The time when most women are trying to understand what is happening to them is during the peri-menopause stage. Please do not be frightened of the medical term  'peri-menopause' it  just simply means ' Around Menopause'. 

This peri-menopause time, is a time of hormonal fluctuation. 
Some  women 'may' experience some, but not all of the oestrogen deficiency symptoms listed . 

For instance, you may go to your doctor with severe joint aches and tiredness which may be worrying you, in relation to this being something else other than menopause.  But on checking a symptom score it will often reveal many more menopausal symptoms than you realised you were experiencing. 

Many women go to their doctor expecting a blood test to diagnose menopause. it is really important to explain that a blood test to check fluctuating hormone levels and especially oestrogen levels, can be at best vague and at worse inconclusive, which can in itself just worry further. 

Symptom Score Sheet 

If you fill in this score sheet you can judge for yourself the severity of your own symptoms. 

If you then decide along with consultation with your doctor to opt for HRT with adequate treatment, and probably after the treatment has been tweaked or even changed,  the score can reduce to 10 or under in 3-6 months. 
 

After the commencement of HRT  the score sheet can be completed again after 1-2 months, this can gauge if the HRT is suiting her, or if the dosage needs altering or the HRT type changed. It may also be considered at this time if changing the route of the HRT may help, ie from oral to patches. Don't forget that ladies with irritable bowel syndrome or may be taking H2 antagonists may not absorb oral HRT properly. 

This symptom score sheet can also be used to help the woman judge if the Alternative Therapy she may have chosen is having an affect, but I would suggest in this case leaving it a little longer say 2-3 months, as these therapies can take a little while longer to get into the system or to have any effect. It should also be noted that the same problem with IBS absorbtion as above may apply with natural remedies. 

Symptom Score Sheet 

Take your score Before HRT and again after  3 months  and then  after 6months 

Hot flushes 
Light headed feelings 
Headaches 
Irritability 
Depression 
Unloved feelings 
Anxiety 
Mood changes 
Sleeplessness 
Unusual tiredness 
Backache 
Joint pains 
Muscle pains 
New facial hair 
Dry skin 
Crawling feelings under the skin 
Less sexual feelings 
Dry vagina 
Uncomfortable intercourse 
Urinary frequency 

SEVERITY OF PROBLEM IS SCORED AS FOLLOWS
SCORE 

0.....None 
1.....Mild 
2.....Moderate 
3.....Severe 

A score of 15 or over usually indicates oestrogen deficiency that is intrusive enough to require treatment, 'but this is only a guideline'. 
We all of us know that we can be very variable in our tolerance of discomfort, we often tolerate quite severe symptoms before we will even consider taking HRT or an Alternative Supplement/Treatment. 

Scores of 20-50 are common in symptomatic women. 

 The symptom score is not comprehensive and other symptoms such as palpitations, muddled thinking, loss of memory are probably related to  the decline in ovarian hormones.