to freeze and forget half of what has been wrecking your weeks. So don't rely on memory. Tick what you're feeling, rate how bad it is, and note anything that stands out. Walk in with this in your hand — it makes you impossible to fob off, and it helps a good doctor help you faster.

1

Symptoms — tick what applies & rate the severity

Leave blank anything you don't get
Symptom Mildniggle Moderatedisrupts Severedaily life How long / notes
Temperature & sweats
Hot flushes / flashes
Night sweats
Sudden chills / palpitations
Sleep & energy
Trouble falling / staying asleep
Waking unrefreshed / exhausted
Mood & mind
Low mood / tearfulness
Anxiety / panicky feelings
Irritability / rage / mood swings
Loss of interest / motivation
Memory & focus
Brain fog / poor concentration
Forgetfulness / losing words
Body & aches
Joint & muscle aches / stiffness
Headaches / migraines
Weight changes / bloating
Dry / itchy / crawling skin
Hair thinning / dry eyes / dry mouth
Periods & bleeding
Irregular / unpredictable cycles
Heavier bleeding / flooding / clots
Vaginal, bladder & intimacy
Vaginal dryness / discomfort
Pain during sex / low libido
Urinary urgency / leaks / repeat UTIs
Anything else

2 · The three that bother me most

If you say nothing else, say these. It tells your doctor where to start.

1
2
3

These started roughly:   and affect my work / relationships:  

3 · Questions to ask your doctor

Tick the ones you want answered. You're allowed to ask all of them.

  • Could this be perimenopause or menopause — and how would we know?
  • Is HRT an option for me, and is it actually safe given my history?
  • What are the real risks vs. benefits for someone like me?
  • What non-hormonal options are worth trying — and which are just marketing?
  • Do I need any blood tests or a referral to a specialist?
  • What should I watch for, and when should I come back?

4 · Medicines & supplements I already take

Include anything over-the-counter, herbal or "menopause" branded — it matters more than you'd think.

A note from us: this checklist is a conversation-starter, not medical advice, and it can't diagnose anything — only you and your doctor can do that. It was built by the Her Honest Review editorial team and reviewed against widely-used menopause symptom scales. If a symptom frightens you or comes on suddenly, don't wait for an appointment — seek care.

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