Menopause Symptom Scale (Greene Climacteric)

Please note, this form is for registered patients of Stow Surgery only. 

The Greene Scale provides a brief measure of menopause symptoms. It can be used to assess changes in different symptoms, before and after menopause treatment. Three main areas are measured:

  • Psychological
  • Physical
  • Vasomotor
Menopause Symptom Scale (Greene Climacteric)

Patient Details

Please use date format DD/MM/YYYY
Any responses will be sent to this email address.

Symptoms

Please indicate the extent to which you are bothered at the moment by any of these symptoms:

Heart beating quickly or strongly: *
Feeling tense or nervous: *
Difficulty in sleeping: *
Excitable: *
Attacks of anxiety, panic: *
Difficulty in concentrating: *
Feeling tired or lacking in energy: *
Loss of interest in most things: *
Feeling unhappy or depressed: *
Crying spells: *
Irritability: *
Feeling dizzy or faint: *
Pressure or tightness in head: *
Parts of body feeling numb: *
Headaches: *
Muscle and joint pains: *
Loss of feeling in hands or feet: *
Breathing difficulties: *
Hot flushes: *
Sweating at night: *
Loss of interest in sex: *