| Q1 |
1. Facial skin blushing and upper body (hot flashes) |
Never = 0, mild = 1, moderate = 2, severe = 3 |
| Q2 |
2. Easy to sweat (sweating) |
Never = 0, mild = 1, moderate = 2, severe = 3 |
| Q3 |
3. Difficulty getting to sleep (insomnia) |
Never = 0, mild = 1, moderate = 2, severe = 3 |
| Q4 |
4. Difficulty staying asleep (light sleep) |
Never = 0, mild = 1, moderate = 2, severe = 3 |
| Q5 |
5. Irritability |
Never = 0, mild = 1, moderate = 2, severe = 3 |
| Q6 |
6. Anxiety |
Never = 0, mild = 1, moderate = 2, severe = 3 |
| Q7 |
7. Often irritated by trifles (anxious trifles) |
Never = 0, mild = 1, moderate = 2, severe = 3 |
| Q8 |
8. Feeling unhappy or depressed (depressive mood), |
Never = 0, mild = 1, moderate = 2, severe = 3 |
| Q9 |
9. Fatigue |
Never = 0, mild = 1, moderate = 2, severe = 3 |
| Q10 |
10. Eye strain |
Never = 0, mild = 1, moderate = 2, severe = 3 |
| Q11 |
11. Memory problems (forgetfulness) |
Never = 0, mild = 1, moderate = 2, severe = 3 |
| Q12 |
12. Dizziness |
Never = 0, mild = 1, moderate = 2, severe = 3 |
| Q13 |
13. Palpitations |
Never = 0, mild = 1, moderate = 2, severe = 3 |
| Q14 |
14. Chest tightness |
Never = 0, mild = 1, moderate = 2, severe = 3 |
| Q15 |
15. Headache |
Never = 0, mild = 1, moderate = 2, severe = 3 |
| Q16 |
16. Neck stiffness |
Never = 0, mild = 1, moderate = 2, severe = 3 |
| Q17 |
17. Backache and low back pain |
Never = 0, mild = 1, moderate = 2, severe = 3 |
| Q18 |
18. Joint pain |
Never = 0, mild = 1, moderate = 2, severe = 3 |
| Q19 |
19. Cold hands and feet |
Never = 0, mild = 1, moderate = 2, severe = 3 |
| Q20 |
20. Numbness in the legs or arms |
Never = 0, mild = 1, moderate = 2, severe = 3 |
| Q21 |
21. Sensitive to sounds |
Never = 0, mild = 1, moderate = 2, severe = 3 |
| Q22 |
Overall improvement in symptoms (not included in the baseline questionnaire) |
Worse = -1, No change = 0, Somewhat = 1, A lot = 2 |
