About You

What is your age group?

25-39 40-49 50-59 Over 60

Your Symptoms

Select any symptoms you’re experiencing

Mood & Emotional Wellbeing

What best describes your periods at the moment?

Regular Less regular than they used to be Heavier or lighter than before They’ve stopped completely I’ve had a hysterectomy / contraception affects my periods / I don’t have periods

Have you noticed changes in how you feel over the last 6-12 months?

Yes, definitely Some changes No major changes I’m not sure

Which areas of your life are being affected? (select all that apply)

Overall, how much are these symptoms affecting you?

Not very much Some days are harder than others They’re having a noticeable impact They’re really affecting my day-to-day life

Have you spoken to anyone about these symptoms?

Your Details

Your Email Address

Your Name

Telephone

How can we support you today?

I want to book an appointment
(We’ll email you a link to our booking system.)
I’d like to discuss with the team before booking
(Our medical secretary can contact you to talk through the next steps and answer any questions.)
I’m just exploring for now
(We’ll email your results and information about menopause support available at The Wye Clinic.)

Menopause

Take the Menopause Self Test

About You

Your Symptoms

Your Details

For more information call us on: 01432 802 600