Welcome to the Hormone Therapy Self-Assessment, that you can take to determine if Hormone Therapy (HT) is right for you. HT has been approved to relieve some of the symptoms of menopause, but like any medication, it has benefits as well as risks that should be reviewed with your OB/GYN or health care provider.

For more accurate results, please take a few minutes to review the information provided on this website before taking the assessment. If you are uncertain of an answer, or it doesn't apply, check "Not Sure." This test should take about 5 minutes to complete. When you're finished, you will be able to print out a report* to review with your OB/GYN or healthcare provider.

*This report is confidential, only you will know the results of your assessment.
Start
Are you experiencing any of the following menopause symptoms?
 
Yes
No
Not sure
Irregular or no periods at all
Hot flashes/night sweats
Irritability, anxiety, moodiness, depression
Sleep disturbances
Memory loss
Vaginal dryness/painful sex
You may be premenopausal or asymptomatic. HT is prescribed to treat severe menopause symptoms that affect the quality of life.

For general information on menopause click here
How severe are your symptoms?
Mild Moderate Severe
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Mild

If you are experiencing mild symptoms, you may not need HT.

For information on the benefits and risk of hormone and non-hormone therapy options that are available click here.

click here
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Many women with symptoms are seeking relief. Hormone Therapy is an option that is commonly prescribed for menopausal symptom relief and is very effective. Non-hormone treatment options can also help.
I want to learn about HT and its risks and benefits.
Continue
I am not interested in HT.
What are my other options?
Options
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To begin, let's review your risks for existing conditions that should be considered before starting HT.

 
Yes
No
Not sure
Risk of Heart Disease
Do you have high blood pressure?
Do you have high cholesterol?
Do you have diabetes?
Do you smoke or use tobacco?
Are you overweight?
(i.e. BMI greater than 25 (calculate your BMI here.))
Do you have little or no physical activity?
(i.e. exercise less than 3 times per week)
Do you have a family history of heart disease?
Are you over 55?
Have you had bypass surgery?
Do you have carotid artery disease?
Do you have blocked arteries in your legs?
Do you have chronic kidney disease?
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Yes
No
Not sure
Risk of Stroke/Blood Clots
Do you have a family history of stroke or blood clots?
Do you have high blood pressure?
Do you have little or no physical activity?
(i.e. exercise less than 3 times per week)
Are you over 55?
Are you African American?
Are you Hispanic or Asian/Pacific Islander?
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Yes
No
Not sure
Risk of Breast Cancer
Do you or any of your immediate family members (mother, sister, daughter) have a history of breast cancer?
Has your mammogram revealed an increased breast density?
Have you ever been told that you have atypical hyperplasia if you have had breast biopsies?
Are you obese?
(i.e. BMI greater than 30 (calculate your BMI here.))
Do you use alcohol frequently?
(i.e. more than 1 drink per day)
Do you have little or no physical activity?
(i.e. exercise less than 3 times per week)
Are you over 55?
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Yes
No
Not sure
Risk of Osteoporosis
Do you have a family history of osteoporosis?
Have you been told that you have a low bone density?
Do you have high levels of thyroid hormones?
Do you have a small body frame?
Do you have a vitamin D deficiency?
Do you have a calcium deficiency?
Do you have a history of eating disorders? (i.e. anorexia)
Do you use alcohol frequently?
(i.e. more than 1 drink per day)
Do you have little or no physical activity?
(i.e. exercise less than 3 times per week)
Have you abused drugs?
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Yes
No
Not sure
Mental Health Concerns
Are you depressed, irritable, or anxious?
Are you more forgetful than usual?
Sexual Health Concerns
Vaginal dryness
Painful sex
Loss of libido/interest in sex
Finish
Please complete all questions.
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Menopause Self Assessment
Your Menopause Symptoms

Here is an overview of your Menopause Self Assessment.
Once you are satisfied with your answers, please click "Print" or "Email." Please review and discuss your answers with your health care provider. Ultimately, you and your health care provider can best determine what treatment is right for you.

You reported having the following menopausal symptoms:

...loading Result

You are interested in Hormone Therapy

Chronic Disease Risk Self-Assessment
You indicate that you have x out of x risks for heart disease.
You indicate that you have x out of x risks for stroke/blood clots.
You indicate that you have x out of x risks for breast cancer.
You indicate that you have x out of x risks for osteoporosis.

Your Quality of Life Concerns

...loading Result

Thank you for participating in the Women's Health Research Institute's Menopause Self Assessment.

We hope that this self assessment has provided valuable information to you regarding your menopause status, the severity of your symptoms, and your personal risk assessment of taking hormone therapy to relieve your symptoms. Hormone therapy does improve many symptoms of menopause, but like any medication, it carries risks and benefits that need to be weighed against your own quality of life issues.

There are various combinations, dosages and delivery methods of hormone therapy that may be safer for your particular needs. You should discuss these with your health care provider. There are also alternative and lifestyle interventions that may help you and those are described on this website.

Menopause is an active area of research, so please return regularly to this site for the latest updates. The guidelines and information provided here are subject to change.

This informational tool and its resultant data was gathered by http://menopause.northwestern.edu
To print out a copy of all your Personal Self-Assessment answers, click 'Print'.
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