MRS (Perinatal and Women's Health) Are you currently experiencing any thoughts of harming yourself or ending your life?(Required) Yes No Hot flushes, sweating (episodes of sweating)(Required) None Mild Moderate Severe Very Severe Heart discomfort (unusual awareness of heart beat, heart skipping, heart racing, tightness)(Required) None Mild Moderate Severe Very Severe Sleep problems (difficulty in falling asleep, difficulty in sleeping through, waking up early)(Required) None Mild Moderate Severe Very Severe Depressive mood (feeling down, sad, on the verge of tears, lack of drive, mood swings)(Required) None Mild Moderate Severe Very Severe Irritability (feeling nervous, inner tension, feeling aggressive)(Required) None Mild Moderate Severe Very Severe Anxiety (inner restlessness, feeling panicky)(Required) None Mild Moderate Severe Very Severe Physical and mental exhaustion (general decrease in performance, impaired memory, decrease in concentration, forgetfulness)(Required) None Mild Moderate Severe Very Severe Sexual problems (change in sexual desire, in sexual activity and satisfaction)(Required) None Mild Moderate Severe Very Severe Bladder problems (difficulty in urinating, increased need to urinate, bladder incontinence)(Required) None Mild Moderate Severe Very Severe Dryness of vagina (sensation of dryness or burning in the vagina, difficulty with sexual intercourse)(Required) None Mild Moderate Severe Very Severe Joint and muscular discomfort (pain in the joints, rheumatoid complaints)(Required) None Mild Moderate Severe Very Severe This field is hidden when viewing the formTotal Score Δ
