AMC Menopause Assessment
*This health assessment tool adapted from the Practitioner’s Toolkit for Managing Menopause (Monash University) and Greene Scale, offers general insights and is not a substitute for a full medical evaluation. For a comprehensive understanding, we recommend consulting with a healthcare professional.

Getting to know you

Details Menstrual Symptoms Personal History Contact

The timing of your last period, , helps us to determine which stage of the menopausal transition you are in: premenopause, perimenopause or postmenopause. It's possible that more than one category might apply to your situation; simply choose the one that fits best.

When was your last Period?
Do you still have your ovaries intact?

Hormonal contraception can stop your periods thereby masking your true menopausal status, so it’s important we understand your current contraceptive medication so you can receive an accurate diagnosis.

Are you currently on any hormonal birth control (e.g oral contraceptive pill, contraceptive patches or injections, vaginal rings, implantable contraceptives)?
Do you experience hot flashes or night sweats when you're not taking hormonal contraception (eg: pill free week of the OCP)?
Have you had your uterus removed (hysterectomy), an IUD implant, or endometrial ablation (surgical removal of the lining of the uterus)?
Please select the option that best applies to you (select 1):

We understand each woman’s experience on the menopause journey is unique. To better understand you, we will ask about some common menopause symptoms you may be experiencing.
Our modified GCS provides a standardized and concise way to understand your symptoms and their impact on your quality of life. You will be asked to rank on a scale of 0 (not at all) to 3 (extremely) how much various symptoms impact you. This scoring can provide a helpful snapshot of your current condition as well as a tool to track changes in your symptoms and quality of life over time.

 
Not at all
A little
Quite a bit
Extremely
Physical Symptoms
Hot Flushes
Night Sweats
Headaches
Muscle and Joint pains
Dizziness or feeling lightheaded
Fatigue
Dry Skin
Moods & Mental Health
Anxiety
Irritability
Crying spells
Mood swings
Feeling depressed or low moods
Cognition & Sleep
Insomnia/Restless sleep
Brain Fog
Difficulty Concentrating
Forgetfulness
Genitourinary & Sexual
Loss of libido/sexual desire
Vaginal dryness
Urinary frequency
Painful intercourse
Do you have any of the following health conditions?
  • Have you ever been diagnosed with breast, ovarian, or endometrial cancer?
  • Have you had a blood clot or been diagnosed with a blood clotting disorder in the last 12 months?
  • Are you experiencing any unexpected vaginal bleeding that hasn’t been checked by your doctor or gynecologist?
  • Have you had severe liver disease in the past year?
  • Do you have untreated or poorly controlled high blood pressure?
Do you have any of the following health risk factors?
  • Have you ever had a blood clot in the past?
  • Do you have diabetes?
  • Do you have heart disease, or have you ever had a heart attack or stroke?
  • Do you get migraines with visual symptoms (like seeing flashes of light) before the headache starts?
  • Do you have liver or gallbladder problems?
  • Do you have high cholesterol?
Have you seen a GP to discuss about your condition?

Thank you for completing AMC’s menopause health assessment! To receive your personalised assessment report please provide your contact details below:

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