Questionnaire Progesterone – Family Naturopathic Clinic

Progesterone Assessment Questionnaire

Please evaluate how often you experience each of the following symptoms by selecting the appropriate column.

The following questions are for women who have not yet reached menopause, and menopausal women who are taking hormone replacement therapy (estrogen or estrogen/progesterone).

My breasts are swollen & tender or painful before my period…

No / Never

Sometimes / Occasionally

Regularly / Often

Very often

Yes / Always / Constantly

Numeric Field